Journal of Preventive Medicine and Public Health

Young Hwangbo

7 Articles

Effects of Comorbid Sleep Disorders on Cardiovascular Complications of Hypertension Among Patients With Newly-diagnosed Hypertension: An Analysis of the Korean National Health Insurance Service-National Sample Cohort: Jeongmook Kang, Yoon-Hyung Park, Kwang Ik Yang, Jose Rene Bagani Cruz, Young Hwangbo; J Prev Med Public Health. 2020;53(1):37-44. Published online November 6, 2019; DOI: https://doi.org/10.3961/jpmph.19.248

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Objectives
This study investigated the effects of comorbid sleep disorders (SD) on the incidence of cardiovascular complications among newly-diagnosed hypertension (HTN) patients.
Methods
As study population, 124 057 newly-diagnosed essential HTN patients aged 30 or older, without cardiovascular complications at diagnosis with HTN, were selected from the National Health Insurance Service-National Sample Cohort. The incidence of cardiovascular complications was calculated, Cox proportional-hazards regression model was used to analyze the risk of complications, and the population attributable fraction (PAF) for cardiovascular complications of having comorbid SD at HTN diagnosis was calculated.
Results
Over 10 years, 32 275 patients (26.0%) developed cardiovascular complications. In HTN patients with comorbid SD at diagnosis of HTN, the incidence of cardiovascular complications (78.3/1000 person-years; 95% confidence interval [CI], 75.8 to 80.9) was higher than in those without comorbid SD (58.6/1000 person-years; 95% CI, 57.9 to 59.3) and the risk of cardiovascular complications was 1.21 times higher (95% CI, 1.17 to 1.25), adjusting for age, gender, income, area of residence, and comorbid diabetes mellitus. The PAF of having comorbid SD at diagnosis of HTN for the incidence of cardiovascular complications was 2.07% (95% CI, 1.69 to 2.44).
Conclusions
Newly-diagnosed essential HTN patients aged 30 or older who had comorbid SD at the time of their HTN diagnosis had a higher incidence of cardiovascular complications than those without comorbid SD. Age, gender, income, area of residence, and comorbid diabetes mellitus had a significant effect on the incidence of cardiovascular complications. Approximately 2% of cardiovascular complications were found to occur due to the presence of SD.

Summary

Korean summary
본 연구 결과 심뇌혈관 합병증이 없었던 30세 이상 신규 일차성 고혈압 환자에서 고혈압 진단시 수면장애을 동반한 경우 심뇌혈관합병증 발생율은 78.3/1000인년(95% CI 75.8-80.9)으로 나타났으며, 수면장애을 동반하지 않은 경우 심뇌혈관합병증 발생율은 58.6/1000인년(95%CI 57.9-59.3)인 것으로 관찰되었다. 고혈압 진단시의 연령, 성별, 수입, 거주지역, 동반된 당뇨병력을 보정한 다중회귀분석에서 수면장애병력이 있는 고혈압 환자군의 심뇌혈관합병증 발생 위험도는 수면장애병력이 없는 환자에 비하여 1.21배(95% CI 1.17-1.25) 높은 것으로 나타났으며, 연구대상자에게 발생한 심뇌혈관합병증의 약 2%는 고혈압 진단시 동반된 수면장애가 기여한 것으로 분석되었다.

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Association Between Sleep Quality and Anxiety in Korean Adolescents
Hyunkyu Kim, Seung Hoon Kim, Sung-In Jang, Eun-Cheol Park
Journal of Preventive Medicine and Public Health.2022; 55(2): 173. CrossRef

A Trend Analysis of the Prevalence, Awareness, Treatment, and Control of Hypertension by Age Group: Jong Youn Moon, Kwan Jun Park, Young Hwangbo, Mee Ri Lee, Byoung In Yoo, Jong Hye Won, Yoon Hyung Park; J Prev Med Public Health. 2013;46(6):353-359. Published online November 28, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.6.353

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Abstract PDF

Objectives

We examined the trends in prevalence, awareness, treatment, and control of hypertension in Korea as a basis for improving hypertension control programs.

Methods

12 598 participants of the Korean National Health and Nutrition Examination Survey were included in this study. Weighted linear regression to test time trends from 2007 to 2011 was performed.

