Journal of Preventive Medicine and Public Health

Original Articles

Effects of the Local Environment and Nutritional Status on the Incidence of Acute Respiratory Infections Among Children Under 5 Years Old in Indonesia: Tri Bayu Purnama, Keita Wagatsuma, Masdalina Pane, Reiko Saito; J Prev Med Public Health. 2024;57(5):461-470. Published online August 2, 2024; DOI: https://doi.org/10.3961/jpmph.24.246

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Objectives
This study aimed to map the incidence of acute respiratory infections (ARIs) among under-5 children in Indonesia, address the triple burden of malnutrition, and analyze the impact of malnutrition on ARIs, taking into account the environmental and wealth disparities in Indonesia.
Methods
This study utilized an ecological design, analyzing aggregate data from the Indonesia Nutrition Survey, 2022. It encompassed 33 provinces and 486 districts/cities, involving a total of 334 878 children under 5 years of age. Partial least squares structural equation modeling was employed to investigate the relationships among wealth, environment, malnutrition (stunting, wasting, and underweight), and ARIs.
Results
The proportion of ARI cases in Indonesia was generally concentrated in central Sumatra, the western and eastern parts of Java, and eastern Papua. In contrast, the northern part of Sumatra, central Kalimantan, central Sulawesi, and central Papua had a higher proportion of malnutrition cases compared to other regions. Negative associations were found between malnutrition and ARIs (path coefficient =-0.072; p<0.01) and between wealth and environment (path coefficient =-0.633; p<0.001), malnutrition (path coefficient=-0.399; p<0.001), and ARIs (path coefficient=-0.918; p<0.001).
Conclusions
An increasing wealth index is expected to contribute to reducing ARIs, malnutrition and environmental burdens in the future. This study emphasizes the necessity for focused strategies that address both immediate health challenges and the underlying socioeconomic determinants to improve child health outcomes in the Indonesian context.

Summary

Key Message
In Indonesia, Acute Respiratory Infections (ARI) cases were predominantly concentrated in central Sumatra, western and eastern Java, and eastern Papua, while malnutrition cases were more prevalent in northern Sumatra, central Kalimantan, central Sulawesi, and central Papua. A negative association was observed between malnutrition and ARIs. Additionally, wealth had significant negative associations with the environment, malnutrition, and ARIs, suggesting socio-environmental disparities contribute to health outcomes in these regions.

Citations

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Prevalence and risk factors of acute respiratory infection and diarrhea among children under 5 years old in low-middle wealth household, Indonesia
Tri Bayu Purnama, Keita Wagatsuma, Reiko Saito
Infectious Diseases of Poverty.2025;[Epub] CrossRef

Associations Between Indoor Air Pollutants and Risk Factors for Acute Respiratory Infection Symptoms in Children Under 5: An Analysis of Data From the Indonesia Demographic Health Survey: Ichtiarini Nurullita Santri, Yuniar Wardani, Yohane Vincent Abero Phiri, Gunchmaa Nyam, Tyas Aisyah Putri, Khoiriyah Isni, Dyah Suryani, Grace Sambo; J Prev Med Public Health. 2023;56(3):255-263. Published online April 18, 2023; DOI: https://doi.org/10.3961/jpmph.22.470

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Abstract PDF: Objectives
The study investigated the association between indoor air pollution (IAP) and risk factors for acute respiratory infection (ARI) symptoms in children under 5 years of age.
Methods
A cross-sectional study was conducted using data derived from Indonesia Demographic and Health Survey in 2017. Binary logistic regression modeling was employed to examine each predictor variable associated with ARI among children under 5 years of age in Indonesia.
Results
The study included a total of 4936 households with children. Among children under 5 years old, 7.2% reported ARI symptoms. The presence of ARI symptoms was significantly associated with the type of residence, wealth index, and father’s smoking frequency, which were considered the sample’s socio-demographic characteristics. In the final model, living in rural areas, having a high wealth index, the father’s smoking frequency, and a low education level were all linked to ARI symptoms.
Conclusions
The results revealed that households in rural areas had a substantially higher level of reported ARI symptoms among children under 5 years old. Furthermore, the father’s smoking frequency and low education level were associated with ARI symptoms.; Summary

