Journal of Preventive Medicine and Public Health

Volume 20(2); November 1987

Original Articles

A Study on the Influences of Noise Induced Hearing Loss to the Blood Pressure.: Jong Hwa Kim, Choong Rteol Lee; Korean J Prev Med. 1987;20(2):205-214.

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Abstract PDF: For the purpose of evaluating the effect of noise induced hearing loss on the blood pressure, a cross-sectional study was conducted in 481 manufacturing industrial workers in Pusan area consisted of 275 workers from noisier plant (over 90 dB(A), high exposed group) and 206 workers from less noisy plant (below 85 dB(A), low exposed group) from April to December in 1985. The summarized results were as follows; 1) The degree of hearing loss according to the audible frequency was most notable in 4,000 Hz. 2) The prevalence of hypertension was 14.8% in total examined subjects. And also in 40 dB(A) hearing lost workers, there was no significant difference between high exposed group as 15.5% and low exposed group as 15.8%. 3) In 3 models analyzed by multiple regression technique to obtain the complexed extents of risk factors related to the diasatolic blood pressure, especially model iIII which contain age, body mass index, smoking, alcohol and family history of hypertension, duration of work, noise exposure level and degree of hearing loss in high exposed group was most remarkable compared to the others. 4) The most potential predictor related to the diatolic pressure in high exposed group was the degree of hearing loss. And the next were body mass index, familial history of hypertension and age in order. But in the case of low exposed group, the potential predictors were body mass index, age and familial history of hypertension.; Summary

A Study on the Catecholamine under the Room Temperature and 5 degrees C Refrigerator Environment in Rat.: Seyng Eui Hong, Tai Young Yoon, Hyung Suk Kim; Korean J Prev Med. 1987;20(2):215-220.

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Abstract PDF: Under the extreme change of the environment, animals react physiologically to adapt to the stress and secrete catecholamines. Cold exposure is a kind of the environmental stress. Author tried to determine the amount of catecholamines in rat urine as a parameter of physiological response to cold stress. Urinary catecholamine was measured by using HPLC with fluorescence detector, coation exchange column prepacked with Bio-Rex 70 and ammonium pentaborate as catecholamine eluent. The amount of dopamine in normal state rat urine was 42.0 ng, but under the low temperature of 5 degrees C, the dopamine amount was increased to 221.25 ng/5 ml. Above findings are suggesting that catecholamine secretion, especially dopamine, increase in the stressful condition such as cold exposure.; Summary

Lipid Peroxidation in Vivo Monitored as Ethane Exhalation in Hyperoxia.: Jae Cheol Song, Soo Hun Cho, Myung Hee Chung, Dork Ro Yun; Korean J Prev Med. 1987;20(2):221-227.

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Abstract PDF: In vivo ethane production in rats was used as an index of oxygen toxicity. The rats were allocated to four exposure conditions; hyperbaric oxygenation (HBO=5 ATA, 100% O2), normobaric oxygenation (NBO=1 ATA, 100% O2), hyperbaric aeration (HBA=5 ATA, 21% O2) and normobaric aeration (NBA=1 ATA, 21% O2). After 120 minutes of exposure, the rats exposed to high concentration and/or high pressure oxygen exhaled significantly larger amounts of ethane than those exposed to NBA, and the differences in ethane production between any two groups were statistically significant (p<0.01). This finding supports the hypothesis that hypothesis that hyperoxia increase oxygen free-radicals and the radicals produce ethane as a result of lipid peroxidation. It is notable that the ethane exhalation level of the HBA group was significantly higher than that of the NBO group. This difference could not be accounted for by the alveolar oxygen partial pressure difference between the two groups.; Summary

A Study on the Concentration of Hippuric Acid in Urine of Workers Exposed to Toluene.: Eun Mi Park, Jae Hoon Roh, Young Hahn Moon; Korean J Prev Med. 1987;20(2):228-235.

