Journal of Preventive Medicine and Public Health

Volume 43(2); March 2010

Reviews

National Level Response to Pandemic (H1N1) 2009.: Dong Han Lee, Sang Sook Shin, Byung Yool Jun, Jong Koo Lee; J Prev Med Public Health. 2010;43(2):99-104.; DOI: https://doi.org/10.3961/jpmph.2010.43.2.99

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The World Health Organization (WHO) announced the emergence of a novel influenza on April 24, 2009, and they declared pandemic on June 11. In Korea, the proportion of influenza-like illness and the consumption of antiviral agents peaked in early November. The government established the Central Headquarters for Influenza Control and operated the emergency response system. In the quarantine stations, we checked the body temperature and collected quarantine questionnaires from all the arrivals from infected countries. We also isolated the confirmed cases in the national isolation hospitals. However, as the community outbreaks were reported, we changed strategy from containment to mitigation. We changed the antiviral agent prescription guideline so that doctors could prescribe antiviral agents to all patients with acute febrile respiratory illness, without a laboratory diagnosis. Also the 470 designated hospitals were activated to enhance the efficacy of treatment. We vaccinated about 12 million people and manage the adverse event following the immunization management system. In 2010, we will establish additional national isolation wards and support hospitals to establish fever clinics and isolation intensive care unit (ICU) beds. We will also make a computer program for managing the national isolation hospitals and designated hospitals. We will establish isolation rooms and expand the laboratory in quarantine stations and we will construct a bio-safety level 3 laboratory in each province. In addition, we plan to construct a bio-safety level 4 laboratory at a new Korea Centers for Disease Control and Prevention (KCDC) facilities in Ossong.

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The Evaluation of Policies on 2009 Influenza Pandemic in Korea.: Won Suk Choi, Woo Joo Kim, Hee Jin Cheong; J Prev Med Public Health. 2010;43(2):105-108.; DOI: https://doi.org/10.3961/jpmph.2010.43.2.105

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Abstract PDF

OBJECTIVES
To evaluate the policies on 2009 influenza pandemic in Korea at the end of first wave. METHODS: The main policies and the estimation of these were described according to the progress of 2009 influenza pandemic. RESULTS: The public health measures for containment were estimated to be successful in the early stage. The preparedness of antiviral agents and vaccines before the pandemic, risk-communication on pandemic influenza and policies of government including vaccines, and the education of health care worker and support of health care institutions was not enough to respond to the pandemic. CONCLUSIONS: The additional evaluation should be performed at the end of the pandemic in various aspects including health and socioeconomic effects.

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Immunogenicity and safety of a cell culture-derived inactivated quadrivalent influenza vaccine (NBP607-QIV): A randomized, double-blind, multi-center, phase III clinical trial in adults and elderly subjects
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Human Vaccines & Immunotherapeutics.2017; 13(7): 1653. CrossRef
Stochastic methods for epidemic models: An application to the 2009 H1N1 influenza outbreak in Korea
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Vaccine.2015; 33(41): 5437. CrossRef
Temporal decrease in overall antibiotic consumption accompanying antibiotic prescribing rate disclosure policy: evidence from analysis of national health insurance claims data in South Korea
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Evaluation and sensitivity analysis of the effectiveness of unadjuvanted A(H1N1)pdm09 vaccine in hospital workers using multi-center cohort study in Korea
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Vaccine.2013; 31(19): 2381. CrossRef
Neurologic Complications and Outcomes of Pandemic (H1N1) 2009 in Korean Children
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Original Article

Mathematical Modeling of the Novel Influenza A (H1N1) Virus and Evaluation of the Epidemic Response Strategies in the Republic of Korea.: Mina Suh, Jeehyun Lee, Hye Jin Chi, Young Keun Kim, Dae Yong Kang, Nam Wook Hur, Kyung Hwa Ha, Dong Han Lee, Chang Soo Kim; J Prev Med Public Health. 2010;43(2):109-116.; DOI: https://doi.org/10.3961/jpmph.2010.43.2.109