Characteristics of Respiratory Syncytial Virus Infection in Hospitalized Children Before and During the COVID-19 Pandemic in Thailand: Wilawan Chaiut, Ratana Sapbamrer, Sauwaluk Dacha, Tavitiya Sudjaritruk, Ida Parwati, Anton Sumarpo, Rungnapa Malasao; J Prev Med Public Health. 2023;56(3):212-220. Published online March 23, 2023; DOI: https://doi.org/10.3961/jpmph.23.019

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Objectives
This study compared the epidemiological and clinical manifestations of patients hospitalized with respiratory syncytial virus (RSV) infection before and during the coronavirus disease 2019 (COVID-19) pandemic at a tertiary care hospital in Chiang Mai Province, Thailand.
Methods
This retrospective observational study utilized data from all cases of laboratory-confirmed RSV infection at Maharaj Nakorn Chiang Mai Hospital from January 2016 to December 2021. Differences in the clinical presentation of RSV infection before (2016 to 2019) and during (2020 to 2021) the COVID-19 pandemic were analyzed and compared.
Results
In total, 358 patients hospitalized with RSV infections were reported from January 2016 to December 2021. During the COVID-19 pandemic, only 74 cases of hospitalized RSV infection were reported. Compared to pre-pandemic levels, the clinical presentations of RSV infection showed statistically significant decreases in fever on admission (p=0.004), productive cough (p=0.004), sputum (p=0.003), nausea (p=0.03), cyanosis (p=0.004), pallor (p<0.001), diarrhea (p<0.001), and chest pain (p<0.001). Furthermore, vigilant measures to prevent the spread of COVID-19, including lockdowns, also interrupted the RSV season in Thailand from 2020 to 2021.
Conclusions
The incidence of RSV infection was affected by the COVID-19 pandemic in Chiang Mai Province, Thailand, which also changed the clinical presentation and seasonal pattern of RSV infection in children.

Summary

Citations

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Characterizing respiratory syncytial virus (RSV) infections before and during the COVID-19 pandemic
Saamia I. Masoom, Gina Aloisio, Elizabeth A. Camp, James J. Dunn, Sarah D. Meskill
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Retrospective Analysis of Clinical Patterns and Antibiotic Utilization in Pediatric Patients Hospitalized with Respiratory Syncytial Virus Pneumonia at a Recently Established General Hospital
Hyejin So, Kyung Min Kim, Eun Young Cho
Pediatric Infection & Vaccine.2024; 31(1): 75. CrossRef
Respiratory syncytial virus infection in children during SARS-CoV-2 pandemic at a referral center in Rio de Janeiro, Brazil
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Jornal Brasileiro de Pneumologia.2024; : e20240072. CrossRef
Exploring the epidemiological burden of RSV pre- and post-COVID-19 pandemic: A Jordanian tertiary hospital experience
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Journal of International Medical Research.2024;[Epub] CrossRef
Predominance of ON1 and BA9 genotypes of human respiratory syncytial virus in children with acute respiratory infection in Chiang Mai, Thailand, 2020–2021
Rungnapa Malasao, Wilawan Chaiut, Wanwisa Tantipetcharawan, Ratchanu Tongphung, Nicha Charoensri, Piyawan Takarn, Tavitiya Sudjaritruk, Niwat Maneekarn
Journal of Infection and Public Health.2023; 16(9): 1418. CrossRef

COVID-19: Original Articles

Associations Between General Perceptions of COVID-19 and Posttraumatic Stress Disorder in Korean Hospital Workers: Effect Modification by Previous Middle East Respiratory Syndrome Coronavirus Experience and Occupational Type: Youngrong Lee, Kwanghyun Kim, Sungjin Park, Sun Jae Jung; J Prev Med Public Health. 2021;54(2):86-95. Published online January 19, 2021; DOI: https://doi.org/10.3961/jpmph.20.540