Results

The prevalence of hypertension was 20.7% in 2007, 29.4% in 2009, and 26.2% in 2011. Awareness of hypertension was 64.8% in 2007 and 61.1% in 2011. Awareness in those aged 65 and over was greater than in younger groups (age 19 to 44 and 45 to 64; p<0.001). The treatment rates were 58.4% in 2007 and 56.8% in 2011. The treatment rate was greater for those 65 and over than for younger age groups (p<0.001). The percentage of controlled hypertension was 37.6% in 2011. The percentage of controlled hypertension in those 65 and over was higher than in younger age groups (p<0.001). The treatment-control rates were 65.9% in 2007 and 67.7% in 2011. The prevalence of hypertension was higher in the males (p<0.001), while the awareness (p<0.001), treatment (p<0.001), and control (p<0.001) rates were higher in the females.

Conclusions

The prevalence of hypertension was increasing and the hypertension awareness, treatment, and control rates were low in younger age groups and males.

Summary

Citations

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Evaluation of Field Epidemiology Specialist Training Program Based on the Satisfaction and the Changes of Educational Needs.: No Rai Park, Ihn Sook Jeong, Jong Gu Lee, Young Taek Kim, Jin Ho Chun, Ki Soon Kim, Sang Soo Bae, Jong Myon Bae, Gyung Jae Oh, Hee Chul Ohrr, Kun Sei Lee, Byung Kook Lee, Hun Jae Lee, Hyun Sul Lim, Young Hwangbo; J Prev Med Public Health. 2004;37(1):80-87.

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Abstract PDF: OBJECTIVE
To evaluate the learning achievement and satisfaction levels for the Field Epidemiology Specialist Training Program (FESTP), on infectious disease control between March 19 and October 31, 2002. METHODS: The FESTP was designed as a set of 84 hours curricula including lectures, discussions, self-studies, and field practicals, and organized both centrally and locally by the Division of Communicable Disease Control of the National Institute of Health and 11 universities. Before and after the program, a questionnaire survey on the educational need (49 items) and satisfaction (15 items) was conducted on 484 trainees, who were responsible for communicable disease control and immunization at 242 regional health centers. The data were analyzed with paired t-tests for comparison of the educational needs between the pre and post scores. RESULTS: The average score for satisfaction was 3.06 out of 5.0; with relatively higher scores for sincerity (4.10) and professionalism (4.01) of the tutors, adequacy (3.54) and clearness (3.51) of the evaluation criteria, usefulness (3.54) and fitness (3.52) of the contents, but with relatively lower satisfaction for schedule (2.96) and self-studies (2.91). The average for requirement for education improved, as shown by the decrease from 2.72 to 2.22 (p< .0001) with the biggest decrease in the outbreak investigation from 2.60 to 2.08. CONCLUSION: The FESTP was evaluated as being effective, the trainees showed moderate satisfaction and decrease educational needs. However, the actual schedules and self-studies should be rearranged to improve the satisfaction level.; Summary

The change of validity of blood zinc protoporphyrin test by different cut-off level in level workers.: Yong Bae Kim, Hyun Cheol Ahn, Young Hwangbo, Gap Soo Lee, Sung Soo Lee, Kyu Dong Ahn, Byung Kook Lee; Korean J Prev Med. 1997;30(4):741-751.

