Journal of Preventive Medicine and Public Health

Soo Hun Cho

43 Articles

Effects of Long-term Fluoride in Drinking Water on Risks of Hip Fracture of the Elderly: An Ecologic Study Based on Database of Hospitalization Episodes.: Eun Young Park, Seung Sik Hwang, Jai Yong Kim, Soo Hun Cho; J Prev Med Public Health. 2008;41(3):147-152.; DOI: https://doi.org/10.3961/jpmph.2008.41.3.147

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OBJECTIVES
Fluoridation of drinking water is known to decrease dental caries, particularly in children. However, the effects of fluoridated water on bone over several decades are still in controversy. To assess the risk of hip fracture related to water fluoridation, we evaluated the hip fracture-related hospitalizations of the elderly between a fluoridated city and non-fluoridated cities in Korea. METHODS: Cheongju as a fluoridated area and Chungju, Chuncheon, Suwon, Wonju as non-fluoridated areas were chosen for the study. We established a database of hip fracture hospitalization episode based on the claims data submitted to the Health Insurance Review Agency from January 1995 to December 2002. The hip fracture hospitalization episodes that satisfied the conditions were those that occurred in patients over 65 years old, the injuries had a hip fracture code (ICD-9 820, ICD-10 S72) and the patients were hospitalized for at least 7days. A total of 80,558 cases of hip fracture hospitalization episodes were analyzed. RESULTS: The admission rates for hip fracture increased with the age of the men and women in both a fluoridated city and the non-fluoridated cities (p<0.01). The relative risk of hip fracture increased significantly both for men and women as their age increased. However, any difference in the hip fracture admission rates was not consistently observed between the fluoridated city and the nonfluoridated cities. CONCLUSIONS: We cannot conclude that fluoridation of drinking water increases the risk of hip fracture in the elderly.

Summary

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The Association between Community Water Fluoridation and Bone Diseases: A Natural Experiment in Cheongju, Korea
Naae Lee, Sungchan Kang, Woojoo Lee, Seung-sik Hwang
International Journal of Environmental Research and Public Health.2020; 17(24): 9170. CrossRef
Community water fluoridation and health outcomes in England: a cross‐sectional study
Nicholas Young, John Newton, John Morris, Joan Morris, John Langford, Jonathan Iloya, Diane Edwards, Semina Makhani, Julia Verne
Community Dentistry and Oral Epidemiology.2015; 43(6): 550. CrossRef
Exposure to Fluoride in Drinking Water and Hip Fracture Risk: A Meta-Analysis of Observational Studies
Xin-Hai Yin, Guang-Lei Huang, Du-Ren Lin, Cheng-Cheng Wan, Ya-Dong Wang, Ju-Kun Song, Ping Xu, Yi-Hsiang Hsu
PLOS ONE.2015; 10(5): e0126488. CrossRef
Effects of Life-long Fluoride Intake on Bone Measures of Adolescents
S.M. Levy, J.J. Warren, K. Phipps, E. Letuchy, B. Broffitt, J. Eichenberger-Gilmore, T.L. Burns, G. Kavand, K.F. Janz, J.C. Torner, C.A. Pauley
Journal of Dental Research.2014; 93(4): 353. CrossRef

Curriculum of Health Promotion and Disease Prevention for the 21st Century -The 5th Revision of Preventive Medicine Learning Objectives.: Byung Chul Chun, Bo Yul Choi, Soo Hun Cho; J Prev Med Public Health. 2006;39(4):293-301.

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Abstract PDF: The preventive medicine learning objectives, first developed in 1977 and subsequently supplemented, underwent necessary revision of the contents for the fourth time to create the fifth revision. However, the required educational contents of health promotion and disease prevention have been changed by the new trends of medical education such as PBL and integrated curriculum, the rapid change of the health and medical environment and the globalization of medicine. The Korean Society of Preventive Medicine formed a task force, led by the Undergraduate Education Committee in 2003, which surveyed all the medical colleges to describe the state of preventive medicine education in Korea, analyzed the changing education demand according to the change of health environment and quantitatively measured the validity and usefulness of each learning objective in the previous curriculum. Based on these data, some temporary objectives were formed and promulgated to all the medical schools. After multiple revisions, an almost completely new series of learning objectives for preventive medicine was created. The objectives comprised 4 classifications and 1 supplement: 1) health and disease, 2) epidemiology and its application, 3) environment and health, 4) patient-doctorsociety, and supplementary clinical occupational health. The total number of learning objectives, contained within 13 sub-classifications, was 221 (including 35 of supplementary clinical occupational health). Future studies of the learning process and ongoing development of teaching materials according to the new learning objectives should be undertaken with persistence in order to ensure the progress of preventive medicine education.; Summary

Public Perceptions of the Risk of Asian Dust Storms in Seoul and its Metropolitan Area.: Hyoung June Im, Ho Jang Kwon, Mina Ha, Sang Gyu Lee, Seung Sik Hwang, Eun Hee Ha, Soo Hun Cho; J Prev Med Public Health. 2006;39(3):205-212.

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Abstract PDF: OBJECTIVES
In spite of the recent increased concern for Asian dust storms, there are few studies concerning how dangerous the general public recognizes these dust storms to be. This study examined the public's perceptions of the risk of the Asian dust storms and also the source of the information concerning the risk. METHODS: A telephone interview survey using a standardized questionnaire was done for the adults living in Seoul and its metropolitan area from May 15th, 2003 to May 16th, 2003. The contents of the questionnaire were the sociodemographic characteristics, the perceptions of risk to the Asian dust storms, and the coping strategy of the study participants. RESULTS: The study participants get their information on Asian dust storms mainly from TV newscasts and they have a good knowledge of them. They regard it as one of the most dangerous health risks, along with dioxin. They think that it is associated with allergic rhinitis, conjunctivitis and bronchial asthma, etc. Of the 500 study participants, 201(40.2%) persons suffered bodily discomforts during the Asian dust storm period. CONCLUSIONS: Although there are uncertainties about the health risks of Asian dust storms, the public thinks these dust storms are very dangerous to health in many ways. This negative perception will not disappear easily. To fill the gap of the public's perceptions of the risk and the objective evidence of its health effects, more studies about its health effects and the methods to reduce exposure are required.; Summary

Effects of the Severe Asian Dust Events on Daily Mortality during the Spring of 2002, in Seoul, Korea.: Seung Sik Hwang, Soo Hun Cho, Ho Jang Kwon; J Prev Med Public Health. 2005;38(2):197-202.

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Abstract PDF: OBJECTIVES
During the spring of 2002, an unprecedented 2 Asian dust events were experienced in Seoul. On those days, the PM10 was surprisingly increased, with daily PM10 averages exceeding 600 and 700 microgram/m3 on March 21 and April 8, respectively. Accordingly, public concern relating to the possible adverse health effects of these dust events has increased, as the dust arrives in Korea after having flown over heavily industrialized eastern China. We investigated the effects of these Asian dust events on the mortality during the spring of 2002, in Seoul, Korea. METHODS: The total number of deaths per day during the spring of 2002 in Seoul was extracted form the mortality records of the National Statistical Office. We constructed 14 Asian dust days (March 17-March 23, April 7-April 13) and 42 control days during the 56 day study period (March 3-April 27) with respect to the days of the week. The daily average numbers of deaths between the Asian dust and control days were analyzed, with adjustment for meteorological variables and pollutants. RESULTS: The daily PM10 average during the Asian dust weeks was 295.2 microgram/m3, which was significantly higher than during the control days (P< 0.001). The daily average number of deaths from all causes during the Asian dust days was 109.9; 65.6 for those aged 65 years and older, 6.7 from respiratory causes (J00-J99) and 25.6 from cardiovascular causes (I00-I99). The estimated percentage increases in the rate of deaths were 2.5% (95% CI=-5.0- 10.6) from all causes; 2.2% (95% CI=-7.4-12.8) for those aged 65 years and older, and 36.5% (95% CI=0.7-85.0) from respiratory causes, but with a 6.1% (95% CI=-19.7- 9.7) decrease in deaths from cardiovascular causes. CONCLUSION: The Asian dust events were found to be weakly associated with the risk of death from all causes. However, the association between dust events and deaths from respiratory causes was stronger. This suggests that persons with advanced respiratory diseases may be susceptible to Asian dust events.; Summary

Perceptions of the Asian Dust: Analysis of the Newspaper Articles about the Asian Dust.: Hyoung June Im, Mina Ha, Soo Hun Cho, Ho Jang Kwon; Korean J Prev Med. 2003;36(3):298-301.