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Abstract PDF

OBJECTIVES
The pandemic of novel influenza A (H1N1) virus has required decision-makers to act in the face of the substantial uncertainties. In this study, we evaluated the potential impact of the pandemic response strategies in the Republic of Korea using a mathematical model. METHODS: We developed a deterministic model of a pandemic (H1N1) 2009 in a structured population using the demographic data from the Korean population and the epidemiological feature of the pandemic (H1N1) 2009. To estimate the parameter values for the deterministic model, we used the available data from the previous studies on pandemic influenza. The pandemic response strategies of the Republic of Korea for novel influenza A (H1N1) virus such as school closure, mass vaccination (70% of population in 30 days), and a policy for anti-viral drug (treatment or prophylaxis) were applied to the deterministic model. RESULTS: The effect of two-week school closure on the attack rate was low regardless of the timing of the intervention. The earlier vaccination showed the effect of greater delays in reaching the peak of outbreaks. When it was no vaccination, vaccination at initiation of outbreak, vaccination 90 days after the initiation of outbreak and vaccination at the epidemic peak point, the total number of clinical cases for 400 days were 20.8 million, 4.4 million, 4.7 million and 12.6 million, respectively. The pandemic response strategies of the Republic of Korea delayed the peak of outbreaks (about 40 days) and decreased the number of cumulative clinical cases (8 million). CONCLUSIONS: Rapid vaccination was the most important factor to control the spread of pandemic influenza, and the response strategies of the Republic of Korea were shown to delay the spread of pandemic influenza in this deterministic model.

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Mathematical model of transmission dynamics and optimal control strategies for 2009 A/H1N1 influenza in the Republic of Korea
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Journal of Theoretical Biology.2017; 412: 74. CrossRef
A real option analysis for stochastic disease control and vaccine stockpile policy: An application to H1N1 in Korea
Hojeong Park
Economic Modelling.2016; 53: 187. CrossRef
Stochastic methods for epidemic models: An application to the 2009 H1N1 influenza outbreak in Korea
Hyojung Lee, Sunmi Lee, Chang Hyeong Lee
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Schools’ Response to MERS(MERS-CoV) Outbreak: Schools’ Discretionary Response in Absence of Control Tower
In Sook Lee, Jae Hee Yoon, Eun Joo Hong, Chae Yoon Kim
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The Effects of School Closures on Influenza Outbreaks and Pandemics: Systematic Review of Simulation Studies
Charlotte Jackson, Punam Mangtani, Jeremy Hawker, Babatunde Olowokure, Emilia Vynnycky, Gerardo Chowell
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Kyung Sun Park, Tae Sung Park, Jin Tae Suh, You Sun Nam, Mi Suk Lee, Hee Joo Lee
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Epidemiological Characteristics of Imported Influenza A (H1N1) Cases during the 2009 Pandemic in Korea
Jun Kil Choi, Sang Won Lee, Bo Youl Choi
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Research Support, Non-U.S. Gov'ts

Participation Determinants in the DRG Payment System of Obstetrics and Gynecology Clinics in South Korea.: Jung Kook Song, Chang yup Kim; J Prev Med Public Health. 2010;43(2):117-124.; DOI: https://doi.org/10.3961/jpmph.2010.43.2.117

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Abstract PDF

OBJECTIVES
The Diagnosis Related Group (DRG) payment system, which has been implemented in Korea since 1997, is based on voluntary participation. Hence, the positive impact of this system depends on the participation of physicians. This study examined the factors determining participation of Korean obstetrics & gynecology (OBGYN) clinics in the DRG-based payment system. METHODS: The demographic information, practice-related variables of OBGYN clinics and participation information in the DRG-based payment system were acquired from the nationwide data from 2002 to 2007 produced by the National Health Insurance Corporation and the Health Insurance Review & Assessment Service. The subjects were 336 OBGYN clinics consisting of 43 DRG clinics that had maintained their participation in 2003-2007 and 293 no-DRG (fee-for-service) clinics that had never been a DRG clinic during the same period. Logistic regression analysis was carried out to determine the factors associated with the participation of OBGYN clinics in the DRG-based payment system. RESULTS: The factors affecting participation of OBGYN clinics in the DRG-based payment system were as follows (p<0.05): (1) a larger number of caesarian section (c/sec) claims, (2) higher cost of a c/sec, (3) less variation in the price of a c/sec, (4) fewer days of admission for a c/sec, and (5) younger pregnant women undergoing a c/sec. CONCLUSIONS: These results suggest that OBGYN clinics with an economic practice pattern under a fee-for-service system are more likely to participate in the DRG-based payment system. Therefore, to ensure adequate participation of physicians, a payment system with a stronger financial incentive might be more suitable in Korea.