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Abstract PDF: Measurement of blood lead (PbB) and blood zinc protoporphyrin (ZPP) are most common biological indices to identify the individual at risk for excess or the health sequences by lead exposure. Because PbB is known most important and reliable index of lead exposure, PbB is often regarded as a gold standard to detect lead exposure. But in Korea PbB is a secondary test item of detailed health check-up with positive finding of screening test in most occasion. Our lead standard requires all lead workers to take annual heath-check twice a year for investigation of their health effect due to lead exposure. Blood ZPP is one of most important index to detect high lead absorption in lead workers as a screening test. Measurement of blood ZPP is known well to correlate with PbB in steady state of exposure in most lead workers and is often used as a primary screening test to detect high lead absorption of lead workers with the advantage of simplicity, easiness, portability and low cost. The current cut-off criteria of blood ZPP for further detailed health check-up is 100 ng/dl which is supposed to match the level of 40 ng/dl of PbB according to our standard. Authors tried to investigate the validity of current criteria of cut-off level(100 ng/dl) of blood ZPP and possible another better cut-off level of it to detect the lead workers whose PbB level over 40 ng/dl. The subjects in our study were 212 male workers in three small scale storage battery industries. Blood ZPP, PbB and hemoglobin(Hb) were selected as the indices of lead exposure. The results were as follows. 1. The mean of blood ZPP, PbB and Hb in lead workers were 79.5+/-46.7 ng/dl, 38.7+/-15.1 ng/dl, and 14.8+/-1.2 g/dl, respectively. There were significant differences in blood ZPP, PbB and Hb by industry(P<0.01). 2. The percents of lead workers whose blood ZPP were above 100 ng/dl in the group of work duration below 1, 1-4, 5-9 and above 10 years were 8.6%, 17.2%, 47.6%, and 50.0%, respectively. The percents of lead workers whose PbB were above 40 ng/dl in those were 31.4%, 40.4%, 71.4%, and 86.4%, respectively. 3. The percents of lead workers whose PbB were below 40 ng/dl, 40-59 ng/dl and above 60 ng/dl were 54.7%, 34.9% and 10.4%, respectively. Those of lead workers whose blood ZPP were below 100 ng/dl, 100-149 ng/dl and above 150 ng/dl were 79.2%, 13.7% and 7.1%, respectively. 4. Simple linear regression of PbB on blood ZPP was statistically significant(P<0.05) and as PbB was 40 ng/dl, blood ZPP was 82.1 ng/dl. 5. While the highest sensitivity and specificity of blood ZPP test to detect lead workers with PbB over 40 ng/dl were observed in the cut-off level of 50 ng/dl and 100 ng/dl of blood ZPP, respectively, the highest validity(sensitivity+specificity) of blood ZPP to detect lead workers with PbB over 40 ng/dl was observed in the cut-off level of around 70 ng/dl of blood ZPP. But even with optimal cut-off level of around 70 ng/dl of blood ZPP, still 25.0% of false negative and 20.7% false positive lead workers were found. As the result of this study, it was suggested that reconsideration of current blood ZPP cut-off of our lead standard from 100 ng/dl to somewhat lower level such as around 70 ng/dl and the inclusion of PbB measurement as a primary screening test for lead workers was highly recommended for the effective prevention of lead workers.; Summary

A study on lead exposure indices of male workers exposed to lead less than 1 year in storage battery industries.: Young Hwangbo, Yong Bae Kim, Gap Soo Lee, Sung Soo Lee, Kyu Dong Ahn, Byung Kook Lee, Joung Soon Kim; Korean J Prev Med. 1996;29(4):747-764.

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Abstract PDF: This study intended to obtain an useful information for health management of lead exposed measuring the lead exposure indices and workers and determine biological monitoring interval in early period of exposure by work duration in all male workers (n=433 persons) exposed less than 1 year in 6 storage battery industries and in 49 males who are not exposed to lead as control. The examined variables were blood lead concentration(PBB), Zinc-protoporphyrin concentration(ZPP), Hemoglobin(HB) and personal history; also measured lead concentration in air(PBA) in the workplace. According to the geometric mean of lead concentration in the air, the factories were grouped into three categories: A; When it is below 0.05mg/m3, B; When it is between 0.05 and 0.10mg/m3, and C; When it is above 0.10mg/m3. The results obtained were as follows: 1. The means of blood lead concentration(PBB), ZPP concentration and hemoglobin(HB) in all male workers exposed to lead less than 1 year in storage battery industries were 29.5+/-12.4 microgram/100ml, 52.9+/-30.0 microgram/100ml and 15.2+/-1.1 gm/100ml. 2. The means of blood lead concentration(PBB), ZPP concentration and hemoglobin(HB) in control group were 5.8+/-1.6 microgram/100ml, 30.8+/-12.7 microgram/100ml and 15.7+/-1.6 microgram/100ml, being much lower than that of study group exposed to lead. 3. The means of blood lead concentration and Zpp concentration among group A were 21.9+/-7.6 microgram/100ml, 41.4+/-12.6 microgram/100ml; those of group B were 29.8+/-11.6 microgram/100ml, 52.6+/-27.9 microgram/100ml; those of group C were 37.2+/-13.5 microgram/100ml, 66.3+/-40.7 microgram/100ml. Significant differences were found among three factory group(P<0.01) that was classified by the geometric mean of lead concentration in the air, group A being the lowest. 4. The mean of blood lead concentration of workers who have different work duration(month) was as follows; when the work duration was 1-2 month, it was 24.1+/-12.4 microgram/100ml,; When the work duration was 3-4 month, it was 29.2+/-13.4 microgram/100ml; and it was 28.9+/-34.5 microgram/100ml for the workers who had longer work duration than other. Significant differences were found among work duration group(P<0.05). 5. The mean of ZPP concentration of workers who have different work duration(month) was as follows; When the work duration was 1 2 month, it was 40.6 18.0 g/100ml, When the work duration was 3-4 month, it was 53.4+/-38.4 microgram/100ml; and it was 51.5+/-60.4 microgram/100ml for the workers who had longer work duration than other. Significant differences were found among work duration group(P<0.05). 6. Among total workers(433 person), 18.2% had PBB concentration higher than 40 microgram/100ml and 7.1% had ZPP concentration higher than 100 microgram/100ml; In workers of factory group A, those were 0.9% and 0.0%; In workers of factory group B, those were 17.1% and 6.9%; In workers of factory group C, those were 39.4% and 15.4%. 7. The proportions of total workers(433 person) with blood lead concentration lower than 25 microgram/100ml and ZPP concentration lower than 50 microgram/100ml were 39.7% and 61.9%, respectively; In workers of factory group A, those were 65.5% and 82.3%; In workers of factory group B, those were 36.1% and 60.2%; In workers of factory group C, those were 19.2% and 43.3%. 8. Blood lead concentration (r=0.177, P<0.01), ZPP concentration (r=0.135, P<0.01), log ZPP (r=0.170, P<0.01) and hemoglobin (r=0.096, P<0.05) showed statistically significant correlation with work duration (month). ZPP concentration (r=0.612, P<0.01) and log ZPP(r=0.614, P<0.01) showed statistically significant correlation with blood lead concentration. 9. The slopes of simple linear regression between work duration(month, independent variable) and blood lead concentration(dependent variable) in workplace with low air concentration of lead was less steeper than that of poor working condition with high geometric mean air concentration of lead. The study result indicates that new employees should be provided with biological monitoring including blood lead concentration test and education about personal hygiene and work place management within 3~4 month.; Summary