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Abstract PDF: The objective of this study is to examine the correlation between the tolylene concentration in the work environment of organic solvents and the concentration of hippuric acid in urine of workers exposed toluene, and to acquire the fundamental materials of workers' health care and to assist the assessment of the biological permissible exposure limit. The control groups are 72 workers who had never been exposed to toluene and the case groups are 101 workers who had been exposed to toluene. This study was conducted to examine the correlation between the concentration of toluene in work environment and workers' hippuric acid concentration, to investigate the complaint difference of subjective symptoms by means of questionnaire, between the case groups and control groups. The results and conclusions are as follows: 1) The highest mean concentration of toluene in the air is 544.13+/-7.75 ppm in the Printing Department of mixing organic solvents. The concentrations of the others are 463.27+/-5.24 ppm in Department of mixture for organic solvents, and 393.56+/-45.69 ppm in the Printing Department(1), and 248.38+/-45.16 ppm in the Printing Department(2), and 159.38+/-18.51 ppm in the Printing Department(3). 2) The highest mean concentration of hippuric acid in urine is 6034.84+/-1298.35 mg/l in the Printing Department with mixing organic solvents. The concentrations of the others are 4798.44+/-784.53 mg/l in Department of mixture of organic solvents, and 2883.06+/-701.90 mg/l in the Printing Department(1), and 1449.98+/-905.19 mg/l in the Printing Department(2), and 598.52+/-299.43 mg/l in the Printing Department(3). 3) As the toluene concentration in the work environment becomes higher, the concentration of hippuric acid in urine also becomes higher. It is found that the coefficient of correlation between toluene concentration and the concentration of hippuric acid are positive (r=0.868, Y=7.18X+349.57). 4) It is found that the case groups complain of much more subjective symptoms than the control groups.; Summary

Effects of n-Hexane and Benzene on Tibial Nerve for Rats.: Young Soo Lee, Jae Hoon Roh, Young Hahn Moon; Korean J Prev Med. 1987;20(2):236-246.

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Abstract PDF: n-Hexane and benezene are organic compounds which have been widely used as industrial solvents. However, they are also increasingly recognized as important pollutants in working environment. The purpose of this study is to analyze neurotoxicity of benzene and n-Hexane. In this study, tibial nerve of Sprague-Dawley rats were observed after exposing them to two different concentrations of these compounds (6000 ppm of n-Hexane and 2000 ppm of benezene) which were known to be the levels to cause subacute toxicity for the three different periods; two weeks, four weeks, and sex weeks. The following results were obtained from the analysis of variance, Duncan's multiple comparison test, and regression analysis: 1) Myelin sheath thickness of nerve fiber for two n-Hexane exposed groups (four weeks and six weeks) were both reduced compared with the control group and the benezene exposed group. 2) There were positive relationships between nerve fiber diameter and myelin sheath thickness for both exposed and control groups. 3) There were significant difference in myelin sheath thickness from equal diameter nerve fibers between benzene exposed group and control group, but the greater number of thin myelin sheath were observed for n-Hexane exposed group compared with control group. Thus, it is concluded that n-Hexane tends to reduce the rate of growth of nerve fiber more than the benzene and control group. While these results shed light on understanding the effects of benzene and n-Hexane, the duration of exposure was not long enough to apply these results to real working environments. In addition, to further understand the mechanism of nerve degeneration caused by organic solvents, both epidemiological and biochemical studies should accompanied by this kind of study.; Summary

Serum Immunoglobulin Levels in Coal Workers' Pneumoconiosis.: Ho Keun Chung, Yong Hee Cheon, Jeong Pyo Hong; Korean J Prev Med. 1987;20(2):247-254.