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Abstract PDF: OBJECTIVES
There is an increasing concern for the social, economic, environmental and health effects of the Asian dust (Hwang-sa in Korean language) in Korea. In this study, we intended to indirectly determine ordinary people's perception about the Asian dust by analyzing the contents of newspaper articles dealing with it. METHODS: By using article searching services in the internet websites of three newspaper companies, we collected newspaper articles dealing with the Asian dust during the period from January 1st of 1998 to December 31st of 2002. We classified the articles into four categories: those forecasting the occurrence of the Asian dust, those about measures to cope with it, those about its occurrence in the neighboring foreign countries, and those about its effects. In particular, we analyzed articles about the health effects of the Asian dust more distinctly. RESULTS: A total of 1, 225 articles dealing with the Asian dust were found during the 5 year period. The number of articles increased from 102 in 1998 to 518 in 2002, approximately a five-fold increase. The numbers of articles about health effects, environmental effects and economical effects were 191 (44%), 171 (41%) and 147 (34%), respectively. It was reported that various diseases such as respiratory diseases (87%), eye problems (69%), and skin diseases (12%) were associated with the Asian dust. CONCLUSION: The increasing concern for the negative effects of the Asian dust necessitates more studies about this field. As the effects of the Asian dust are various, the information on the major concern of ordinary people could help establish the research agendas and measures for the Asian dust.; Summary

Summertime Heat Waves and Ozone : an Interaction on Cardiopulmonary Mortality? - Based on the 1994 Heat Wave in Korea -.: Joohon Sung, Ho Kim, Soo Hun Cho; Korean J Prev Med. 2001;34(4):316-322.

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Abstract PDF: OBJECTIVES
To explore the possible effect of an interaction between summertime heat waves and ozone on cardiopulmonary mortality during the 1994 heat wave in Korea. METHODS: The unusually hot summer of 1994 in Korea was defined as the heat wave in this study. We examined the associations of air pollutants with daily cardiopulmonary deaths between 1991-1995, considering the product term of the heat wave and each pollutant, weather and time trends. RESULTS: During the heat wave, while temperatures were uniformly higher than those of other summers, the within-heat-wave difference in mortality paralleled that in the regional ozone levels. In terms of the influence of the heat wave, the results of ozone were different to those of total suspended particles (TSP) and sulfur dioxide (SO2). The ozone association (relative risk (RR) =1.036; 95% confidence interval (CI) = 1.018-1.054) was observed only under heat wave conditions, while the TSP (RR =1.006, 95% CI = 0.999-1.012) and the SO2 (RR =1.018, 95% CI = 1.011-1.024) associations were found under normal weather conditions (per interquartile increase of each pollutant; results of three pollutants model). The ozone association under heat wave was attributable to the statistical interaction between the heat wave and ozone. CONCLUSIONS: These results support the possibility of a biological synergy between the heat wave and ozone, one that is not evident between the heat wave and other major pollutants like particles or SO2.; Summary

Short-term Effect of Air Pollution on Respiratory Disease in Seoul : A Case-Crossover Study.: Young Ju Lee, Jong Tae Lee, Young Su Ju, Dong Chun Shin, Hyoung June Im, Soo Hun Cho; Korean J Prev Med. 2001;34(3):253-261.

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Abstract PDF: OBJECTIVES
To evaluate the hypothesis that air pollution could increase emergency room visits for respiratory diseases, and if so, to quantify the strength of association between those. METHODS: We compiled daily records of hospital emergency room visits for respiratory diseases in Seoul, from November 1. 1995 to October 31. 1996, by using medical utilization data of unscheduled visits. In addition, air quality and weather data for the same period was collected. And a case-crossover design was applied by adopting conditional logistic regression analysis to determine the relationship between air pollutants and emergency room visits for respiratory diseases. In particular, the control periods were chosen by a bidirectional paired matching technique 7, 14, and 21days before and after the case periods. RESULTS: Only ozone was associated with the increased number of emergency room visits for respiratory diseases. The relative risk according to a 30ppb increase of ozone concentration (24hr mean, lagged 1day) was 1.91 (95% confidence interval = 1.78-2.05). CONCLUSION: There was a statistically significant association between the ambient ozone and daily emergency room visits for respiratory diseases.; Summary

Health Effects of Ambient Particulate Pollutants.: Yun Chul Hong, Soo Hun Cho; Korean J Prev Med. 2001;34(2):103-108.

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Abstract PDF: Recently, numerous studies have focused on the health effects of ambient particulate pollutants. Compared to earlier studies that focused on severe air pollution episodes, recent studies are more relevant to understanding the health effects of air pollution at levels common to contemporary cities. We reviewed recent epidemiologic studies that evaluated health effects of particulate air pollution and concluded that respirable particulate air pollution is an important contributing factor to acute mortality and morbidity. We observed increased respiratory and cardiovascular deaths, increased hospital admissions and visits, and decreased lung function. We also observed increased mortality and morbidity in a Korean population. Theses health effects were observed at levels below the current Ambient Air Quality Standard for particulate air pollution.; Summary

Effect of Air Pollution on Emergency Room Visits for Asthma: a Time Series Analysis.: Young Su Ju, Soo Hun Cho; Korean J Prev Med. 2001;34(1):61-72.

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Abstract PDF: OBJECTIVES
To evaluate the hypothesis that increasing ambient levels of ozone or particulate matter are associated with increased emergency room visits for asthma and to quantify the strength of association, if any, between these. METHODS: Daily counts of emergency room visits for asthma, air quality, and weather data were collected from hospitals with over 200 beds and from monitoring stations in Seoul, Korea from 1994 through 1997. Daily counts of emergency room visits for asthma attack were analyzed using a general additive Poisson model, with adjustment for the effects of secular trend, seasonal variation, Sunday and holiday, temperature, and humidity, according to levels of ozone and particulate matter. RESULTS: The association between daily counts of emergency room visits for asthma attack and ozone levels was statistically significant in summer(from June to August), and the RR by unit increment of 100 ppb ozone was 1.30(95% CI = 1.11-1.52) without lag time. With restriction of the period from April to September in 1996, the RR was 1.37(95% CI = 1.06-1.76), and from June to August in 1995, the RR was 1.62(95% CI = 1.12-2.35). In the data for children(5?14 yr), the RR was 2.57(95% CI = 1.31-5.05) with restriction of the period from April to September in 1997. There was no significant association between TSP levels and asthma attacks, but a slight association was seen between PM10 levels and asthma attacks in a very restricted period. CONCLUSION: There was a statistically significant association between ambient levels of ozone and daily counts of emergency room visits for asthma attack. Therefore, we must make efforts to effectively minimize air pollution, in order to protect public health.; Summary

Urinary 1-Hydroxypyrene and 2-Naphthol as a Biological Exposure Markers of Total Suspended Particulate in the General Population .: Jong Won Kang, Soo Hun Cho, Heon Kim, Daehee Kang, Chul Ho Lee; Korean J Prev Med. 2000;33(3):306-312.

