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Volume 36(2); May 2003
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Original Articles
The Exposure Status and Biomarkers of Bisphenol A in Shipyard Workers.
Sang Baek Koh, Cheong Sik Kim, Jun Ho Park, Bong Suk Cha, Jong Ku Park, Heon Kim, Soung Hoon Chang
Korean J Prev Med. 2003;36(2):93-100.
  • 2,233 View
  • 39 Download
AbstractAbstract PDF
OBJECTIVES
Because shipyard workers are involved with various manufacturing process, they are exposed to many kinds of hazardous materials. Welders especially, are exposed to bisphenol-A (BPA) during the welding and flame cutting of coated steel. This study was conducted to assess the exposure status of the endocrine disruptor based on the job-exposure matrix. The effects of the genetic polymorphism of xenobiotic enzyme metabolisms involved in the metabolism of BPA on the levels of urinary metabolite were investigated. METHODS: The study population was recruited from a shipyard company in the K province. A total of 84 shipbuilding workers 47 and 37 in the exposed and control groups, respectively, were recruited for this study. The questionnaire variables included, age, sex, use of personal protective equipment, smoking, drinking and work duration. The urinary metabolite was collected in the afternoon and correction made for the urinary creatinine concentration. The of the CYP1A1, CYP2E1 and UGT1A6 genotypes were investigated using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods with the DNA extracted from venous blood. RESULTS: The urinary BPA level in the welders group was significantly higher than in the control group (p< 0.05). The urinary BPA concentration with the wild type UGT1A6 was higher than the other UGT1A6 genotypes, but with no statistical significant. From themultiple regression analysis of the urinary BPA, the regression coefficient for job grade was statistically significant (p< 0.05). CONCLUSIONS: The grade of exposure to BPA affected the urinary BPA concentration was statistically significant. However, the genetic polymorphisms of xenobiotics enzyme metabolism were not statistically significant. Further investigation of the genetic polymorphisms with a larger sample size is needed.
Summary
Availability of the Time and Change Test in Screening for Dementia in the Elderly.
Jung Ae Rhee, Eun Kyung Chung, Min Ho Shin
Korean J Prev Med. 2003;36(2):101-107.
  • 14,549 View
  • 23 Download
AbstractAbstract PDF
OBJECTIVES
Dementia has emerged as a leading public health problem in elderly persons, and its early detection is important for the treatment of curable cases, and in the educational support for other family members. Although dementia screening tests are available, they have not gained widespread use in community or primary care settings. Our goal was to validate the Time and Change (T and C) Test, -including its validity and reliability in patients, and to assess it as a simple, standardized method for the screening of dementia in the rural elderly. METHODS: The participants in this study comprised of 59 patients from an urban hospital and 405 persons from a rural community aged 65 years or older. The time test evaluated the understanding of clock hands indicating 11: 10, and the change test the ability to make 1, 000 Won from a group of coins, consisting of one 500, seven 100, and seven 50 Won coins. The T and C ratings were validated against a reference standard based on the physician? diagnosis of the patients. The convergent validity in relation to other cognitive measure, test-retest agreement, and inter-observer reliability were assessed. To assess the relationship between the Korean Mini-Mental State Exam (K-MMSE) and the T and C Test, the mean K-MMSE scores were compared with the results of the T and C Test in the elderly from a rural community. RESULTS: The T and C Test had a sensitivity and specificity of 73.0, and 90.9%, and positive and negative predictive values of 93.1, and 66.7%, respectively. The test-retest and inter-observer agreement rates were both 95%. The K-MMSE scores and T and C Test were significantly related in the elderly from a rural community (p< 0.01). The T and C Test was not influenced by the educational status. The Time and Change Tests took a mean of 6.3 and 12.7 seconds, respectively, to complete. CONCLUSION: The T and C Test is a simple, accurate and reliable, performance-based tool in the screening for dementia. Because it is quick, and easy-to-use, it is hoped the T and C Test will be used for the widespread cognitive screening of aging populations.
Summary
Customer's Intention to Use Hospital-based Health Promotion Services.
Myung Il Hahm, Myung Geun Kang, Choon Sun Park, Woo Hyun Cho
Korean J Prev Med. 2003;36(2):108-116.
