Journal of Preventive Medicine and Public Health

Volume 26(1); March 1993

Original Articles

Recognition and attitude to fundtional division between physicians and pharmacists of practising physicians and pharmacists in Taegu city.: Moo Sik Lee, Nung Ki Yoon, Suk Kwon Suh, Jae Yong Park; Korean J Prev Med. 1993;26(1):1-19.

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Abstract PDF: Mail questionnaire was administrated to 370 practising physicians and 388 pharmacists in Taegu city selected by systematic sampling to examine utilization states and opinion of pharmacy under medical care insurance programme and the attitude to the functional division between physicians and pharmacists from April to May 1992. Regarding the opinion on the outcome of drug-store under medical insurance, 71.2 percent of practicing physician answered failure but 13.4 percent of practicing pharmacists answered failure in contrast. Fifty percent of practicing physician asserted introducing functional division between physician and pharmacist while 66.9 percent of practicing pharmacist answered drug-store under medical insurance itself is successful programme. Average daily numbers of preparation of medicine was 32.2 case. Percentage of utilization of drug-store under medical insurance to average daily cases of preparing of medicine was 20 percent, percentage of utilization with physician's prescription was 0.7 percent. And 58.7 percent of practicing physician experienced outside the institute prescription. Regarding the opinion on the pros and cons of enforcing functional division between physician and pharmacist, 59.2 percent of practicing physician preferred pros and 17.7 percent cons ,but 38 percent of practicing pharmacist preferred pros and 45.5 percent cons. And pharmacist know better the content of functional division between physician and pharmacist, practicing emphasized to prevent misuse or abuse of medicine but practicing pharmacist emphasized to display physician and pharmacist's professional ability. And as an opinion on implementation style of functional division between physician and pharmacist in pros respondents, practicing physician favored mandatory enforcement (52.3%), while practicing pharmacist favored partial incomplete functional division (81.7%). As the method of prescription if functional division between physician and pharmacist will be enforced, both practicing physician and pharmacist preferred generic name (44.0%, 89%) mostly, but physician preferred brand name (35.3%) secondly. Regarding the reason for not implementing functional division between physician and pharmacist up to date, both physician and pharmacist answered problem of business right between physician and pharmacist, followed by lack of recognition, and interest of people and lack of the governmental willness. Regarding the opinion on prior decision of condition for enforcing functional division between physician and pharmacist, practicing physician and pharmacist named uneven distribution of medical facilities and drug-store between rural and urban, inequality of physician and pharmacist manpower and the problem of manpower demand and supply mostly, and practicing physician pointed out establishing attitude of acceptance on the part of pharmacist and practicing pharmacist favored establishing attitude of acceptance on the part of physician, which was different attitudes between physician and pharmacist. Following conclusion was reached; 1. Current drug-store under medical insurance program yield insufficient outcome, so we should consider program conversion from drug-store under medical insurance program to functional division between physician and pharmacist. 2. There were problem of business right and conflicts between physician and pharmacist at enforcing functional division between physician and pharmacist, so the government should search for formulating plan to resolve the problem and have neutral willness for the protection of the national health.; Summary

Risk factors of work-related low back pain in manufacturing workers.: Dae Hwan Kim, Jung Ho Kim, Hae Lim Shin, Jin Ho Chun, Yong Wan Kim, Chae Un Lee; Korean J Prev Med. 1993;26(1):20-36.