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Abstract PDF: BACKGROUND
Polycyclic aromatic hydrocarbons (PAH) are well known environmental pollutants. The measurement of PAH in ambient air is not commonly used, because it is quite difficult to perform and is unreliable. Using biomarkers of PAH can be an alternative approach to this problem. The PAH in ambient air is absorbed in particulate matter. Total suspended particulate(TSP) or particulate matter of less than 10 micrometer in diameter (PM10) can be easily measured. Therefore, TSP or PM10 can be used as a surrogate measurements of ambient air PAH. CONCLUSIONS: We investigated whether the urinary concentration of two biomarkers of PAH, 1-hydroxypyrene (1-OHP) and 2-naphthol, could reflect the total suspended particulate in the general population. METHODS: In order to exclude the effects of occupational exposure and smoking, first grade middle school students were included in this study. Four middle schools within a one kilometer boundary of ambient air monitoring stations were selected. Total suspended particulate was regarded as the marker of airborne PAH. Diet and smoking data were collected by self administered questionnaires, and spot urine samples were collected. Urinary 1-OHP and 2-naphthol were analyzed by high performance liquid chromatography. RESULTS: The correlation between urinary 1-OHP, 2-naphthol and passive smoking was not statistically significant. The correlation between urinary 1-OHP and TSP indices was not statistically significant. The correlations between urinary 2-naphthol and TSP of two lag days, one lag day, and zero lag days were statistically significant. The statistical significance of two lag days was the strongest (p=0.001), one lag day was the next (p=0.0275), and zero lag days was the weakest (p=0.0349). CONCLUSION: Our results imply that the urinary concentration of 2-naphthol can be applied as a PAH exposure marker for the general population with low PAH exposure.; Summary

Assessment of the Glycophorin A Mutant Assay as a Biologic Marker for Low Dose Radiation Exposure.: Mina Ha, Keun Young Yoo, Sung Whan Ha, Dong Hyun Kim, Soo Hun Cho; Korean J Prev Med. 2000;33(2):165-173.

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Abstract PDF: OBJECTIVES
To assess the availability of the glycophorin A (GPA) assay to detect the biological effect of ionizing radiation in workers exposed to low-doses of radiation. METHODS: Information on confounding factors, such as age and cigarette smoking was obtained on 144 nuclear power plant workers and 32 hospital workers, by a self-administered questionnaire. Information on physical exposure levels was obtained from the registries of radiation exposure monitoring and control at each facility. The GPA mutant assay was performed using the BR6 method with modification by using a FACScan flow cytometer. RESULTS: As confounders, age and cigarette smoking habits showed increasing trends with GPA variants, but these were of no statistical significance. Hospital workers showed a higher frequency of the GPA variant than nuclear power plant workers in terms of the NO variant. Significant dose-response relationships were obtained from in simple and multiple linear regression models. The slope of the regression equation for nuclear power plant workers was much smaller than that of hospital workers. These findings suggest that there may be apparent dose-rate effects. CONCLUSION: In population exposed to chronic low-dose radiation, the GPA assay has a potential to be used as an effective biologic marker for assessing the bone marrow cumulative exposure dose.; Summary

Health Effects from Odor Pollution in Sihwa Industrial Complex.: Soo Hun Cho, Seong Woo Choi, Sun Mean Kim, Young Su Ju, Jae Yong Kim; Korean J Prev Med. 1999;32(4):473-481.

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Abstract PDF: OBJECTIVES
In recent days, the problem of odor pollution in community near Sihwa Industrial complex, Kynuggi Province is becoming of significant public concern. We have investigated the health effects of the Sihwa residents from odor pollution comparing with other less polluted areas. METHODS: The Ansan and Kuri Cities were selected as control areas. The parents of the elementary and middle school students in these three areas were surveyed with structured questionnaire twice, Nov 1997 and June 1998 each. As a exposure index, the ambient air concentrations of five major air pollutants(particulates, O3, SO2, NO2, CO) and subjective odor perception were used. We have focused health outcomes such as the prevalence of nonspecific irritant symptoms, respiratory disease among family members and the score of quality of life(QOL). RESULTS: Although the mean concentrations of major air pollutants except particulates were similar or lower in Sihwa than other areas, the odor perception rate and the monthly odor perception days were significantly higher. It suggested that odor producing chemical compounds are the major source of environmental pollution problem. There were higher prevalence rates of nonspecific irritant symptoms and respiratory disease among family members in Sihwa than other control areas. The QOL score was also lower in Sihwa. The odor perception proved to be a most important factor in reporting adverse health effects and lowering the QOL score. CONCLUSION: The residents living near Sihwa industrial complex were suffering from more adverse health symptoms and poorer QOL status than control areas. And it may be due to environmental odor pollution from industrial complex. Therefore, further research will be needed for monitoring of the responsible chemicals emitted from industries.; Summary

Development of Work-related Musculoskeletal Disorder Questionnaire Using Receiver Operating Characteristic Analysis.: Jaiyong Kim, Ho Jang Kwon, Yeongsu Ju, Soo Hun Cho, Daehee Kang, Joohon Sung, Seong Woo Choi, Jae Wook Choi, Jae Young Kim, Don Gyu Kim; Korean J Prev Med. 1999;32(3):361-373.

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Abstract PDF: OBJECTIVES
Receive Operating Characteristic(ROC) curve with the area under the ROC curve(AUC) is one of the most popular indicator to evaluate the criterion validity of the measurement tool. This study was conducted to develop a standardized questionnaire to discriminate workers at high-risk of work-related musculoskeletal disorders using ROC analysis. METHODS: The diagnostic results determined by rehabilitation medicine specialists in 370 persons(89 shipyard CAD workers, 113 telephone directory assistant operators, 79 women with occupation, and 89 housewives) were compared with participant's own replies to 'the questionnair on the worker's subjective physical symptoms'(Kwon, 1996). The AUC's from four models with different methods in item selection and weighting were compared with each other. These 4 models were applied to 225 persons, working in an assembly line of motor vehicle, for the purpose of AUC reliability test. RESULTS: In a weighted model with 11 items, the AUC was 0.8155 in the primary study population, and 0.8026 in the secondary study population(p=0.3780). It was superior in the aspects of discriminability, reliability and convenience. A new questionnaire of musculoskeletal disorder could be constructed by this model. CONCLUSION: A more valid questionnaire with a small number of items and the quantitative weight scores useful for the relative comparisons are the main results of this study. While the absolute reference value applicable to the wide range of populations was not estimated, the basic intent of this study, developing a surveillance tool through quantitative validation of the measures, would serve for the systematic disease prevention activities.; Summary

Laboratory-Acquired Infections with Hantavirus at a Research Unit of Medical School in Seoul, 1996.: Soo Hun Cho, Young Su Ju, Daehee Kang, Suhnggwon Kim, Ik Sang Kim, Sung Tae Hong; Korean J Prev Med. 1999;32(3):269-275.

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Abstract PDF: BACKGROUND
In April 6, 1996, a male researcher who has worked at a research unit at the Basic Research Building of Seoul National University(SNU) College of Medicine admitted to SNU Hospital due to persistent fever. He was diagnosed serologically as hemorrhagic fever with renal syndrome(HFRS). Another female researcher in the same unit was also diagnosed as HFRS at the same hospital several days later. Epidemic investigation of HFRS was conducted to determine the magnitude of the problems since these two cases were strongly suspected to have laboratory-acquired infections of HFRS. METHODS: All researchers and employees working at the Basic Research Building(BRB) of SNU College of Medicine as of April 1, 1996 were recruited for the study. Information on symptoms of HFRS and history of contact to experimental animals were collected by self-administered questionnaires and serological tests among study subjects were also conducted by indirect immunofluorescent antibody(IFA) to hantavirus. The experimental animals were also serologically tested for infection with hantavirus by IFA. RESULTS: Among 218 surveyed, six researchers and an animal caretaker had hantavirus antibodies above 1:20 in IFA titer. Five of seven sero-positive subjects had antibodies above 1:640 in IFA titer and had shown clinical symptoms compatible to HFRS during Jan. 1 to Apr. 20, 1996. The sero-positive persons had handled animals more frequently than sero-negative persons (OR, 19.68; 95% CI, 1.11 - 350.40) and handling animals at the animal quarter at School of Public Health(SPH) had shown consistently higher risk to get infected with hantavirus irrespective of types of animals handled (OR, 4.90 - 6.37). Sero-positivity of rats of the aniamal quarter at BRB was 30-60%, whereas 80% of rats at SPH tested were shown sero-positivity. CONCLUSION: There was a epidemic of HFRS in research units of a medical school during the period from Jan. through Apr. Further investigation is needed to determine the extent and the mode of transmission of the laboratory-acquired infection with hantavirus in other research facilities.; Summary

Air Pollution and Daily Mortality in Seoul.: Ho Jang Kwon, Soo Hun Cho; Korean J Prev Med. 1999;32(2):191-199.