  • 15,191 View
  • 24 Download
AbstractAbstract PDF
OBJECTIVE
To determine the relationships between customer's attitude, the subjective norm and the intention to use hospital-based health promotion services. METHODS: This study was based on the theory of reasoned action, suggested by Fishbein and Ajzen. The subjects of this study were 501 residents of Seoul, Bun-dang, Il-san and Pyung-chon city, under 65 years, who were stratified by sex and age. A covariance structural analysis was used to identify the structural relationships between attitude towards health promotion programs or services, their subjective norm and their intention to use the aforementioned services. RESULTS: The subjective norm for using the health promotion programs or services provided by hospitals was a significant predictor of the intention to use, but the attitude towards the services was not significant. CONCLUSIONS: Our results suggest that a customer's reference group affects their use of the hospital-based health promotion services. Because the subjects of this study were restricted to specific urban areas, there are limitations to generalizing the study results. Despite the limitations of these results, they can serve as baseline information for the understanding of consumer's behavior toward hospital-based health promotion services.
Summary
Maternal Exposure to Environmental Tobacco Smoke (ETS) and Pregnancy Outcome (low birth weight or preterm baby) in Prospective Cohort Study.
Bo Eun Lee, Yun Chul Hong, Hye Sook Park, Jong Tae Lee, Jeong Youn Kim, Young Joo Kim, Sang Hyun Kim, Kang Jung Goo, Joo Oh Kim, Eun Hee Ha
Korean J Prev Med. 2003;36(2):117-124.
  • 38,374 View
  • 44 Download
AbstractAbstract PDF
OBJECTIVES
This study was performed to examine the relationship between maternal exposure to environmental tobacco smoke (ETS) and pregnancy outcomes (low birth weight or preterm baby) in a prospective cohort study. METHODS: We made a pregnant women's cohort, and followed the pregnancy outcomes, between May 1st 2001 and August 31st 2002. We surveyed 2, 250 women who visited our hospital during their 35th gestational week, with a self-administered questionnaire. The final total of mother-infant pairs analyzed in this study was 1, 712. We used a multiple logistic regression analysis to analyze the effect of maternal ETS on the incidence of preterm or low birth weight, and a linear regression analysis for the birth weight and gestational age. RESULTS: Higher exposure to ETS (> or =1 hours/day) during pregnancy was more negatively associated with the gestational age and birth weight, than no exposure to ETS (no or less than 1hour). Maternal exposure to ETS was associated with preterm baby (adjusted odds ratio (AOR) 1.7; 95% confidence interval (CI) 0.9, 3.3) and low birth weight (AOR 2.3; 95% CI 0.9, 5.5). In addition, we found that maternal ETS may reduce the birth weight by 70g after adjusting for potential confounding factors. CONCLUSIONS: This study suggests that maternal exposure to ETS during pregnancy may increase the frequency of low birth weights and preterm births.
Summary
Community Based Study for Stress and It's Related Factors.
Gyung Jae Oh, Jeong Mi Lee, Sang Sun Kil, Keun Sang Kwon
Korean J Prev Med. 2003;36(2):125-130.
  • 2,241 View
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AbstractAbstract PDF
OBJECTIVES
This study evaluated the stress of community residents using the General Health Questionnaire, GHQ-60, as an instrument of stress measurement. METHODS: The study included 2100 residents, aged 20 and over, living in three areas, a large city, a medium sized city and a rural area, between June and September 2001. A questionnaire interviewing method was used to collect data. The data were analyzed using a t-test, ANOVA, Pearson's correlation coefficients and multiple regression analysis. RESULTS: In this study, the degree of stress, as measured by the GHQ-60, was shown to be significantly higher in the following categories: females, people over 60 years old, people engaged in the primary industries and labor work, low incomes, the divorced and the bereaved, people who received no more than an elementary education, people who suffer from chronic diseases and non-exercisers. A factor analysis suggested that there were three factors of social dysfunction factors; psychosomatic symptom, and depression and anxiety. The social dysfunction factors was statistically significant for the groups described above. The factor of psychosomatic symptoms was statistically significant in the rural residents, and in the groups described above. The depression and anxiety factor was statistically significant in the large city residents, people aged between 20-29 years, students, unmarried persons, university graduates and those having suffered from chronic diseases. From the multiple linear regression analyses, chronic disease, exercise, gender and income, proved to be significant stress related factors. CONCLUSIONS: This study suggests that special attention should be given to the management of the chronic invalided, non-exercisers, females and small income earners, in order to maintain and promote the psychological health of residents in a community.