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Abstract PDF: Serum Immunoglobulin (Ig)A, IgG, IgM, levels were measured in 99 coal workers' pneumoconiosis (CWP) patients and 12 healthy coal workers and 9 non-miners to compare with each group by the radiological categories, its complications and working period in coal mine. Serum were measured by nephelometry. The findings were as follows: 1) Serum IgA levels were significantly different between three groups of CWP patient, healthy coal worker and non-miner (mean+/-standard deviation: 226.4+/-87.7, 221.3+/-45.1, 170.1+/-65.7 respectively). 2) There were no significant differences of Ig levels among radiological categories of CWP. 3) There were no significant differences of Ig levels among simple pneumoconiosis and its complicated disorders. 4) The three Ig levels were slightly increased in the group of mining years less than 20 years (IgA: r=0.1869, p<0.10 IgG: r=0.2902, p<0.05 IgM: r=0.2889, p<0.05).; Summary

Relationship between the Measurement Values of the Digitial Dust Indicator and Personal Dust Sampler.: Young No Yoon, Jeong Joo Lee, Ho Keun Chung, Ho Chun Choi; Korean J Prev Med. 1987;20(2):255-260.

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Abstract PDF: The digital dust indicator (Sibata P-5), one of the direct-reading instruments was evaluated for the respirable dust in the underground coal mine environments. As a reference, respirable dust was determined using three cyclones and/or impactors. All the tests were performed on aerosol in twenty underground coal mines. The coefficients of mass-relative concentration were 0.067+/-0.054 (Mean+/-Standard deviation) (range: 0.006-0.172). The relationship between relative concentration and temperature was not significant statistically. Also, the relationship of relative concentration and relative humidity was not significant. Mass concentration and relative concentration were 5.31+/-5.22 mg/m3 and 162+/-163 CPM (Mean+/-Standard deviation) respectively. The range of mass concentration was 1.22-22.69 mg/m3; relative concentration 16-628 CPM. The relationship of mass concentration and relative concentration was not significant in these ranges.; Summary

Quartz Concentration and Respirable Dust of Coal Mines in Taeback and Kangneung Areas.: Ho Chun Choi, Yong Hee Cheon, Young No Yoon, Hae Jeong Kim; Korean J Prev Med. 1987;20(2):261-269.

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Abstract PDF: In order to investigate working conditions of underground coal mines, this work was undertaken to evaluate the respirable dust and the concentration of quartz in Taeback and Kangneung areas. The concentration of quartz was determined by Fourier Transform Infrared Spectrophotometry. The results were as follows; 1) The concentration of respirable dust of drilling and coal face in Taeback and Kangneung areas were as followed. 2) Distribution of respirable dust was well fitted to the long-normal distribution and geometric mean value was log(-1) 0.37+/-log(-1) 0.47 (2.34+/-2.95) mg/m3. 3) The difference of respirable dust concentrations in Taeback and Kangneung areas was not significant statistically (p>0.05). 4) The concentration of quartz of drilling and coal face in Taeback and Kangneung areas were as followed. 5) Distribution of quartz concentrations was well fitted to the log-normal distribution and geometric mean value was log(-1) 0.33+/-log(-1) 0.45 (2.14+/-2.82)%. 6) The difference of quartz concentrations in Taeback and Kangneung areas was not significant (p>0.05), but significant at drilling sites and coal faces (p<0.05).; Summary

A Study on the Attitude Toward the Perodic Health Screening for Workers in Korea: Attitude of Personnels in Health Screening Institutions and Enterprises.: Dong Yoon Seo, Dong Bin Song; Korean J Prev Med. 1987;20(2):270-279.

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Abstract PDF: In all enterprises of Korea employing workers more than five, employees have a duty of conducting a periodic health screening for improvement and maintaining healthful living and working conditions of employees. The health screening is performed annually in line workers and biennially in table workers under the supervision of the government. But there are some argument to the health screening programme in view of effectiveness, efficiency, reliability and etc. In order to obtain basic reference materials for increasing the efficiency of periodic health screening programme for workers and understand the attitude of health screening institutions and enterprises toward the periodic health screening, mail questionnaire survey was conducted in July 1987. The questionnaire went to 950 health screening institutions and 700 enterprises in whole land but they were returned from 254 health institutions and 187 enterprises, which were analyzed. The results were as follows: 1) The attitude of the respondents toward the necessity and benefit of the periodic health screening was showed highly positive responses in both of screening institutions and enterprises, and it was more positive in screening institutions. The attitude toward the affirmative and the contentment was showed less positive than that of the necessity and benefit. 2) The respondent recognized may problems on regard to the screening programme. The health screening institutions lie in the state of competition with other institutions for undertaking the screening programme. 3) One of major complaints from enterprises was the lack of sincerity in performing the screening programme. They wanted more practical and reliable health screening examination rather than showy one. 4) Health screening institutions and enterprises showed some mutual contradictions in the matter of screening fee, and so the screening fee should be adjusted to the appropriate cost.; Summary