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Abstract PDF: OBJECTIVES
To examine the relationship between air pollution exposure and mortality in Seoul for the years of 1991-1995. METHODS: Daily counts of death were analyzed by general additive Poisson model, with adjustment for effects of secular trend, seasonal factor, day of the week, heat wave, temperature, and humidity. Pollution variables were ozone, nitrogen dioxide, total suspended particles(TSP), and sulfur dioxide. RESULTS: Daily death counts were associated with ozone(1 day before), nitrogen dioxide(1 day before), TSP(2 days before), sulfur dioxide(2 days before). The association with ozone was most statistically significant and independent of other air pollutants. Increase of 100 ppb in ozone was associated with 6%(95% CI= 2%-10%) increase in the daily number of death. This effect was greater in persons aged 65 and older. The relative risks of death from respiratory disease and cardiovascular disease were greater than for all-cause mortality in each pollutant. After ozone level exceeds 25 ppb, the dose-response relationship between mortality and ozone was almost linear. However, the effect of TSP, sulfur dioxide, and nitrogen dioxide on mortality might be confounded with each other. CONCLUSION: Daily variations in air pollution within the range currently occurring in Seoul might have an adverse effect on daily mortality.; Summary

Prediction Equations for FVC and FEV1 among Korean Children Aged 12 Years.: Jong Won Kang, Yeong Su Ju, Joohon Sung, Soo Hun Cho; Korean J Prev Med. 1999;32(1):60-64.

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Abstract PDF: OBJECTIVES
Changes in lung function are frequently used as biological markers to assess the health effects of criteria air pollutants. We tried to formulate the prediction models of pulmonary functions based on height, weight, age and gender, especially for children aged 12 years who are commonly selected for the study of health effects of the air pollution. METHODS: The target pulmonary function parameters were forced vital capacity(FVC) and forced expiratory volume in one second(FEV1). Two hundreds and fifity-eight male and 301 female 12-year old children were included in the analysis after excluding unsatisfactory tests to the criteria recommended by American Thoracic Sosiety and excluding more or less than 20% predicted value by previous prediction equations. The weight prediction equation using height as a independent variable was calculated, and then the difference of observed weight and predicted weight (i.e. residual) was used as the independent variable of pulmonary function prediction equations with height. RESULTS: The prediction equations of FVC and FEV1 for male are FVC(ml) = 50.84 x height(cm) + 7.06 x weight residual - 4838.86, FEV1(ml) = 43.57 x height(cm) + 3.16 x weight residual - 4156.66, respectively. The prediction equations of FVC and FEV1 for female are FVC(ml) = 42.57 x height(cm) + 12.50 x weight residual - 3862.39, FEV1(ml) = 36.29 x height(cm) + 7.74 x weight residual - 3200.94, respectively.; Summary

Reliability and Validity of the Korean Version of ISAAC Questionnaire.: Seong Woo Choi, Yeong Su Ju, Dae Sung Kim, Jae Yong Kim, Ho Jang Kwon, Dae Hee Kang, Sang Il Lee, Soo Hun Cho; Korean J Prev Med. 1998;31(3):361-371.

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Abstract PDF: Recent increases of asthma and allergies in childhood made the need for a standardized approach to international and regional comparisons of their prevalence and severity. To address these issues, "International Study of Asthma and Allergies in Childhood (ISAAC)" is currently underway. In Korea, "Nationwide Study of Asthma and Allergies in Korean Children" began in 1995 according to ISAAC protocol. ISAAC written and video questionnaires were used in this survey, but their reliability and validity were not evaluated properly yet. In this study, our aim was to evaluate the reliability and validity of two kinds of questionnaires and their usefulness in international and regional comparisons. The test and retest of two questionnaires were completed by male(n=110) and female(n=111) middle school students with two and three weeks interval each. Kappa(or weighted kappa) were calculated from each questions and validity coefficients were estimated from those statistics. In Korean version of written questionnaire, the questions for allergic rhinitis, atopic dermatitis, allergic conjunctivitis, and food allergy proved to have high kappa values(or weighted kappa values) and validity coefficients and they can be used in further studies without any correction. But some questions about asthma(especially nocturnal cough, wheezing in exercise, and severe asthma) and drug allergy need to be revised for better understanding to study subjects. Video questionnaire has the same degree of reliability and validity when compared to written questionnaire and this is the unexpected result. Accordingly, it also need to be revised to overcome the racial and cultural differences of the study subjects. In conclusion, the Korean version of written and video questionnaires may be considered to be useful methods in international and regional comparisons of asthma and allergic diseases in childhood after correction of some questions.; Summary

Development of Questionnaire for Evaluating Health Effect Associated with Air Pollution.: Yeong Su Ju, Dae Sung Kim, Jong Won Kang, Joo Heon Seong, Dae Hee Kang, Soo Hun Cho, Do Myung Paek; Korean J Prev Med. 1997;30(4):852-869.

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Abstract PDF: This study was conducted to develope and evaluate the reliability and the validity of a questionnaire in order to determine the applicability as a screening tool for estimating environmental exposure and health effects related to air pollution. The questionnaire was developed with adopting some items of others such as ISAAC or ATS-DLD. And then we performed test-retest to 89 middle school students and their mothers at interval of three months. Cohen's Kappa values, weighted Kappa values, Spearman's correlation coefficients, and Pearson's correlation coefficients for each item were computed as reliability coefficients. The validity coefficients and validity coefficient bounds were also obtained by simply using these reliability coefficients. As results, Kappa ranged broadly from 0.10 to 0.61 of the items 'diet', 0.52~0.79 of the environmental tobacco smoke, 0.39~0.44 of the functional categories of surrounding environment, and 0.54~0.63 of the using transportation systems; these items were regarded as confounding factors. For items related to health outcomes, Kappa ranged from -0.02 to 0.37 in the respiratory system of past medical history, and from 0.11 to 0.55 in the current health status. But Kappa of the others were over 0.60. In conclusion, if some items can be corrected or modified, the questionnaire developed in this study can be used as a tool for evaluating environmental exposure and health effects associated with air pollution.; Summary

Lung cancer, chronic obstructive pulmonary disease and air pollution.: Joo Hon Sung, Soo Hun Cho, Dae Hee Kang, Keun Young Yoo; Korean J Prev Med. 1997;30(3):585-598.

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Abstract PDF: BACKGROUND
Although there are growing concerns about the adverse health effect of air pollution, not much evidence on health effect of current air pollution level had been accumulated yet in Korea. This study was designed to evaluate the chronic health effect of air pollution using Korean Medical Insurance Corporation (KMIC) data and air quality data. Medical insurance data in Korea have some drawback in accuracy, but they do have some strength especially in their national coverage, in having unified ID system and individual information which enables various data linkage and chronic health effect study. METHOD: This study utilized the data of Korean Environmental Surveillance System Study (Surveillance Study), which consist of asthma, acute bronchitis, chronic obstructive pulmonary diseases (COPD), cardiovascular diseases (congestive heart failure and ischemic heart disease), all cancers, accidents and congenital anomaly, i.e., mainly potential environmental diseases. We reconstructed a nested case-control study with Surveillance Study data and air pollution data in Korea. Among 1,037,210 insured who completed questionnaire and physical examination in 1992, disease free (for chronic respiratory disease and cancer) persons, between the age of 35-64 with smoking status information were selected to reconstruct cohort of 564,991 persons. The cohort was followed-up to 1995 (1992-5) and the subjects who had the diseases in Surveillance Study were selected. Finally, the patients, with address information and available air pollution data, left to be 'final subjects'. Cases were defined to all lung cancer cases (424) and COPD admission cases (89), while control groups are determined to all other patients than two case groups among 'final subjects'. That is, cases are probable chronic environmental diseases, while controls are mainly acute environmental diseases. For exposure, Air quality data in 73 monitoring sites between 1991 - 1993 were analyzed to surrogate air pollution exposure level of located areas (58 areas). Five major air pollutants data, TSP, O3, SO2, CO, NOx was available and the area means were applied to the residents of the local area. 3-year arithmetic mean value, the counts of days violating both long-term and shot-term standards during the period were used as indices of exposure. Multiple logistic regression model was applied. All analyses were performed adjusting for current and past smoking history, age, gender. Results: Plain arithmetic means of pollutants level did not succeed in revealing any relation to the risk of lung cancer or COPD, while the cumulative counts of non-attainment days did. All pollutants indices failed to show significant positive findings with COPD excess. Lung cancer risks were significantly and consistently associated with the increase of O3and CO exceedance counts(to corrected error level - 0.017) and less strongly and consistently with SO2 and TSP. SO2and TSP showed weaker and less consistent relationship. O3and CO were estimated to increase the risks of lung cancer by 2.04 and 1.46 respectively, the maximal probable risks, derived from comparing more polluted area (95%) with cleaner area (5%). CONCLUSIONS: Although not decisive due to potential misclassication of exposure, these results were drawn by relatively conservative interpretation, and could be used as an evidence of chronic health effect especially for lung cancer. O3might be a candidate for promoter of lung cancer, while CO should be considered as surrogated measure of motor vehicle emissions. The control selection in this study could have been less appropriate for COPD, and further evaluation with another setting might be necessary.; Summary

The effects of aircraft noise on the hearing loss, blood pressure and response to psychological stress.: Sang Hwan Han, Soo Hun Cho, Kyungshim Koh, Ho Jang Kwon, Mina Ha, Yeong Su Ju, Myung Hee Shin; Korean J Prev Med. 1997;30(2):356-368.