Summary
Relationships of Smoking, Stress and Social Support of High School Students.
Eun Hyun Lee, Chun Ki Hong, Mi Sook Song, Soon Young Lee, Jee Yoon Kim
Korean J Prev Med. 2003;36(2):131-136.
  • 2,400 View
  • 38 Download
AbstractAbstract PDF
OBJECTIVES
The purpose of the present study was to explore a possible interaction effect of stress and social support on the smoking status and identify smoking related factors of high school students. METHODS: A cross-sectional design was used for this study. A total of 1, 251 high school students from Gyeonggi-do were selected using stratified-proportional random cluster sampling methods. The participants completed a set of questionnaires to measure their smoking status, stress, social support and sociodemographic information. The obtained data were analyzed using descriptive statistics, x2-tests and hierarchical logistic regressions. RESULTS: The interaction effect of stress and social support on smoking status was not supported. However, stress, sex, types of school, parent's smoking and friends' smoking were significantly predicted the smoking status of the high school students. CONCLUSIONS: In relation to the prevention of adolescents' smoking, it is recommended to decrease the stress levels of students, to make adolescents' parents cease smoking, and to educate adolescents on how to refuse the temptation to smoke or pressure from their smoking friend.
Summary
The Effect of Working Noise Exposure and Military Background on the Hearing Threshold.
Kyoo Sang Kim, Ho Keun Chung
Korean J Prev Med. 2003;36(2):137-146.
  • 2,187 View
  • 30 Download
AbstractAbstract PDF
OBJECTIVES
Impaired hearing is a prevalent occupational hazard, not only in industry, but also in the armed forces. In military life, noise has unusual characteristics, and constitutes a serious hazard to hearing. The aim of this study was to analyze the hearing threshold data in order to compare the hearing loss among shipyard workers, representing different workers, and a military service background. METHODS: A cross-sectional audiological survey, combined with a questionnaire study, was conducted on a stratified random sample of 440 shipyard workers, with long-term exposure to noise. The employees were divided into four groups, according to their working and military service backgrounds, in relation to their exposure to noise. RESULTS: As expected, the working and military noise exposure group (Group I) had significantly poorer hearing than the other groups. The high frequencies (2-8 kHz) showed the greatest difference in terms of poorer hearing in both ears. The prevalence of noise-induced hearing loss (NIHL) was highest in Group I. A logistic regression analysis was applied to determine the dependence of the NIHL in relation to age, smoking, drinking, working duration, ear protection, past history of ear diseases, and working and military service backgrounds, on the noise exposure. The important factors found to be related to the NIHL, in relation to noise exposure were: age, work duration, and working and military service backgrounds. The adjusted odds ratio estimates for NIHL in the right ear were 4.5 times greater (95% CI 1.7-11.6) for the military noise exposed group, and 7.9 times greater (95% CI 2.0-31.3) for the working noise exposed group than in the controls. The hearing thresholds at the pure-tone average and 4 kHz were significantly increased with age and work duration with both the working and military service backgrounds. CONCLUSIONS: From these results, specific preventive programs were planned, which should be assessed by epidemiological surveillance of the military noise exposed population.
Summary
Efficient DRG Fraud Candidate Detection Method Using Data Mining Techniques.
Duho Hong, Jung Kyu Lee, Min Woo Jo, Kidong Park, Sang Il Lee, Moo Song Lee, Chang Yup Kim, Yong Ik Kim
Korean J Prev Med. 2003;36(2):147-152.