Persistence and Anamnestic Response of Antibody to HBsAg Induced by Natural Immunization or Vaccine Treatment.: Whan Kook Chung, Hee Sik Sun, Kyu Won Chung, Jae Chul Ro, Boo Sung Kim; Korean J Prev Med. 1987;20(2):280-286.

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Abstract PDF: For evaluating the boosting (anamnestic) effects of the most recent commercially produced plasma derived heat-inactivated hepatitis B vaccine (A. Co.), 117 adults with naturally acquired antibody to hepatitis B surface antigen (anti-HBs) were selected at random. In addition, out of case immunized at zero and 1 month, and boosted at 6 months (primary booting) by conventional vaccine (B.Co), inactivated by pepsin digestion and formalin treatment, 11 cases who showed elevated titer after primary boosting were also submitted to the study. The results were as follows: 1) Out of the 117 subjects with naturally acquired anti-HBs, 6(5.1%) showed isolated anti-HBs and the titers were below 10 ratio units (RU). Negative seroconversion was seen in 4 (3.4%) of the 117 cases at 12 months after the screening and, of these cases, 3 showed isolated anti-HBs below 10 RU (increased GMT, 28.04) at one month after primary booster injection with 3 microgram dose of A. Co. Vaccine at all, but 90% of the other subjects responded. 3) The anti-HBs titers of all the 11 cases who showed a rise of more than 10 RU (increased GMT, 28.04) at one month after primary booster injection by 20 microgram dose of B. Co. vaccine decreased at 19 months after the primary booster. And 3 subjects (27.3%) of the 11 reached negative seroconversion. All of the 11 cases, who had secondary booster injection with 3 microgram dose of A. Co. vaccine at 19 months after primary boosting, showed increased anti-HBs titer at least 20 RU or more (increased GMT, 57.72) at one month after the boosting. According to the above results in the anti-HBs screening survey for the purpose of immunization with hepatitis B vaccine, subjects with isolated anti-HBs below 10 RU should be regarded as being in an unimmunized state. In cases who are in risk circumstances, immunized primarily with a 20 microgram dose of B. Co. vaccine, a secondary booster injection should be given within 2 years after initiation of primary immunization and a 3 microgram booster dose of A. Co. vaccine can be reliably used.; Summary

Health Care Utilization and Its Determinants among Island Inhabitants.: Seung Hum Yu, Woo Hyun Cho, Chong Yon Park, Myung Keun Lee; Korean J Prev Med. 1987;20(2):287-300.

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Abstract PDF: Island regions suffer from a shortage of health care in part because they are less developed, they cover a widespread area relative to the population, and due to transportation barriers. The purpose of this study was to assess the level of illness and the magnitude of medical care utilization, and to investigate the determinants of utilization in these area. The data were collected by means of a household survey conducted from February 16 to 25, 1987 on 5 islands which were selected in consideration of the size of the population, the distance from the main land, and the distribution of health care facilities. The household response rate was 89.1% (491 of 551 households), and 1971 persons were surveyed. The major findings of this study are as follows: 1) The morbidity rate of the island inhabitants was 27.7% during the two weeks, and 25.5 chronic illnesses and 9.1 acute illnesses per 100 persons, were noted. Differences in the magnitude of illness were statistically significant by sex, age, education, and family size. 2) The magnitude of total ambulatory care utilization was 16.8 visits per 100 persons during the two weeks, which was less than that of other regions; and differences in the magnitude of total ambulatory care were statistically significant by sex, age, education, occupation, and family size. 3) Unmet needs were classified as 56.0% in chronic illnesses and 19.6% in acute illnesses; and differences in unmet needs were statistically significant by sex, age, education, occupation, income, and family size. 4) Statistically significant determinants in medical care utilization included the frequency of acute illness and chronic illness, and income in total utilization; the frequency of chronic illness and acute illness, and medical care insurance in physician visits. 5) According to the results of the path analysis, need factors had the greatest effect on utilization, and predisposing factors had more indirect effects through enabling or need factors than direct effects.; Summary