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Abstract PDF: In effort to determine whether aircraft noise can have health effects such as hearing loss, hypertension and psychological stress, a total of 111 male professors and administrative officers working a college near a military airport in Korea(exposed group) and a total of 168 males and 112 females matched by age groups(control groups) were analyzed. Personal noise exposure and indoor and outdoor sound level of jet aircraft noise were measured at the exposed area. And pure tone, air conduction test and measurement of blood pressure were given to the exposed(males) and matched control groups(males and females). BEPSI(Brief Encounter Psychological Instrument) and psychological response to aircraft noise were examined for the exposed group. The noise dosimetry results revealed time-weighted averages(TWAs) that ranged from 61 to 68 dBA. However the levels encountered during taking off jet airplanes reached 126 dBA for two half minutes time period. The audiometric test showed that mean values of HTL(hearing threshold level) in exposed group at every frequency(500, 1,000, 2,000, 4,000, and 8,000 Hz were much lower than them of male and female control groups. And in old age groups, interaction of age and noise was observed at 8,000 Hz in both ears(p< 0.05). Conclusively, aircraft noise does not appear to induce hearing loss directly, but may decreased hearing threshold level by interaction of aging process and noise exposure. However, difference of mean values of exposed and control groups on blood pressure was not significantly. In psychological test, annoyance was the most severe psychological response to noise in exposed group, but mean value of BEPSI was not correlated with job duration in exposed group; Summary

Sick Building Syndrome and the Related Factors in Office Workers.: Jae Joong Bak, Soo Hun Cho, Byung Ju Park, Dae Hee Kang; Korean J Prev Med. 1997;30(1):157-170.

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Abstract PDF: A cross-sectional study was conducted to investigate the prevalence and risk factors for symptoms associated with sick building syndrome in four office buildings located in Seoul. Information on personal factors, job-related factors, and medical history were collected using self-administered questionnaires modified from the National Institute for Occupational Safety and Health Indoor Air Quality questionnaire in 321 office workers in these buildings. The prevalence of general and irritant symptom groups was higher than the prevalence of dermatologic and respiratory symptom groups. Daily total work time, work time in the office, and work time with video display terminals(VDT) were identified as the risk factors for symptom groups associated with sick building syndrome by multiple linear logistic regression analysis. In conclusion, these results indicated that the symptom prevalence in this study is similar with the results reported from previous studies conducted in other countries and work time and work with VDT are related to sick building syndrome in Korea.; Summary

Health Assessment for Glass Fibre Landfill at Gozan-dong, Inchon.: Soo Hun Cho, Yeong Su Ju, Kyung Ryul Kim, Kang Kun Led, Kug Sun Hong, Hee Chul Eum, Dong Bim Song, Jae Woong Hong, Ho Jang Kwon, Mi Na Ha, Sang Hwan Han, Jpp Heon Seong, Jong Won Kang; Korean J Prev Med. 1997;30(1):77-102.

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Abstract PDF: In September 1994, residents of Gozan-dong, Incheon City, made a petition to the government about their health problems which might be caused by previous glass fibre landfill nearby "H" company. In February 1995, at regular academic meeting of occupational and environmental medicine, a research team of "D" University presented that they had found glass fibres in groundwater of the area through their survey. They were suspicious of probable association between ingestion of groundwater contaminated with glass fibres and skin tumors among residents. A joint research team was formed and carried out the survey of environment concerning groundwater and its glass fibre existence, and health assessment of residents in the area and industrial workers of "H" company during May to November, 1995. Analysis of groundwater flow system indicates that the flow lines from the glass fibre landfill pass through or terminate at the 6 houses around the landfill. This means that the groundwater of the 6 houses around the glass fibre landfill could be affected by some possible contaminants from the landfill, but the groundwater quality of the other houses was irrelevant to the landfill. The qualitative and quatitative analyses for glass fibres in 54 groundwater samples including those from the nearby 6 houses, were carried out using SEM equipped with EDS, resulting in no evidence for the presence of glass fibres in the waters. Major precipitates, formed in waters while boiling, were identified as calcium carbonates, in particulary, aragonites in needle form. The results of health assessments of 889 residents in Gozan-dong, participated in this study, showed statistically significant differences in past medical histories of skin tumor and respiratory disease between the exposed group (31 persons who inhabited in 6 houses around the landfill) and the control group, but no significant differences in past medical histories of other diseases, such as cancer mortality, current gastroscopic findings, current skin diseases and respiratory diseases, etc. Also, we could not prove any glass fibres in excised specimens of 9 skin tumors in both groups and there were no health problems possibly associated with glass fibres in employees of the "H" company. After all, we could not authenticate the association, raised by prior investigators, between groundwater streams, assumedly contaminated with glass fibres or not, and specific disease morbidities or common disease/symptom prevalences. That is, we could not find any glass fibres in groundwater as the only exposure factor of this study hypothesis, and there were not enough certain evidences such as increasing disease prevalences, for examples, skin, respiratory and gastrointestinal diseases etc, possibly related to glass fibre exposure, in exposed group. As a matter of course, the conditions for confirming causal association, for example, strength of the association, consistency of the association, specificity of the association, temporality of the association and dose-response relationship etc, have not been satisfied. In conclusion, we were not able to certify the hypothesis that contamination of groundwater with glass fibres might cause any hazardous health effects in human who used it for drinking.; Summary

Histopatholigical Changes of Subcutaneous Exposure to Glass Fibers in Rats.: Min Jae Lee, Soo Hun Cho, Ja June Jang; Korean J Prev Med. 1997;30(1):69-76.

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Abstract PDF: To exanime in vivo tissue reactions of glass fibers, we injected glass fibers to rats subcutaneously. We made fibers of average dimensions of approximately 2 nm in diameter and 60 nm in length. After instilation of glass fiber we sacrificed rats sequentially at 1, 3 and 6 months. At 1 month after injection of glass fibers, the exposure area turned to yellow color and formed well-demarcated round mass. The average size of the mass was 1X0.3 cm. Grossly detectable mass was decreased in size at 6 months compared to 1 or 3 months. Microscopically, strong foreign body reaction to glass fibers, inflammation and fibrosis were observed until 6 months. Foreign body reaction was increased up to 3 months, but it was decreased after 6 months. In scanning electron microscope, there was many bundles of glass fibers around the inflammation area, but the size of glass fibers were gradually reduced from 1 month to months. These results suggest that subcutaneous exposure of glass fiber can provoke strong tissue reaction including foreign body granulomas, inflammation and fibrosis. But glass fiber itself did not produce any neoplastic changes.; Summary

Cost-Benefit Analysis of Back School Program for Occupational Low Back pain Patients.: Yeong Su Ju, Mi Na Ha, Sang Hwan Han, Ho Jang Kwon, Soo Hun Cho, Chang Yup Kim, Sun Min Kim; Korean J Prev Med. 1996;29(2):347-358.