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Objectives
This study investigated associations between perceptions of coronavirus disease 2019 (COVID-19) and the prevalence of posttraumatic stress disorder (PTSD) in workers at hospitals designated to treat COVID-19, as well as the difference in the magnitude of these associations by occupational type and previous Middle East respiratory syndrome coronavirus (MERS-CoV) experience.
Methods
The participants were workers at hospitals designated to treat COVID-19 who completed a questionnaire about their perceptions related to COVID-19, work experience during the previous MERS-CoV outbreak, and symptoms of PTSD ascertained by the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders. Participants’ characteristics were compared using the chi-square test. Multivariable logistic regression was performed to evaluate the associations between perceptions and the prevalence of PTSD, stratified by occupational type and previous MERS-CoV experience.
Results
Non-medical personnel showed stronger associations with PTSD than medical personnel according to general fear (odds ratio [OR], 6.67; 95% confidence interval [CI], 1.92 to 23.20), shortages of supplies (OR, 1.29; 95% CI, 1.07 to 1.56), and issue-specific fear (OR, 1.29; 95% CI, 1.05 to 1.59). Those with prior MERS-CoV quarantine experience were more prone to PTSD than those without such experience in terms of general fear (OR, 1.70; 95% CI, 1.22 to 2.37), shortages of supplies (OR, 1.24; 95% CI, 1.10 to 1.40), and issue-specific fear (OR, 1.21; 95% CI, 1.06 to 1.38).
Conclusions
During the COVID-19 pandemic, non-medical personnel tended to have higher odds of being categorized as having PTSD. Workers with prior MERS-CoV experience were more susceptible than those without such experience. These findings suggest the need for timely interventions to manage human resources for a sustainable quarantine system.

Summary

Korean summary
본 연구는 COVID-19관련 인식과 COVID-19 안심 병원 근로자들의 외상 후 스트레스 장애 (PTSD) 유병률 사이의 연관성에서 직업 유형과 이전 중동 호흡기 증후군 (MERS-CoV) 방역 경험 여부로 인한 연관성의 크기 차이를 조사하였다. 비의료인이 의료인보다 PTSD유병에 더 강한 연관성을 보였고, 이전 메르스 방역 경험이 있는 근로자들이 COVID-19에 대한 "일반적 공포", "물품 부족 공포" 및 "특정 문제에 따른 공포"로 구분한 인식의 크기가 클 수록 방역 경험이 없는 근로자들보다 PTSD유병과의 관련성이 더 컸다. 결론적으로 COVID-19 대유행 기간 중 비의료 인력은 PTSD유병 확률이 더 높은 경향이 있었다. 이전 MERS-CoV 경험이 있는 근로자는 그러한 경험이 없는 근로자보다 더 취약했다.

Citations

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Association between social networks and symptoms of post-traumatic stress during the pandemic: Cohort study in South Korea
Ji Su Yang, Yu Jin Lee, Hyeon Chang Kim, Chul-Hyun Cho, Alexander C. Tsai, Sun Jae Jung
Comprehensive Psychiatry.2023; 127: 152432. CrossRef
Development and Validation of COVID-19 Stress Scale (CSS) in an Iranian Non-clinical Population
Roghieh Nooripour, Nikzad Ghanbari, Laurel E. Radwin, Simin Hosseinian, Peyman Hassani-Abharian, Mohsen Hosseinbor, Keyvan Kakabraee, Mojtaba Amiri Majd, Serge Brand, Esmaeil Soleimani, Hossein Ilanloo
Zahedan Journal of Research in Medical Sciences.2022;[Epub] CrossRef

Association of Comorbidities With Pneumonia and Death Among COVID-19 Patients in Mexico: A Nationwide Cross-sectional Study: Akram Hernández-Vásquez, Diego Azañedo, Rodrigo Vargas-Fernández, Guido Bendezu-Quispe; J Prev Med Public Health. 2020;53(4):211-219. Published online May 28, 2020; DOI: https://doi.org/10.3961/jpmph.20.186