  • 21,214 View
  • 30 Download
AbstractAbstract PDF
OBJECTIVES
To develop a Diagnosis-Related Group (DRG) fraud candidate detection method, using data mining techniques, and to examine the efficiency of the developed method. METHODS: The study included 79, 790 DRGs and their related claims of 8 disease groups (Lens procedures, with or without, vitrectomy, tonsillectomy and/or adenoidectomy only, appendectomy, Cesarean section, vaginal delivery, anal and/or perianal procedures, inguinal and/or femoral hernia procedures, uterine and/or adnexa procedures for nonmalignancy), which were examined manually during a 32 months period. To construct an optimal prediction model, 38 variables were applied, and the correction rate and lift value of 3 models (decision tree, logistic regression, neural network) compared. The analyses were performed separately by disease group. RESULTS: The correction rates of the developed method, using data mining techniques, were 15.4 to 81.9%, according to disease groups, with an overall correction rate of 60.7%. The lift values were 1.9 to 7.3 according to disease groups, with an overall lift value of 4.1. CONCLUSIONS: The above findings suggested that the applying of data mining techniques is necessary to improve the efficiency of DRG fraud candidate detection.
Summary
Professional Job Perception, Job Stress and Job Satisfaction of Doctors Practicing in Local Clinic in Daegu City.
Dae Gu Jin, Sin Kam, Yune Sik Kang, Yong Kee Cho, Sang Won Lee, Jong Yeon Kim, Soon Gi Ahn, Byung Yeol Chun, Min Hae Yeh
Korean J Prev Med. 2003;36(2):153-162.
  • 2,599 View
  • 37 Download
AbstractAbstract PDF
OBJECTIVE
This study was conducted in order to investigate professional job perception, job stress and job satisfaction in doctors. METHOD: The authors conducted a survey using a self-administered questionnaire, conducted between August and September, 2001. The study subjects were 457 doctors practicing at local clinics in Daegu City. RESULTS: For the professionalism scale, the score for 'sense of calling to field' and 'feeling of autonomy' were relatively high. Age, working hours per day, and perception of socioeconomic status significantly influenced the professionalism scale scores (p< 0.01). For the job stress scale, the scores for 'clinical responsibility/ decision' factor were the highest of all the surveyed factors. Working hours per day significantly influenced the job stress scores (p< 0.01). To investigate the overall relationship between the variables, the authors conducted a linear structural equation model analysis. The equation was statistically appropriate and a good fit. The job stress, and the professionalism factors, respectively influenced job satisfaction negatively and positively (T> 2.0). The working hours per day and status perception also influenced their job satisfaction (T> 2.0). CONCLUSION: To promote the job satisfaction of doctors, the development of coping tools and other intervention methods are needed to increase doctor's professional job perception and reduce their job stress. Further studies are required to understand the characteristics of job satisfaction and for its promotion with doctors.
Summary
Comparative Study
Disability Weights for Diseases in Korea.
Jung Kyu Lee, Seok Jun Yoon, Young Kyung Do, Young Hoon Kwon, Chang Yup Kim, Kidong Park, Yong Ik Kim, Young Soo Shin
Korean J Prev Med. 2003;36(2):163-170.
  • 15,001 View
  • 47 Download
AbstractAbstract PDF
OBJECTIVES
This study aimed to develop an evaluation protocol of disability weights using person trade-off, and to test the reliability of the developed protocol in a Korean context. METHODS: To develop the valuation protocol, the Global Burden of Disease (GBD) and the Dutch studies were replicated and modified. Sixteen indicator conditions were selected from the Korean version of disease classification, which was based on that of the GBD Study, and the person trade-off method referred to the Dutch method. RESULTS: The disability weights were valued in a two step panel study. The first step was a carefully designed group process by three panels, using person trade-off to establish the disability weights for sixteen selected indicator conditions. The second step consisted of interpolation of the remaining diseases, on a disability scale, by the individual members of three panels. The members of three panels were all medical doctors, with sufficient knowledge of the consequences of a broad variety of diseases. The internal consistency of the Korean disability weights was satisfactory. Considerable agreement existed within each panel and among the panels. CONCLUSIONS: It was feasible to use a modified evaluation protocol from those used in GBD and Dutch studies. This would provide a rational basis for an international comparative study of disability weights.
Summary
Original Articles
Pilot Study on Recruiting Medical Checkup Participants by Mail Survey among Korean Vietnam Veterans.