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Abstract PDF: Work-related low back pain is one of the major factors that cause the loss of working power especially in actively working age, therefore controlling the work-related low back pain is one of the major issues in the field of industrial safety and health. This study was performed for detecting the risk factors and proposing the efficient control program of the work-related low back pain. The subjects were male workers employed at the manufacturing industry in Pusan with longer than 6 month's working duration. The data was collected by self-reported questionnaire and interview from May 1 to October 31, 1992. The contents of questionnaire were as follows : the experience of low back within the recent one month, general characteristics(age, marital status, education level, religion, regular exercise), physical characteristics(height, weight), employment status(working duration, daily working hours, rest during work, satisfaction for the job), type of work and working environments(posture, forward bending, lifting and movement, satisfaction for table and chair). The result was analyzed for 608 entire respondents by case-control comparative method. The number of cases was 152 with a history of work-related low back pain, so the relative frequency of self-reported work-related low back pain was 25.0%, and the number of controls was 344 without any history of low back pain. As a result, two characteristics of the employment status(working duration, satisfaction for the job) and all characteristics of type of work and working environments showed a statistical significance between the case and control groups(p<0.01). The Odds ratios of these variables for Work-related low back pain were calculated. They were 7.88 for the satisfaction for chair, 7.86 for lifting and movement, 3.31 for satisfaction for table, and 2.22 for bending forward(p<0.01). And for the multivariate logistic regression analysis confirmed that unsatisfaction for table was independent risk factor for Work-related low back pain. In summary, though this study was based upon the self-reported questionnaire and the subjective complaints, the satisfaction for chair, lifting and movement, satisfaction for table, and bending forward concerned with the type of work and working environments were considered as the main factors causing the work-related low back pain, and the work-related low back pain may be preventable by the ergonomic control of these factors.; Summary

A study on the development of low back pain and the risk factors of manufacturing workers.: Am Park; Korean J Prev Med. 1993;26(1):37-48.

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Abstract PDF: This study was conducted to investigate the prevalence rate of low back pain during past one year and its risk factors. The data were collected form 1,384 manafacturing factory workers from March 1, 1992 to August 30, 1992. The results obtained were as follows: 1. The one year prevalence rate of low back pain by manufacturing company was 38.4% in textile manufacturing, 35.2% in concrete reenforcement, 31.0% in cigarette and 26.1% in metal part(P<0.01). 2. In textile manufacturing, age groups with high prevalence rate of low back pain were 30's (36.8%) and 40's (36.4%) (P<0.05), and the one year prevalence rates of low back pain by marital state were 34.9% in married workers and 28.5% in unmarried(P=0.0511). 3. The one year prevelence rates of low back pain by job part are 35.0% in labor workers and 26.1% in clerical(P<0.05), and by work hour per day it was 34.9% in 9 or more and 28.9% in 8 or less (P<0.05). 4. The highest group of low back pain by work posture was 43.5% in 'lifting and transfering materials', and it by fitness of chair was 56.0% in uncomfortable one, and by height of working board was 33.6% in low working one. 5. In logistic regression analysis, significant determinants with low back pain were marital state (P<0.05), work hour per day(P<0.05), height of working board(P<0.01), and work posture(P<0.01).; Summary

Assessment of renal function in silicosis with urinary N-acetyl-beta-D-glucosaminidase activity.: Hoo Rak Lee, Don Kyoun Kim, Su Ill Lee, Byung Mann Cho, Wha Jo Kim; Korean J Prev Med. 1993;26(1):49-64.

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Abstract PDF: To provide the basic for assessment of renal dysfunction related to silicosis, urinary N-acetyl-beta-D-glucosaminidase(NAG) activity known as a sensitive markers for early renal damage were measured in 58 silicosis patients, and control subjects of 40 pulmonary tuberculosis patients and 51 official workers. The results were summarized as follows. 1. The values of blood urea nitrogen and serum creatinine in all subjects were within reference limits. But the mean value of urinary NAG activity(7.25+/-7.31 U/g creatinine) was beyond reference value and more sensitive test than others. 2. The mean value of urinary NAG activity in silicosis group was 11.98+/-9.05 U/g creatinine and significantly higher than in tuberculosis and healthy group(p<0.01), but the mean values of NAG activity in tuberculosis and healthy group were not different(p>0.05). 3. The value of NAG activity in tuberculosis had a tendency to be increased according to severity of disease, but that was not significant(p>0.05). The value of NAG activity was increased significantly by use of nephrotoxic antituberculosis drugs(p<0.05). 4. The value of NAG activity in silicosis had a tendency to be increased according to the size of nodule, use of nephrotoxic antituberculosis drugs and shortness of onset duration, but the increase was not significant(p>0.05). 5. After excluding the users of nephrotoxic antituberculosis drugs, the mean values of NAG activity in healthy control and in tuberculosis control were same as 3.63 U/g creatinine and 3.60 U/g creatinine, respectively. But the mean value of NAG activity in silicosis group was remarkably increased as 10.90 U/g creatinine(p<0.01). As above results, even though there are no abnormal findings in screening renal function test, silicosis can be related with renal dysfunction. And it will be very useful to apply urinary NAG activity in health management of workers exposed to dust.; Summary