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Polypharmacy, hospitalization, and mortality risk: a nationwide cohort study
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Jae-Woo Choi, Sung-In Jang, Suk-Yong Jang, Seung-Ju Kim, Hye-Ki Park, Tae Hyun Kim, Eun-Cheol Park
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The Distribution of Intraocular Pressure and Its Association With Metabolic Syndrome in a Community.: Sang shin Park, Eun Hee Lee, Ganchimeg Jargal, Domyung Paek, Sung Il Cho; J Prev Med Public Health. 2010;43(2):125-130.; DOI: https://doi.org/10.3961/jpmph.2010.43.2.125

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Abstract PDF

OBJECTIVES
The current study was performed to assess the distribution of intraocular pressure (IOP) and its association with metabolic syndrome (MS) in a community. METHODS: We measured IOP and MS components from 446 adults, age 20 or more years old, who reside in a community in Kyunggi Province, South Korea. We compared the level of IOP according to the number of metabolic abnormalities and between normal and abnormal metabolic components. Linear regression analyses were used to determine the relationship between IOP and metabolic components. RESULTS: No significant difference in IOP (mean +/- SE) was found between men (12.24 +/- 2.42) and women (12.55 +/- 2.41 mmHg, p > 0.1), while IOP of men tended to decrease as age increased (p for trend < 0.01). After adjusting for age, IOP of subjects with abdominal obesity in men and high blood pressure in women were significantly higher than those without abdominal obesity or high blood pressure (p < 0.05). Female subjects with MS showed significantly higher IOP than those without MS. Participants with more metabolic disturbances tended to have a greater IOP elevation with a linear trend after adjusting for age and sex. In the univariate regression analysis, age and waist circumference were significantly associated with IOP in men, but systolic and diastolic blood pressure were associated with IOP in women. In final multiple regression model, age, systolic blood pressure, and triglyceride were associated with IOP in women, and age in men. CONCLUSIONS: These findings suggest that MS and its components may be important determinants of elevated IOP.

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Original Articles

Acute Testis Toxicity of Bisphenol A Diglycidyl Ether in Sprague-Dawley Rats.: Yun Jung Yang, Shin Young Lee, Kyung Yong Kim, Yeon Pyo Hong; J Prev Med Public Health. 2010;43(2):131-137.; DOI: https://doi.org/10.3961/jpmph.2010.43.2.131

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Abstract PDF

OBJECTIVES
Bisphenol A diglycidyl ether (BADGE) is a liquid compound obtained by condensation of two molecules of epichlorohydrin with one molecule of bisphenol A. General and reproductive toxicity with BADGE has been reported higher than 1000 mg/kg/day. This study was performed to show the effects of acute exposure to BADGE below 1000 mg/kg/day on the testis in adult male rats. METHODS: BADGE was administered by gastric lavage in a single dose of 500, 750, 1000, and 2000 mg/kg/day in 8-week old male SPF Sprague-Dawley rats. The right testis was processed for light microscopic analysis. The left testis was homogenized and spermatids were counted to determine the daily sperm production and daily abnormal sperm production. The sperm count, sperm motility, and incidence of abnormal sperm were estimated in the epididymis. In testicular sections, the seminiferous tubules were observed for qualitative changes. The progression of spermatogenesis was arbitrarily classified as full-matured, maturing, and immature. The specimen slide was observed at 3 points and 10 seminiferous tubules were evaluated at each point. RESULTS: The male rats exposed to single oral dose of BADGE at 750, 1000, and 2000 mg/kg/day were significantly increased the number of immature and maturing sperm on the testis. There were no significant differences with respect to sperm head count, sperm motility, and sperm abnormality in the BADGE treatment groups. CONCLUSIONS: These results suggest that single oral exposure of BADGE 750 mg/kg/day can affect adult male testis development.