Geographic Distribution of Physician Manpower by Gini Index.: Byung Wook Moon, Jae Yong Park; Korean J Prev Med. 1987;20(2):301-311.

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Abstract PDF: The purpose of this study is to analyze degree of geographic maldistribution of physicians and changes in the distributional pattern in Korea over the years 1980-1985. In assessing the degree of distribution and in identifying changes in the distribution pattern, the Gini index of concentration was used. The geographical units selected for computation of the Gini index in this analysis are districts (Gu), cities (Si), and counties (Gun). Locational data for 1980 and 1985 were obtained from the population census data in the Economic Planning Board and regular reports of physicians in the Korean Medical Association. The rates of physician located countries to whole physicians were 10.4% in 1980 and 9.6% in 1985. In term of the ratio of physicians per 100,000 population, rural area had 9.18 physicians in 1980 and 12.95 in 1985, 7.13 general practitioner in 1980 and 7.29 in 1985, and 2.05 specialists in 1980 and 5.66 in 1985. Only specialists of general surgery and preventive medicine were distributed over 10% in county and distribution of every specialists except chest surgery in county increased in 1985, comparing with that rates of 1980. The Gini index computed to measure inequality of physician distribution in 1985 indicate as follows; physicians 0.3466, general practitioners 0.5479, and specialists 0.5092. But the Gini index for physicians and specialists fell -15.40% and -10.42% from 1980 to 1985, indication more even distribution. The changes in the Gini index over the period for specialists from 0.3639 to 0.4542 for districts, from 0.2510 to 0.1949 for cities, and 0.5303 for countries indicate distributional change of 24.81%, -22.35%, and 10.65% respectively. The Gini indices for specialists of neuro-surgery, chest surgery, plastic surgery, ophthalmology, tuberculosis, preventive medicine, and anatomical pathology in 1985 were higher than Gini indices in 1980.; Summary

Maternal and Child Factors Associated with Early Detection of Cerebral Palsy.: Sung Soo Bae, Jung Han Park; Korean J Prev Med. 1987;20(2):312-321.

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Abstract PDF: To investigate the maternal and child factors associated with early detection of cerebral palsy, 74 mothers of cerebral palsy children who were born since January 1, 1980 and being treated at Taegu Rehabilitation Center for the Handicapped, Rehabilitation Center of Taegu University, St. Paul Children's House and Pusan Welfare Association of Cerebral Palsy Children were interviewed from February to April 1987. There is no association between age of child when parents noticed the child's abnormality and educational level of father but it tend to be detected earlier when education level of mother is college or above compared with high school or under. There is a trend of earlier detection of child's abnormality although statistically not significant in case father is professional or managerial worker, monthly income of father is over 610,000 won, child is first-born, age of the parents is 34 years or under, child is a boy, and child has periodic well-baby check-up. The child's abnormality is detected earlier when mothers had 7 prenatal visits or more compared with those who had 6 visits or less (P<0.05). Parents noticed the child's abnormality first in 85.1% of the case whereas doctors detected it first in 2.7% and this percentage was not different whether the child had periodic well-baby check-up or not. The first physician's diagnosis of the children was cerebral palsy in 36.5% and the rest was normal, need for observation, uncertain, etc. Parents took the child to doctor for diagnosis 2-3 months after they noticed the child's abnormality and after the child was diagnosed as cerebral palsy parents either took no therapeutic measure or brought the child to physiotherapy or acupuncture or gave herb medicine before they started specific rehabilitative therapy. For early detection of the cerebral palsy children, teaching of evaluation method for child development should be reinforced both in medical school and clinical training course and should train the specialist for diagnosis and treatment of crippling conditions. Also, public education needed for the importance of early detection of crippling conditions and currently available methods for diagnosis and treatment.; Summary

Changing Pattern of Birth Weight and Relationship of Birth Weight with Maternal Age and Parity.: Jung Han Park, Bong Sun Shin; Korean J Prev Med. 1987;20(2):322-330.