Relationship Between The Biological Lead Exposure Indices And Air Lead Concentrations Measured By Personal Air Samplers.: Haeng Ryeol Lee, Jung Man Kim, Kap Yull Jung, Joon Youn Kim; Korean J Prev Med. 1993;26(1):65-73.

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Abstract PDF: This study was carried out to evaluate the relationship between the biological lead exposure indices and air lead concentrations measured by personal air samplers. The 72 occupationally lead exposed workers were observed and the biological lead exposure indices chosen for this study were blood lead(PuB), urine lead(PbU), zinc protoporphyrin in whole blood(ZPP), gamma-aminolevulinic acid in urine(ALAU), gamma-aminolevulinic acid dehydratase activity(ALAD), coproporphyrin in urine(CPU) and hemoglobin(Hb). The workers were divided into four groups by air lead concentrations: Group I; under 0.05 mg/m3, Group II; 0.05-0.10 mg/m3, Group III; 0.10-0.15 mg/m3 and Group IV; and over 0.15 mg/m3. For evaluation the relationship between the biological lead exposure indices and air lead concentrations was used as correlation coefficients. The results obtained were as follows: 1. In Group I, II, III and IV, the mean value of PbB were 25.45+/-1.84 microgram/dl, 27.87+/-3.53 microgram/dl, 31.21+/-1.76 microgram/dl and 47.02+/-13.96 microgram/dl. Between Group IV and other groups showed statistically significant difference(p<0.05). 2. There was an increasing tendency of PbB, PbU, ALAU and ZPP according to the increase the mean air lead concentration, while ALAD has decreasing tendency. CPU and Hb did not show any constant tendency. 3. Correlation coefficients between PbB, PbU, ZPP, ALAU, ALAD, CPU, Hb and air lead concentration were 0.95, 0.83, 0.89, 0.72, -0.83, 0.51 and -0.45 respectively, and regression coefficient between PbB(Y) and PbA(X) was Y=126.8746X+16.9996(P<0.01).; Summary

A study of succiny trialanine p-nitroanilide hydrolytic activity in workers exposed to organic solvents.: Hae Ju Oh, Jae Hoon Roh; Korean J Prev Med. 1993;26(1):74-85.

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Abstract PDF: To measure the serum succinyl trialanine p-nitroanilide hydrolytic activity as new index of liver function in workers exposed to organic solvents, this study conducted 114 workers in department of shoe-making of shoes factories. The results obtained from this study were as follows: 1. The mean values of serum GOT, GPT, gamma GT in whole workers were 22+/-12.32, 20+/-9.65, 28+/-21.35IU/l, respectively and the mean value of serum STN hydrolytic activity was 0.08 0.05. 2. The serum STN hydrolytic activity was significantly higher for male(p<0.05) and there was no difference among the groups of age. 3. There was no difference in the groups by working hours but significant difference in persons who worked over 3 years or were exposed to toluene over 100ppm(p<0.05). 4. The correlation of the exposed dose of toluene and serum GOT, GPT, gamma GT and serum STN hydrolytic activity were statistically significant(r=0.027-0.518). 5. The exposed dose of toluene was most explainable variable and statistically significant among the factors affecting serum STN hydrolytic activity(p<0.05).; Summary

Perception and attitude toward group health management and service system for small and medium industries in Inchon.: Chong Yon Park, Jae Hoon Roh, Kyoo Sang Kim, Kyung Jong Lee, Young Hahn Moon; Korean J Prev Med. 1993;26(1):86-95.