Sang Wook Yi, Jae Seok Hong, Heechoul Ohrr
Korean J Prev Med. 2003;36(2):171-178.
  • 2,078 View
  • 21 Download
AbstractAbstract PDF
OBJECTIVE
The aim of this study was to identify the validity of recruiting medical checkup participants of Vietnam veterans using a mail survey, and to identify the 'Vietnam service related characteristics' and `general characteristics' of Vietnam veterans groups. METHOD: In this study, a total 900 veterans were randomly selected from the list of Vietnam veterans from 1964 to 1973. The veterans were classified into 5 groups, taking into consideration their registered status in the Ministry of Patriots and Veterans Affairs; the VRD (veterans who have agent orange-related diseases), VSD (veterans who have agent orange-suspected disease), VM (veterans who performed meritorious deeds during the war), VR (veterans who were registered with the Ministry of Patriots and Veterans Affair) and OV (other veterans) groups. By means of postal surveys, the veterans' intention to participate in the medical checkup for our research, and their socioeconomic and general characteristics were investigated. 52 surveys were returned due to the subjects not residing at the listed address, and were excluded from the analysis. RESULT: 699 of the 848 veterans (82.4%) responded to the survey, of which 619 (88.6%) intended to participate in the medical checkup for our research. The 5 veterans groups all had similar ages, Vietnam service period, Agent Orange exposure, troop characteristic and wartime class, with the exception of VM, who were older, and with a greater number of officers than the other 4 groups. There was a big difference in the health statius among the Vietnam veterans group. The VM and OV were much healthier than VRD, VSD and VR groups. The socioeconomic stati of the VRD, VSD and VR groups were lower than those of the VM and OV groups. CONCLUSION: Although there were some limitations, the recruitment, by mail, of medical checkup participants from Vietnam veterans is a valid and feasible method. The VM and OV groups were much healthier, and with higher socioeconomic stati, than the VRD, VSD, and VR groups.
Summary
Assessment on Quality Improvement of the Abstracts of the Original Research Articles in the Korean Journal of Preventive Medicine.
Chun Bae Kim, Jun Ho Park, Hwa Soon Lee, Jong Ku Park, Bong Suk Cha
Korean J Prev Med. 2003;36(2):179-186.
  • 2,153 View
  • 26 Download
AbstractAbstract PDF
OBJECTIVES
To compare the quality improvement of the abstracts of original articles, according to the revised manuscript format, of the Korean Journal of Preventive Medicine (Korean J Pre Med) was adopted in 1999. METHODS: A total 63 abstracts for 1997, and 49 for 2001, were selected as the original articles from the Kor J Pre Med. This study was carried out by the separate-sample pretest-posttest design. The quality of the abstracts was measured by a checklist of Narine' evaluation criteria, and the other information related to the articles were also surveyed by e-mail and fax or telephone using a self-made questionnaire. From the response rate, a total of 62 abstracts for 1997 and 49 for 2001 were finally analyzed. RESULTS: The mean number of words in an abstract decreased from 285 in 1997, to 250 by 2001. The mean number of key words per abstract decreased from 3.9 in 1997, to 3.6 by 2001. The mean number of inappropriate usage of key words per abstract, by the MeSH standard, decreased from 1.9 in 1997, to 0.4 by 2001. Also, the overall mean score of abstract quality increased from 0.54 in 1997 to 0.61 by 2001. The range of scores for the abstract quality was better in 2001 (0.40~0.77) than in 1997 (0.20~0.81). From the multiple regression analyses of the 1997 and 2001 databases, the intervention of the manuscript format's revision, and the number of English words to the quality score of the abstract, were the only statistically significant factors. CONCLUSIONS: In conclusion, the quality of abstracts in the Kor J Pre Med has improved since the revised manuscript format was adopted in 1999. The Korean Society for Preventive Medicine will continuously recommend proposals for more informative abstracts in their journal, and will evaluate the abstracts' content with quality criteria. Future studies should address these issues, and compare the quality of abstracts between different international and domestic journals.
Summary

JPMPH : Journal of Preventive Medicine and Public Health