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Abstract PDF: The objectives of this study were to examine the changes of birth weight and relationship of birth weight with maternal age and parity. The study population included 13,634 single live births out of 14,346 births delivered at a general hospital in Busan between January 1, 1977 and December 31, 1986. Data were obtained from the delivery record. In 1979 the mean birth weight of male was 3,074 gm and that of female to 2,985 gm. In 1986 birth weight of male was increased to 3,266 gm and that of female to 3,210 gm. Low birth weight (< or = 2,500 gm) incidence rate was 7.2% in 1977 and it was increased gradually to 10.4% in 1980 but decreased thereafter to 6.5% in 1986. Incidence rate of overweight infant (4,001 gm < or =) was 3.9% for 10 years and it ranged from 2.9% to 4.6% but no particular changing pattern was observed. The percentage of mothers who had history of induced abortion was decreased from 51.6% in 1979 to 45.1% in 1986. Also, stillbirth rate was decreased from 2.6% in 1977 to 1.5% in 1986. The proportion of the first and second births was increased from 85.4% in 1977 to 96.0% in 1986 and the proportion of mothers of 25-34 years increased from 72.1% in 1977 to 84.7% in 1986. The incidence rates of low birth weight and over weight infant are lower in the first and second births of 25-34 years old mothers than other parities and age groups. In creased mean birth weight and decreased low birth weight incidence rate indicate that the health status of newborn infants has been improved and substantial portion of these changes can be attributed to increase in family planning practice rate and delayed marriage. There is no evidence, however, for increasing incidence rate of overweight infant.; Summary

A Cohort Study of Incidence Rate and Causes of School Accidents in a Boys' Middle School in Taegu.: Jung Han Park, Mi Wha Park; Korean J Prev Med. 1987;20(2):331-340.

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Abstract PDF: To determine the incidence rate of school accidents and its associated factors, a cohort observation was carried out in a boys' high school of a total 2,324 students for an academic year from March 1986 to February 1987. Data for accidents were collected by the author (school nurse) as students came to the school health station for treatment of accidental injury. Data for school activities were obtained from the diary of academic affairs. A total of 603 students made 1,126 visits to the station for accidental injury during the study period that gave an average 1.9 accidents per student. The average number of visits for accidental injury per day was 5.1 and the incidence rate of accidental injury was 2.2 per 1,000 student days. Each class had about 30 accidents on the average in a year. However there were two classes that had exceptionally high incidence rate of accidents; 54 accidents in one class where 10 athletes were assigned and 58 accidents in the other class where the teacher in charge was on vacation for two months. The highest incidence rate of accident was observed in June (3.4 per 1,000 student days) and the lowest rates were in December and February (1.5 and 0.7 per 1,000 student days, respectively) and there were no appreciable difference by day of week. Accidents were caused by mischief or carelessness of students in 62.2% and by the inappropriate tools and facilities of school in 18.6%. The accidents caused by tools and facilities were mainly due to the antiquated chairs and tables. Referral rate to hospital for severe injury was three times higher in cloudy days and five times higher in rainy days than in clear days. There was almost no accident during the examination period but increased after the examination. Based on these findings, following measures are recommended to prevent school accident: disperse the athletes throughout the classes; should the teacher in charge leave the class for a long period, replace with another teacher who is familiar with the class to keep order; replace or repair the inappropriate tools and facilities; and warn the students for the risk of accident or broadcast music or let the students have light physical exercise to relieve the tension in cloudy or rainy day and after examination.; Summary

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