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Abstract PDF: To investigate perception and attitude toward Group Health Management and Services System for Small and Medium Industries, a survey using self-administered questionnaire was conducted to a part of industries in Inchon, at October 1992. Major dependent variables were perception, attitude, and practice related with Group Health Management and Service System; these variables were measured by 3-point Likert like scale consisted of 7, 5, and 5 items, respectively. Data were collected in 149 industries, 72.7% out of 205. Perception was slightly high, 1.25; attitude was some positive, 1.46; and practice was some passive, 0.94. Major determinants of perception, attitude, and practice were sex and age of industry's health manager; perception influenced upon attitude, and perception and attitude had positive effect upon practice. To activate Group Health Management and Service System, it is necessary to develop education and promotion programs for industry's health managers of small and medium industries.; Summary

The Change In Blood Pressure And Factors Affecting The Change In Blood Pressure For Korean Children: A Six-Year Follow-Up Study.: Il Suh, Soon Young Lee, Chung Mo Nam, Il Soon Kim; Korean J Prev Med. 1993;26(1):96-109.

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Abstract PDF: For the purposes of analyzing the distribution and the change in blood pressure according to age and determining the factors affecting the change in blood pressure, a follow-up study had been conducted for 6 years from 1986 to 1991 for 430 primary school children age 6 years old in 1986 in Kangwha County, Korea. The mean blood pressure increased according to age. Specifically mean systolic blood pressure increased from 97.3 mmHg for male and 96.4mmHg for female(at 6 years of age) to 108.8mmHg for male and 112.1mmHg for female(at 11 years of age). Mean diastolic blood pressure increased from 60.0mmHg for male and 61.8mmHg for female(at 6 years of age) to 72.9mmHg for male 73.8mmHg for female(at 11 years of age). The average annual increase in blood pressure was 2.3mmHg(in systolic blood pressure) and 2.4mmHg(in diastolic blood pressure) for female, respectively. To determine the factors affecting the change in blood pressure, the stepwise regression analysis was conducted. Children were divided into the three groups(low, middle, and upper) according to the level of systolic and diastolic blood pressure at the age of 6, and the regression analysis was performed in each group. For the change in systolic blood pressure, the changes in weight and skinfold thickness or initial skinfold thickness for male, and the change in weight for female were selected as significant factors for children in middle and upper group. For the change of blood pressure in diastolic blood pressure, no variables was significant.; Summary

Some hair mineral contents of non-violent criminal and normal control.: Sung Cheul Hong, Doo Hie Kim; Korean J Prev Med. 1993;26(1):110-125.

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Abstract PDF: This study was designed to determine whether non-violent criminal and normal control on the basis of concentration of levels of trace mineral and toxic metal by analysis of human scalp hair. The subjects were selected 87 nonviolent criminal from a prison population and 120 normal control from periodic health checks for study. Hair samples were taken from the napes and Minnesota Multiple Personality Inventory(MMPI) was performed also. Five trace mineral(Zn, Cu, Mg, Fe, Na) and two toxic metal(lead, cadmium) contents were determined by an atomic absorption spectrometer. The contents of zinc and magnesium in hair of non-violent criminal were significantly lower than the control group(p<0.01). In the case of lead and cadmium, mean value of criminal group was significantly higher than control group. Significantly higher T-score of MMPI was seen in non-violent criminal group for psychopathic deviate (Pd), paranoia scale(Pa), and Mania scale(Ma) than control group, but T-score of depression scale(D) was significantly higher in the control group. In the non-violent criminal group, the content of copper inversely proportion to T-score of Hs, D, Hy, Pd, Mf, Pa, Pt, Sc, Si except Ma, also Zinc inversely proportion to T-score of Hy, Mf, Pa, Pt. These results suggest that difference of some hair mineral contents exist between criminal and normal control group. Thus further studies are necessary to determine whether violent and nonviolent criminal group attributed biochemical imbalance with carefully constructed and controlled studies.; 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

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

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