Follow-up Management State of Lead Battery Workers in Periodic Health Examination.: Gap Soo Lee, Young Hwangbo, Yong Bae Kim, Hwa Sung Kim, Jung Oh Ham, Sung Soo Lee, Kyu Dong Ahn, Byung Kook Lee, Jung Hur; Korean J Prev Med. 1996;29(4):733-746.

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Abstract PDF: To evaluate the follow-up management state and related factor of lead battery workers in periodic health examination as part of program of group occupational health service, author studied 293 workers with questionnaire on knowledge of results and follow-up management state and related factors, and compared the responses to their periodic health examination result charts. The results were as follows: 1. 252(86%) workers responsed that they had received the health examination result chart, but only 116(39.6%) workers responsed that they had been educated or explained about the result of health examination, and 11(57.9%) workers among 19 workers with non-occupational disease D, 101(44.3%) workers among 228 workers with non-occupational disease C, and 19(28.4%) workers among 67 workers with occupational disease C knew accurately their health examination results. 2. 78(24.8%) of the workers responsed that they had follow-up management, and contents of follow-up management were follow-up(36.6%), out-patient treatment(31%), change worksite(8.5%), temporary retirement(7.0%) and others(16.9%). 3. Most of the workers responsed that the health examination were necessary, but three-fourths of the workers responsed that the health examination had been superficial or that they didn't know. 4. In this study, follow-up management show significant association with only explanation or education about health examination result chart.; Summary

A study on renal function indices in lead exposed male workers.: Sung Soo Lee, Young Hwangbo, Kyu Dong Ahn, Byung Kook Lee, Joung Soon Kim; Korean J Prev Med. 1995;28(2):421-432.

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Abstract PDF: The influence of lead exposure on renal function was studied. Eighty nine lead exposed workers who worked in 2 storage battery factories, and seventy one control workers were chosen for this study. Blood lead(pbB) and zinc protoporphyrin in whole blood(ZPP) were selected as indicators of lead exposure. As indicators of renal function, urinary N-acetyl-beta-D-glucosaminidase(NAG), blood urea nitrogen(BUN), serum creatinine(S-Cr), total protein in urine(U-Tp),and serum uric acid(S-Ua) were selected. The results obtained were as follows: 1. while the mean values of lead exposure indicators of lead workers were significantly different from non-exposed ones, the mean values of NAG, U-TP, BUN and S-Cr of renal function indicators of exposed were also significantly different from non-exposed but their mean values were all within normal limits. 2. BUN, logarithmic U-TP, logarithmic NAG and S-Cr showed statistically significant correlation with pbB. 3. The proportion of workers whose values of renal function indicators were over the normal limits(NAG7.5 U/g cr; U-TP 10.9mg/dl; BuN20 mg/dl; S-Cr1.2 mg/dl; S-Ua7.0 mg/dl) by the level of lead absorption in terms of pbB and ZPP were calculated. The proportion of workers with over the normal limits of U-TP among total workers showed the dose-response relationship. when age is adjusted, U-TP showed significantly strong dose-response relationship with the level of pbB and ZPP.; Summary

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