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Abstract PDF

Objectives
The goal of this study was to identify chronic conditions and multimorbidity patterns in patients with coronavirus disease 2019 (COVID-19) and to examine their associations with pneumonia and death.
Methods
This cross-sectional study analyzed the official data of COVID-19 patients in Mexico through May 18, 2020 (released by the Secretaría de Salud de México). Adjusted logistic regression models were applied to assess the associations of comorbidities with pneumonia and death. The marginal effects were estimated, and the probability of pneumonia or death according to the number of comorbidities was graphed for each year of age.
Results
Of the 51 053 COVID-19 patients enrolled in the final analysis, 27 667 (54.2%) had no chronic conditions, while 13 652 (26.7%), 6518 (12.8%) and 3216 (6.3%) were reported to have 1, 2, and 3 or more simultaneous conditions, respectively. Overall, a significant incremental gradient was observed for the association between multimorbidity and pneumonia (p<0.001); for 2 chronic conditions, the adjusted odds ratio (aOR) was 2.07 (95% confidence interval [CI], 1.95 to 2.20), and for ≥3 conditions, the aOR was 2.40 (95% CI, 2.22 to 2.60). A significant incremental gradient was also found for the relationship between multimorbidity and death (p<0.001); an aOR of 2.51 (95% CI, 2.30 to 2.73) was found for 2 chronic conditions and an aOR of 3.49 (95% CI, 3.15 to 3.86) for ≥3 conditions.
Conclusions
Underlying chronic conditions and multimorbidity are associated with pneumonia and death in Mexican COVID-19 patients. Future investigation is necessary to clarify the pathophysiological processes behind this association, given the high burden of chronic diseases in various countries, including Mexico.

Summary

Citations

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Original Article

Prescription of Systemic Steroids for Acute Respiratory Infections in Korean Outpatient Settings: Overall Patterns and Effects of the Prescription Appropriateness Evaluation Policy: Taejae Kim, Young Kyung Do; J Prev Med Public Health. 2020;53(2):82-88. Published online November 18, 2019; DOI: https://doi.org/10.3961/jpmph.19.090

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Objectives
The objective of this study was to identify individual and institutional factors associated with the prescription of systemic steroids in patients with acute respiratory infections and to investigate the role of a policy measure aimed to reduce inappropriate prescriptions. Methods: We used data from the National Health Insurance Service-National Sample Cohort from 2006 to 2015 and focused on episodes of acute respiratory infection. Descriptive analysis and multiple logistic regression analysis were performed to identify individual-level and institution-level factors associated with the prescription of systemic steroids. In addition, steroid prescription rates were compared with antibiotic prescription rates to assess their serial trends in relation to Health Insurance Review and Assessment Service (HIRA) Prescription Appropriateness Evaluation policy. Results: Among a total of 9 460 552 episodes of respiratory infection, the steroid prescription rate was 6.8%. Defined daily doses/1000 persons/d of steroid increased gradually until 2009, but rose sharply since 2010. The steroid prescription rate was higher among ear, nose and throat specialties (13.0%) than other specialties, and in hospitals (8.0%) than in tertiary hospitals (3.0%) and other types of institutions. Following a prolonged reduction in the steroid prescription rate, this rate increased since the HIRA Prescription Appropriateness Evaluation dropped steroids from its list of evaluation items in 2009. Such a trend reversal was not observed for the prescription rate of antibiotics, which continue to be on the HIRA Prescription Appropriateness Evaluation list. Conclusions: Specialty and type of institution are important correlates of steroid prescriptions in cases of acute respiratory infection. Steroid prescriptions can also be influenced by policy measures, such as the HIRA Prescription Appropriateness Evaluation policy.