Summary

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Analysis for the Impact of Adulthood and Childhood Socioeconomic Positions and Intergenerational Social Mobility on Adulthood Health.: Jae Hee Seo, Ho Kim, Young Jeon Shin; J Prev Med Public Health. 2010;43(2):138-150.; DOI: https://doi.org/10.3961/jpmph.2010.43.2.138

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Abstract PDF

OBJECTIVES
There are at least three conceptual models for the effects of the childhood social environment on adult health: the critical period model, the social mobility model, and the cumulative risk model. However, few studies have investigated all three different models within the same setting. This study aims to examine the impact of childhood and adulthood socioeconomic positions and intergenerational social mobility over the life course on the health in adulthood based both on the critical period model and the social mobility model. METHODS: This study was conducted on 9583 adults aged between 25 and 64 years old and they were the respondents to the Korea Welfare Panel Study (2006). A multivariate logistic regression analysis was carried out, using the critical period model and the social mobility model out of the life course approaches, to look into the impact of childhood and adulthood socioeconomic positions and intergenerational social mobility on the health status in adulthood. RESULTS: Household income and occupation out of the adulthood socioeconomic position indicators had an independent influence on the adulthood health status. The childhood socioeconomic position indicators, except for the place of childhood residence, affected the adulthood health status even after adjustment for the adulthood socioeconomic position. The effect of intergenerational social mobility was also statistically significant even after adjusting for the adulthood socioeconomic position, but it became insignificant when the childhood socioeconomic position was additionally adjusted for. CONCLUSIONS: Adulthood health is indeed affected by both the childhood and adulthood socioeconomic positions as well as intergenerational social mobility. This result shows that a life course approach needs to be adopted when dealing with health issues.

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Grandparental education, parental education and child height: evidence from Hong Kong’s “Children of 1997” birth cohort
Man Ki Kwok, Gabriel M. Leung, Tai Hing Lam, Shirley S.L. Leung, C. Mary Schooling
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Health Inequalities Policy in Korea: Current Status and Future Challenges
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Multicenter Study

Cigarette Smoking and Mortality in the Korean Multi-center Cancer Cohort (KMCC) Study.: Eun Ha Lee, Sue K Park, Kwang Pil Ko, In Seong Cho, Soung Hoon Chang, Hai Rim Shin, Daehee Kang, Keun Young Yoo; J Prev Med Public Health. 2010;43(2):151-158.; DOI: https://doi.org/10.3961/jpmph.2010.43.2.151

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OBJECTIVES
The aim of this study was to evaluate the association between cigarette smoking and total mortality, cancer mortality and other disease mortalities in Korean adults. METHODS: A total of 14 161 subjects of the Korean Multi-center Cancer Cohort who were over 40 years of age and who were cancer-free at baseline enrollment reported their lifestyle factors, including the smoking status. The median follow-up time was 6.6 years. During the follow-up period from 1993 to 2005, we identified 1159 cases of mortality, including 260 cancer mortality cases with a total of 91 987 person-years, by the national death certificate. Cox proportional hazard regression model was used to estimate the hazard ratio (HR) of cigarette smoking for total mortality, cancer mortality and disease-specific mortality, as adjusted for age, gender, the geographic area and year of enrollment, the alcohol consumption status, the education level and the body mass index (BMI). RESULTS: Cigarette smoking was significantly associated with an increased risk of total mortality, all-cancer mortality and lung cancer mortality (p-trend, <0.01, <0.01, <0.01, respectively). Compared to non-smoking, current smokers were at a higher risk for mortality [HR (95% CI)=1.3 (1.1-1.5) for total mortality; HR (95% CI)=1.6 (1.1-2.2) for all-cancer mortality; HR (95% CI)=3.9 (1.9-7.7) for lung cancer mortality]. CONCLUSIONS: This study's results suggest that cigarette smoking might be associated with total mortality, all-cancer mortality and especially lung cancer mortality among Korean adults.