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Abstract PDF: Although occupational low back pain accounts for 20~40% of all occupational illness and injury, there are limited numbers of studies regarding the effectiveness of back school program. The objective of this study was to evaluate the economic benefit of back school program for early return to work of occupational low back pain patients in the current occupational injury compensation and management system. The cost-benefit analysis in this study was conducted to evaluate the relative magnitude of benefit to cost. The total cost was estimated by calculating the value of components in back school program according to governmental budget protocol. The back school program was consisted of three major approaches, pain center, work-hardening program and functional restoration program and each of components had various facilities and experts. The total amount of cost was estimated as 250,866,220 won per year. The most promising type of back school program were quite intensive (a 3 to 5-week stay in a specialized center), therefore, if we adopted the 5-week stay course, 10 courses could be held in a year. Following to the medical act, 20 patients per doctor could participate in a each course, ie, total 200 patients in a year. As a result, we could estimate the cost of 1,254,331 won a patient. we estimated the benefit by using data of a few local labor offices about average medical treatment beneficiary and off-duty beneficiary of 46 occupational low back pain patients in 1994. Ullman and Larsson(1977) mentioned that the group of chronic low back pain patients who participated in back school program needed less time to recover by 48.4% of beneficiary duration. And in the trying to estimate the benefit, we asked 10 rehabilitation board certificate doctors about reduction proportion of treatment cost by introducing back school program. The answered reduction proportions were in the range of 30~45%, average 39%. As a final result, we could see that the introduction of back school program in treatment of chronic occupational low back pain patients could produce the benefit to cost ratio as 3.90 and 6.28. And we could conclude that the introduction of back school program was beneficial to current occupational injury compensation and management system.; Summary

Psychometric Charateristics of Occupational Low Back Pain Patients.: Mi Na Ha, Soo Hun Cho, Ho Jang Kweon, Sang Hwan Han, Young Soo Joo, Nam Jong Pack; Korean J Prev Med. 1995;28(3):715-725.

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Abstract PDF: This study was done for identifying the factors which affect psychologic symptoms of low back(LBP) patients. The study subjects were 43 work-related low back pain patients, 28 work-related non-low back pain patients and 47 general low back injury patients. The study material is SCL 90-R for checking psychologic symptoms and questionnaire for obtaining general information about the subjects. The data were analyzed by model of analysis of covariance adjusted by several variables such as gender, age, education and marital status and then compared the least square means of symptom score between groups. To identify the factors that affect psychologic symptom, duration of suspension, return to work and interaction factor of these two variables were analyzed by multivariate model and we calculated partial correlation coefficient of these variables. As a result, work-related LBP patients showed higher score of symptoms in somatization, depression and psychosis than work-related non-LBP and non-work-related LBP. Duration of suspension and return to work were significant explanatory variables for psychologic symptom score of work-related LBP. Then, we may conclude that the treatment and rehabilitation programe for work-related LBP should cover the strategy of early return to work.; Summary

The effects of chromium exposure on sister chromatid exchange and concentration of 8-hydroxydeoxyguanosine.: Sang Hwan Han, Soo Hun Cho, Heon Kim, Soo Min Park, Mina Ha, Young Soo Joo, Ho Jang Kwon, Yong Dae Kwon, Myung Hee Kwon; Korean J Prev Med. 1995;28(2):511-525.

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Abstract PDF: To elucidate some DNA adducts as a biological marker for workers of chromate pigment, the effects of chromium exposure on the formation of 8-hydroxydeoxyguanosine(8-OH-dG) and sister chromatid exchanges(SCEs) frequency in 38 workers of a pigment plant in Bucheon which utilized lead chromates, were examined. The chromium contents of venous blood and urine were measured as working environmental exposure level. The concentrations of 8-OH-dG in DNA isolated from lymphocytes were determined with high performance liquid chromatography and electrochemical detector and denoted as a molar ratio of 8-OH-dG to deoxyguanosine(dG). The SCEs frequency were analyzed in DNA isolated from lymphocytes. A significant correlation was found between creatinine adjusted urine chromium concentration and the molar ratio of 8-OH-dG to dG(r=0.47, p<0.01). After adjusting the current smoking habit, the correlation coefficient was increased(r=0.62, p<0.05). However, there was no significant correlation between the SCE frequency and chromium exposure. This significant results between molar ratio of 8-OH-dG to dG and chromium exposure are in good agreement with in vitro studies that support the importance of DNA adduct formation for the carcinogenic effect of chromium.; Summary

Cross-sectional Study on Respiratory Symptoms due to Air Pollution Using a Questionnaire.: Ho Jang Kwon, Soo Hun Cho, Sun Min Kim, Mi Na Ha, Sang Hwan Han; Korean J Prev Med. 1994;27(2):313-325.

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Abstract PDF: A cross-sectional study was conducted in an effort to investigate the effect of air pollution on respiratory symptoms. Two groups of female aged more than 20 living in the unpolluted rural area of Taebul(n=159) and urban area of Taegu(n=140)were selected. The ATS-DAD-78 questionnaire was translated into Korean and administered with minor modification. The proportion of smoker was less than 1% in both area. Exposure to smoking and higher educational level were more frequent in Taegu. Age-adjusted prevalence rates of 'chronic cough', 'chronic sputum', 'wheezing', and 'dyspnea' were higher in Taegu than in Taebul. In particular, the prevalence rate of 'chronic sputum' in Taegu was found to be higher, which was statistically significant. Exposure to smoking and education level were not concerned with all respiratory symptom prevalence rates. In conclusion, this study indicates that an urban factor is related to the rates of respiratory symptoms in Korea.; Summary

Effects of Hyperoxia on 8-Hydroxydeoxyguanosine Formation in Carbon Monoxide Exposed Rats.: Heon Kim, Soo Hun Cho, Myung Hee Chung; Korean J Prev Med. 1994;27(1):84-106.

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Abstract PDF: Hyperbaric oxygen(HBO) therapy for carbon monoxide(CO) poisoning eventually inducing the hypoxia-reoxygenation condition, may produce oxygen free radicals, which forms 8-hydroxydeoxyguanosine(8-OH-dG) by attacking C-8 position of deoxy-guanosine (dG) in DNA. Effects of oxygen partial pressure or duration of HBO therapy with or without CO poisoning on the tissue 8-OH-dG formation were investigated. Male Sprague-Dawley rats were grouped and exposed to air(control group), 4000ppm of CO for 10 to 30 minutes(CO only group), air for 30 minutes after 30 minute exposure to 4000ppm of CO(CO-air exposure group), HBO after 30 minute exposure to 4000ppm of CO(CO-HBO group), or HBO therapy for 10-120 minutes (HBO only group). The 8-OH-dG concentrations in the brain and the lung tissues were measured with high performance liquid chromatography and electrochemical detector (ECD). Average concentrations of the 8-OH-dG of each group were statistically compared. In the brain tissues, 8-OH-dG concentrations of the CO only group, the CO-air exposure group, and the CO-HBO group did not significantly differ from those of the control group. Similar insignificance was also found between the CO-HBO group and the HBO only groups. No appreciable dose-response relationship was observed between the 8-OH-dG concentration and the oxygen partial pressure or the duration of HBO. However, the 8-OH-dG concentrations of the 30 minute CO only group were higher than those of the CO-air exposure group (p-value<0.05). In the lung tissues, there were no significant differences between the 8-OH-dG concentrations of the control group and those of the CO only group, the CO-air exposure group, and the CO-HBO group. However, mean 8-OH-dG concentration of the CO-air exposure group was significantly higher than that of the CO only group under the same CO exposure condition(p-value<0.05). With the duration of CO exposure, the 8-OH-dG concentrations of the lung tissues decreased significantly (p-value<0.05). The concentrations of 8-OH-dG in the lung tissues proportionally increased with the duration of HBO, but no such relation was observed with the oxygen partial pressure. These results suggest that the brain may be more resistant to oxygen free radicals as compared with the lungs, and that oxygen toxicity following HBO may be affected by factors other than oxygen free radicals.; Summary

Effects Of Glue Sniffing On Weight Increase Or Central Nervous System Of Young Rat.: Heon Kim, Sun Min Kim, Soo Hun Cho; Korean J Prev Med. 1993;26(2):222-230.