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Original Articles

Reliability of Covariates in Baseline Survey of a Cohort Study: Epidemiological Investigation on Cancer Risk Among Residents Who Reside Near the Nuclear Power Plants in Korea.: Sanghyuk Bae, Bo Young Park, Zhong Min Li, Yoon Ok Ahn; J Prev Med Public Health. 2010;43(2):159-165.; DOI: https://doi.org/10.3961/jpmph.2010.43.2.159

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OBJECTIVES
We evaluated the reliability of the possible covariates of the baseline survey data collected for the Epidemiological Investigation on Cancer Risk Among Residents Who Reside Near the Nuclear Power Plants in Korea. METHODS: Follow-up surveys were conducted for 477 participants of the cohort at less than 1 year after the initial survey. The mean interval between the initial and follow-up surveys was 282.5 days. Possible covariates were identified by analyzing the correlations with the exposure variable and associations with the outcome variables for all the variables. Logistic regression analysis with stepwise selection was further conducted among the possible covariates to select variables that have covariance with other variables. We considered that these variables can be representing other variables. Seven variables for the males and 3 variables for the females, which had covariance with other possible covariates, were selected as representative variables. The Kappa index of each variable was calculated. RESULTS: For the males, the Kappa indexes were as follow; family history of cancer was 0.64, family history of liver diseases in parents and siblings was 0.56, family history of hypertension in parents and siblings was 0.51, family history of liver diseases was 0.50, family history of hypertension was 0.44, a history of chronic liver diseases was 0.53 and history of pulmonary tuberculosis was 0.36. For females, the Kappa indexes were as follow; family history of cancer was 0.58, family history of hypertension in parents and siblings was 0.56 and family history of hypertension was 0.47. CONCLUSIONS: Most of the possible covariates showed good to moderate agreement.

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Cancer Risk in Adult Residents near Nuclear Power Plants in Korea - A Cohort Study of 1992-2010
Yoon-Ok Ahn, Zhong Min Li
Journal of Korean Medical Science.2012; 27(9): 999. CrossRef

Acute Health Effects of the Hebei Oil Spill on the Residents of Taean, Korea.: Cheol Heon Lee, Young A Kang, Kyu Jin Chang, Chang Hoon Kim, Jong Il Hur, Jae Youn Kim, Jong Koo Lee; J Prev Med Public Health. 2010;43(2):166-173.; DOI: https://doi.org/10.3961/jpmph.2010.43.2.166

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Abstract PDF

OBJECTIVES
On December 7, 2007, the Hebei Spirit oil tanker spilled out 12,547 kl of crude oil on the Yellow Sea 10 km away from the cost of Taean Province, Korea. As the coastline has been contaminated, local residents have been exposed to crude oil. Because the residents were showing many symptoms, we investigated the acute health effects of this oil spill on them. METHODS: We conducted a cross-sectional study consisting of the heavy and moderately oil soaked area in Taean and the lightly oil soaked area in Seocheon. Ten seashore villages were selected from each area, and 10 male and female adults were selected from each village. We interviewed the subjects using a structured questionnaire on the characteristics of residents, the cleanup activities, the perception of oil hazard, depression and anxiety, and the physical symptoms. The odds ratios and 95% confidence intervals were analyzed using logistic regression analysis. The logistic regression model was adjusted for age, gender, education, smoking, the perception of oil hazard and anxiousness. RESULTS: The more highly contaminated the area, the more likely it was for residents to be engaged in cleanup activities and have a greater chance of exposure to oil. The indexes of anxiety and depression were higher in the heavy and moderately oil soaked areas. The increased risks of headache, nausea, dizziness, fatigue, tingling of limb, hot flushing, sore throat, cough, runny nose, shortness of breath, itchy skin, rash, and sore eyes were significant. CONCLUSIONS: The results suggest that exposure to crude oil is associated with various acute physical symptoms. Long-term investigation is required to monitor the residents' health.

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Assessment of Applicability of Standardized Rates for Health State Comparison Among Areas: 2008 Community Health Survey.: Geun Yong Kwon, Do Sang Lim, Eun Ja Park, Ji Sun Jung, Ki Won Kang, Yun A Kim, Ho Kim, Sung Il Cho; J Prev Med Public Health. 2010;43(2):174-184.; DOI: https://doi.org/10.3961/jpmph.2010.43.2.174

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OBJECTIVES
This study shows the issues that should be considered when applying standardized rates using Community Health Survey(CHS) data. METHODS: We analyzed 2008 CHS data. In order to obtain the reliability of standardized rates, we calculated z-score and rank correlation coefficients between direct standardized rate and indirect standardized rate for 31 major indices. Especially, we assessed the change of correlations according to population composition (age and sex), and characteristics of the index. We used Mantel-Haenszel chi-square to quantify the difference of population composition. RESULTS: Among 31 major indices, 29 indices' z-score and rank correlation coefficients were over 0.9. However, regions with larger differences in population composition showed lower reliability. Low reliability was also observed for the indices specific to subgroups with small denominator such as 'permanent lesion from stroke', and the index with large regional variations in age-related differences such as 'obtaining health examinations'. CONCLUSIONS: Standardized rates may have low reliability, if comparison is made between areas with extremely large differences in population composition, or for indicies with large regional variations in age-related differences. Therefore, the special features of standardized rates should be considered when health state are compared among areas.

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Myung-Jae Hwang, Hae-Kwan Cheong, Jong-Hun Kim, Youn Seo Koo, Hui-Young Yun
Epidemiology and Health.2018; 40: e2018028. CrossRef
Illustration of Calculating Standardized Rates Utilizing Logistic Regression Models: The National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS)
Sang-Hoon Cho, Gunseog Kang, Hyeon Chang Kim
Journal of Health Informatics and Statistics.2017; 42(1): 70. CrossRef
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Yang Wha Kang, Yun Sil Ko, Yoo Jin Kim, Kyoung Mi Sung, Hyo Jin Kim, Hyung Yun Choi, Changhyun Sung, Eunkyeong Jeong
Osong Public Health and Research Perspectives.2015; 6(3): 211. CrossRef
Health behavior affecting on the regional variation of standardized mortality
Jin A Han, Soo Jeong Kim, Se Rom Kim, Ki Hong Chun, Yun Hwan Lee, Soon Young Lee
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Convergence-based analysis on geographical variations of the smoking rates
Ji-Hye Lim, Sung-Hong Kang
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Overview of Korean Community Health Survey
Young Taek Kim, Bo Youl Choi, Kay O Lee, Ho Kim, Jin Ho Chun, Su Young Kim, Duk-Hyoung Lee, Yun A Ghim, Do Sang Lim, Yang Wha Kang, Tae Young Lee, Jeong Sook Kim, Hyun Jo, Yoojin Kim, Yun Sil Ko, Soon Ryu Seo, No-Rye Park, Jong-Koo Lee
Journal of the Korean Medical Association.2012; 55(1): 74. CrossRef

Meta-Analysis

Radiation Exposure and Cancer Mortality Among Nuclear Power Plant Workers: a Meta-analysis.: Eun Sook Park, Kieun Moon, Han Na Kim, Won Jin Lee, Young Woo Jin; J Prev Med Public Health. 2010;43(2):185-192.; DOI: https://doi.org/10.3961/jpmph.2010.43.2.185

5,625 View
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Abstract PDF

OBJECTIVES
We conducted a meta-analysis to investigate the relationship between low external doses of ionizing radiation exposure and the risk of cancer mortality among nuclear power plant workers. METHODS: We searched MEDLINE using key words related to low dose and cancer risk. The selected articles were restricted to those written in English from 1990 to January 2009. We excluded those studies with no fit to the selection criteria and we included the cited references in published articles to minimize publication bias. Through this process, a total of 11 epidemiologic studies were finally included. RESULTS: We found significant decreased deaths from all cancers (SMR = 0.75, 95% CI = 0.62 - 0.90), all cancers excluding leukemia, solid cancer, mouth and pharynx, esophagus, stomach, rectum, liver and gallbladder, pancreas, lung, prostate, lymphopoietic and hematopoitic cancer. The findings of this meta-analysis were similar with those of the 15 Country Collaborative Study conducted by the International Agency for Research on Cancer. A publication bias was found only for liver and gallbladder cancer (p = 0.015). Heterogeneity was observed for all cancers, all cancers excluding leukemia, solid cancer, esophagus, colon and lung cancer. CONCLUSIONS: Our findings of low mortality for stomach, rectum, liver and gallbladder cancers may explained by the health worker effect. Yet further studies are needed to clarify the low SMR of cancers, for which there is no useful screening tool, in nuclear power plant workers.

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