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Abstract PDF: Industrial glues, known as 'Bonds' in Korea, contain many kinds of organic solvents, and glue sniffing of youths became one of the social problems in Korea. Mixed exposures to solvents by glue sniffing may induce chronic toxicities different from those by exposures to solvents of single component. To test effects of the glue sniffing on weight gain or central nervous system, two groups of 20 male Sprague-Dawley rats were exposed to air(control group) or vapors of the glues to narcotic status(exposed group), and weight check, tail flick test, hot plate test, rotarod treadmill test were done on the 14th, 24th, 36th, 45th, 53rd, 86th, 102nd, 117th, 134th and 151st days after the first exposure. On the 188th day, their brains were excised and examined by a pathologist. Weight gain, controlled against time change, showed significant difference between the groups, but response times in tail flick test, hot plate tests, and rotarod treadmill test didn't. In pathological examination with blind method, no macroscopic or microscopic difference were found between the two groups. These results suggests that organic lesion in central nervous system may not ensue glue sniffing, but, before firm conclusion, more studies in various exposure conditions should be followed.; Summary

Development Of An On Site Diagnostic Tool To Detect Neuropsychiatric Impairment Due To Chronic Organic Solvent Exposure.: Soo Hun Cho, Sun Min Kim, Ho Jang Kwon, Yong Hyun Yim, Hyun Sul Lim; Korean J Prev Med. 1993;26(1):147-164.

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Abstract PDF: A study has been conducted on developing questionnaire to serve as on site diagnostic tools for the early detection of neuropsychiatric impairment among workers chronically exposed to low-level organic solvents. Two drafts of tentative questionnaire have been developed as follows ; several question items were selected from questionnaires which were administered to workers exposed to organic solvents in previous studies and were grouped into each symptom category based on the presence of its association using Guttman scaling method, then these selected items were reviewed by neuropsychiatry specialists. The final draft of the questionnaire (total symptom score=36) was developed by selecting 33 question items which had more than a 0.88 Guttman coefficient of reproducibility in each symptom category from a pilot study in which these tentative questionnaires were administered to workers manufacturing soles. Three plants using organic solvents and one plant never using organic solvents as a control group were selected to test the reliability and validity of the developed questionnaires. The major organic solvent in the workplace environment detected by a personal air sampler and GC/MSD was toluene. The concentration of toluene in air from the department using organic solvent was statistically different from that of the department never using organic solvent. The concentration of toluene from almost all of the workplace did not exceed the allowable level. There was no statistically significant difference between the concentration of urinary hippuric acid from the workers of the department using organic solvent and that of the department never using it. Total symptom score of the plant never using organic solvents was 9.8 and those of the three plants using organic solvents were 15.6, 14.7, and 13.7 respectively. In order to evaluate the validity of the questionnaires, the workers from two different department of the plant in which usage of organic solvents are totally different were compared. The total symptom score was 17.8 for workers of the department using organic solvent and 13.5 for the department never using organic solvent and scores of each symptom group between exposure and non-exposure group also showed statistically significant difference. The finding that total symptom score of the usefulness of the developed questionnaire to assess the health effects of chronic exposure to organic solvents. The correlation coefficient, which was calculated to evaluate the test-retest reliability, was 0.581(p=0.001). The coefficient of Crohnbach which reflects the internal consistency of the questionnaire was 0.91. In conclusion, the reliability of the questionnaire was well maintained over the time lapse between the two administrations of the questionnaire and despite the seasonal difference.; Summary

Environmental pullution related health problems reported in newspapers.: Soo Hun Cho, Sun Min Kim, Sung Il Cho; Korean J Prev Med. 1993;26(1):126-136.

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Abstract PDF: To understand the possible hazards to health from the environmental pollution in Korea, the articles reported in 16 daily newspapers were collected and analyzed. From 1980 to 1991, ninety three cases were reported. Statistics show that, during the last 2 years, there has been a remarkable increases of health problems reported. The main sources of pollution were plants and the transportation facilities. Except the noise, the exact causative factors were, for the most part, not clearly described. Although many residents complained of neurological symptoms, the exact effects on health were not clearly investigated. The responses of the residents were diverse in the contents of the demand and the method of its pushing, however, the government did not show immediate and consistent counterplans.; Summary

The Effect Of Gunshot Or Cannonade Training During Military Service On Hearing Threshold Levels.: Heon Kim, Soo Hun Cho, Hyun Sul Lim; Korean J Prev Med. 1991;24(1):86-92.

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Abstract PDF: To test if exposure history to rifle fire or cannonade training during military duty can induce hearing loss, history of personal military service and history of gunshot exposure were asked to 228 male college students with self-administrative questionnaire. Otoscopic examination and Rinne's test were performed if any abnormal finding was detected by pure-tone audiometry. Average hearing threshold levels of 500 Hz, 1,000 Hz, 2,000 Hz, 4,000 Hz and threshold levels at 4,000 Hz were calculated for 112 students who were remained after exclusion of cases with history of ear disease, of ototoxic drug administration, and of neuropsychiatric disease, and mean of those were compared between group of students who have completed military duty (completed group) and group of those who have not (not-completed group), and between group exposed(exposed group) and group unexposed to gunshot sound(unexposed group). Mean of average hearing threshold level and mean of threshold levels at 4,000 Hz of completed group and those of exposed group were higher than those of not-completed group and unexposed group, respectively. Proportion of cases that average threshold level was greater than 40 dB of threshold levels at 4,000 Hz was greater than 50 dB were higher also in completed group and exposed group than in duty not-completed group and unexposed group, respectively. Multiple linear regression analysis including age, duration of military service, degree of gunshot sound exposure as independent variables and average hearing threshold level as dependant variable, was performed in order to estimate the effect of age on hearing, and any considerable effect of age on hearing could not be found. In conclusion, hearing impairment can be induced by rifle fire or cannonade training.; Summary

Effect of Hyperoxia on Pregnancy in the Rat.: Seung Chul Lee, Soo Hun Cho, Hyeong Sik Ahn, Dork Ro Yun; Korean J Prev Med. 1989;22(1):71-80.

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Abstract PDF: The adverse effect of diving on the fetus may extend beyond n gestational process and outcome. Primiparous Sprague-Dawley rats were assigned to one of ten exposure schedules during gestatred PO2 level, the following question about the effect of exposing a pregnant female to high partial pressure of inspired oxygen has been raised. "What effect does an increased maternal PIO2 have on fetal arterial PO2 and therefore on possible fetal oxygen poisoning?" This study was carried out to observe the effects of maternal hyperoxia on gestational process and outcome. Primiparous Sprague-Dawley rats were assigned to one of ten exposure schedules during gestation. The treatment groups were subjected to either the high concentration of oxygen, or the high atmospheric pressure. On day 21 of gestation, laparotomy was performed to examine for number and distribution of implantations and live and resorbing embryos. Fetuses were weighed, and examined for gross malformations. Subsequently, they were fixed, measured in physical parameters, and examined for visceral anomalies. Minor visceral anomalies and anatomical variation was not found. Similarily, there were no significant differences when number of resorptions, mean fetal weights, pregnancy interruption rate were compared by analysis of variance. These results indicate that exposing rats to oxygen at increased atmospheric pressure doese not affect fetal health or survival.; Summary

Effect of Hyperbaric Oxygenation on Pulmonary Superoxide Dismutase Activity in Neonatal and Adult Rats.: Hyeong Sik Ahn, Soo Hun Cho, Dork Ro Yun, Dong Ryool Lee, Yong Sik Kim; Korean J Prev Med. 1989;22(1):51-56.

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Abstract PDF: To investigate the effect of hyperbaric oxygenation on superoxide dismutase activity, neonatal rats (7-10 days old) and adult rats (approximately 100 days old) were continuously exposed to hyperbaric oxygen environment of 2.4ATA for 8 hours and their superoxide dismutase activity were measured. Neonatal rats, all survived through exposure, showed significant increases in the pulmonary superoxide dismutase activity at immediately and 24 hours after exposure. Adult rats, whose 8 hour survival rates were 14 %, did not show any significant increase in the activity of pulmonary superoxide dismutase as compared to the control adult rats. These findings are indicating that increased tolerance to oxygen toxicity in neonatal animals during exposure may be attributed to the increase in activity of superoxide dismutase in neonatal rats.; 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

An Experimental Study on the Efficacy of Vitamin E against Oxygen Toxicity.: Sung Gyu Lee, Sang Il Lee, Soo Hun Cho, Dork Ro Yun; Korean J Prev Med. 1986;19(2):184-192.

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Abstract PDF: Since the wide spread application of hyperbaric oxygenation in clinical setting, the problems of oxygen toxicity have been attracting a deep interest from the researchers on hyperbaric medicine as a practical issue. Among extensive research trials, the study on the protective agents against oxygen toxicity occupied one of the most challenging field. As the mechanisms of oxygen toxicity, the role of the oxygen free radicals produced by peroxidation process are strongly accepted by the leading researchers on oxygen toxicity, the probable protective effects of antioxidant against oxygen toxicity are sustaining a sufficient rationale. In this study, the author attempted to evaluate the effect of vitamin E as a protective agent against oxygen toxicity through the observation of death rate, convulsion rate, time to convulsion, and macroscopic and microscopic pathological changes of experimental rats exposed to 100% oxygen at 5 ATA for 120 minutes. The findings observed are as follows: 1) The death rate, convulsion rate, time to convulsion, organ/body weight ratio and microscopic pathological findings were identified as reliable objective and quantitative indices for oxygen toxicity. 2) Vitamin E showed excellent protective effects against CNS and pulmonary oxygen toxicity as a strong antioxidant. The most effective dose seemed to be around 400 mg/kg. 3) The results of this study are supporting the oxygen free radical hypothesis on oxygen toxicity.; Summary

Influence of Intrauterine Position on Fetal Weight in albino Rats Exposed to Carbon Monoxide.: Soo Hun Cho, Jang Seok Choi, Dork Ro Yun; Korean J Prev Med. 1986;19(1):123-129.

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Abstract PDF: Fetal weight data from 84 litters of Sprague-Dawley rats were statistically analyzed for the effect of position in the uterine horn on fetal weight. The standard score obtained from the mean weight and standard deviation of all fetuses in a uterine horn were studied for position effect. In control group, the heaviest fetus occupied the middle position with a progressive decrease in weights toward the ovarian and cervical ends of the horn. But the effect related to position for the fetal weight was not statistically significant. In contrast, rats acutely or chronically exposed to carbon monoxide showed statistically significant positional differences of fetal weight within the uterine horns. The findings that the intrauterine position effect on fetal weight which is not significant in control group may act one of confounders at the situation of transplacental toxicological studies.; Summary

A Study on the Incidence of Carbon Monoxide Poisoning.: Soo Hun Cho, Young Soo Shin, Doek Hyoung Lee, Yong Ik Kim, Dork Ro Yun; Korean J Prev Med. 1985;18(1):1-11.

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Abstract PDF: A decade ago a survey on the population-base incidence rate of anthracite coal gas(mainly carbon monoxide) poisoning in Seoul area was investigated, resulting in the incidence rate of 306/10,000 risk population and 1 death/10,000. Another survey on the carbon monoxide poisoning was investigated during 1 year period from Apr. 1983 to Mar. 1984. Total subjects of risk population were 67,740 households covering 353,287 persons. The major findings of this survey are as follows: 1. Household-base incidence rate was 8.4%; spell-base 10.4%. 2. The incidence rate was the highest in houses having each of slate roof, cement wall, vinyl floor of bedroom and direct 'ondol' heating system. 3. Average 2.1 person was attacked from one incidence of the poisoning; severity-wise person-base incidence rates per 10,000 were 352 in mild poisoning, 54 in severe poisoning and 1.4 in death-overall incidence rate 407. Several facts were identified which supported that this figure was moderately underestimated. As the incidence of the poisoning is affected by socioeconomic and environmental factors, it is natural that one expects the incidence will decrease in proportion to general improvement of the above factors. Thus the results of these two surveys seemed preposterous. But further study suggested that the incidence rate (306/10,000) decade before had been significantly underestimated and corrected-rate should have been 478/10,000 level. 4. Age and sex distribution by the degree of the poisoning was uniform with little statistical difference; overall incidence rates by sex were 339/10,000 in male and 475/10,000 in female with significant statistical difference(p<.01). 5. 5.3% of the patients were treated at hospital or local clinic; 3.0% of the patients were hospitalized. Admission rate in comatose patient(severe poisoning) was 14.2%. In conclusion, carbon monoxide poisoning remains a major health problem by now.; Summary

An Epidemiological Study on the Neurological Sequelae of Acute Carbon Monoxide Poisoning.: Byung Joo Park, Soo Hun Cho, Yoon Ok Ahn, Young Soo Shin, Dork Ro Yun; Korean J Prev Med. 1984;17(1):5-24.

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Abstract PDF: There has been an immense need for elaborate studies on the complications and the neuological sequelae generated by acute carbon monoxide (CO) poisoning which is highly prevalent in Korea due to widespread adoption of the anthracite coal briquette as domestic fuel for heating and for cooking. For this epidemiological study, a total of 444 subjects who received hospital emergency care for acute CO poisoning during the period of March 1982 February 1983 were randomly selected from the emergency patients's lists of 13 general hospitals in Seoul area. Informations on the neurological sequelae were elucidated by means of home visiting with prearranged questionnaire consisting questions and concise neurological examination. The findings obtained were summarized as follows; 1. The complications were found in 18% of the surveyed and acute decubitus was comprised 67.5% of the complications. 2. The total cumulative incidence of the neurological sequelae was 41.2 per 100 patients and the absolute incidence rate regardless of the duration after poisoning was 40.8%. 3. The incidence of the neurological sequelae was higher in the older age than in the younger and also higher in female than in male. Twice higher incidence was observed in the admitted patients than in the non-admitted patients and the incidence became higher in proportion to the duration of CO exposure, coma and admission. The poorer the consciousness level of patients found, at emergency room and at discharge, the higher the incidence. The incidence of the neurological sequelae by emergency care was higher in hyperbaric oxygen therapy group(51.9%) than in 100% O2 group(38.0%). 4. A total of five variables significantly associated with the occurrence of the neurological sequelae were selected by the stepwise discriminant analysis. The variables were following course of emergency care, age, consciousness level at discharge, admission duration, and consciousness level at emergency room in their sequence of discriminant power. Eight variables were selected as those associated with the degree of the neurological sequelae through the stepwise multiple regression analysis. Of these variables, the acute decubitus alone explained 21.1% of the total variation and all the eight variables could explain 36.5% of the same. The remaining seven variables listed in the order of their relative importance were: age, consciousness level at discharge, admission duration, coma duration and consciousness level at emergency room. 5. It was postulated that unexpectedly high incidence of the neurological sequelae of the CO poisoning in this epidemiological study was mainly due to the inadequate emergency care and the lack of efficient and sophisticated treatment measure. In the effort to minimize the incidence of grave neurological sequelae of acute CO poisoning, new guidelines for the emergency care and treatment should be pursued with efficient ways.; Summary

Hyperbaric Oxygen Treatment in Acute CO Poisoning.: Dork Ro Yun, Soo Hun Cho; Korean J Prev Med. 1983;16(1):153-156.

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Abstract PDF: No abstract available.; Summary

An Investigation on Acute Drug Intoxication.: Soo Hun Cho; Korean J Prev Med. 1977;10(1):25-33.

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Abstract PDF: The epidemiological informations on 1828 cases of acute drug intoxication admmitted to the emergency rooms of 5 general hospitals, 4 in Seoul City and 1 in Incheon City from Jan. 1974 to Dec. 1974, were reviewed for statistical analysis. More detailed information on 796 cases from 3 hospitals were available in terms of the causative agent. The general findings obtained are as follows; 1. The sex ratio of the patient is 1.26 females to 1 male and this figure is almost consistent with the reports of previous authors. 49.7% of total cases were found in the age group of 20-29, which indicate the highest in percent distribution of age. 2. The incidence of acute drug intoxication was different by the season as the highest in summer and the lowest in winter. 3. As the cause of the intoxication, the attempted suicide occupied the single highest one with 91.7%. 4. The kind of causative agents varies with season as more economic poisons in the summer time and more drugs in the winter time.; Summary

Normal Range of Blood Pressure of Korean.: In Dal Kim, Yoon Ok Ahn, Soo Hun Cho; Korean J Prev Med. 1974;7(2):395-402.

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Abstract PDF: No abstract available.; Summary

Epidemiological Studies on the Acute Carbon Monoxide Poisoning.: Soo Hun Cho, Dork Ro Yun, In Dal Kim; Korean J Prev Med. 1974;7(2):359-366.

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Abstract PDF: No abstract available.; Summary

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