Summary

Korean summary
이 연구에서는 요양급여 청구자료를 기준으로 급성 상기도 감염에서 스테로이드를 처방하는 경우와 관련하여 다음과 같은 특징을 확인하였다. 첫째, 환자 특성과 기관 특성을 모두 고려하였을 때 진료과목과 기관의 종별 구분에서 감기 스테로이드 처방률은 상당한 변이를 보였다. 둘째, 약제급여적정성평가 항목에서 스테로이드가 제외된 직후 처방률이 시계열적으로 상승하였으며, 이는 처방 행태에 정책 요인이 중요한 영향을 미칠 수 있음을 뜻한다.

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Special Articles

Ethical Perspectives on the Middle East Respiratory Syndrome Coronavirus Epidemic in Korea: Ock-Joo Kim; J Prev Med Public Health. 2016;49(1):18-22. Published online January 29, 2016; DOI: https://doi.org/10.3961/jpmph.16.013

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Abstract PDF

Ethical considerations are essential in planning for and responding to outbreaks of infectious diseases. During the outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) in the Republic of Korea in 2015, serious challenges emerged regarding important ethical issues, such as transparency and the protection of privacy. The development of bioethics in Korea has been influenced by individualistic perspectives applied in clinical contexts, leading to a paucity of ethical perspectives relevant to population-level phenomena such as outbreaks. Alternative theories of public health ethics include the perspectives of relational autonomy and the patient as victim and vector. Public health actions need to incorporate clear and systematic procedures founded upon ethical principles. The MERS-CoV epidemic in Korea created significant public support for more aggressive early interventions in future outbreaks. This trend makes it all the more imperative for ethical principles and procedures to be implemented in future planning and responses to outbreaks in order to promote perceptions of legitimacy and civic participation.

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Structural Factors of the Middle East Respiratory Syndrome Coronavirus Outbreak as a Public Health Crisis in Korea and Future Response Strategies: Dong-Hyun Kim; J Prev Med Public Health. 2015;48(6):265-270. Published online November 30, 2015; DOI: https://doi.org/10.3961/jpmph.15.066

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Abstract PDF

The recent Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak has originated from a failure in the national quarantine system in the Republic of Korea as most basic role of protecting the safety and lives of its citizens. Furthermore, a number of the Korean healthcare system’s weaknesses seem to have been completely exposed. The MERS-CoV outbreak can be considered a typical public health crisis in that the public was not only greatly terrorized by the actual fear of the disease, but also experienced a great impact to their daily lives, all in a short period of time. Preparedness for and an appropriate response to a public health crisis require comprehensive systematic public healthcare measures to address risks comprehensively with an all-hazards approach. Consequently, discussion regarding establishment of post-MERS-CoV improvement measures must focus on the total reform of the national quarantine system and strengthening of the public health infrastructure. In addition, the Korea Centers for Disease Control and Prevention must implement specific strategies of action including taking on the role of “control tower” in a public health emergency, training of Field Epidemic Intelligence Service officers, establishment of collaborative governance between central and local governments for infection prevention and control, strengthening the roles and capabilities of community-based public hospitals, and development of nationwide crisis communication methods.

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Perspective

Costly Lessons From the 2015 Middle East Respiratory Syndrome Coronavirus Outbreak in Korea: Sang-il Lee; J Prev Med Public Health. 2015;48(6):274-276. Published online November 25, 2015; DOI: https://doi.org/10.3961/jpmph.15.064

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Abstract PDF

Since the Middle East respiratory syndrome (MERS) outbreak in the Republic of Korea (hereafter Korea) began on May 11, 2015, a total of 186 persons have been infected by the MERS coronavirus, 38 of whom have died. With this number, Korea becomes second only to the Kingdom of Saudi Arabia in the ranking of cumulative MERS cases. In this paper Korea’s unique experience of an outbreak of MERS will be summarized and discussed briefly.

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Original Article

Respiratory Syncytial Virus Outbreak in the Basic Military Training Camp of the Republic of Korea Air Force: Won-Ju Park, Seok-Ju Yoo, Suk-Ho Lee, Jae-Woo Chung, Keun-Ho Jang, Jai-Dong Moon; J Prev Med Public Health. 2015;48(1):10-17. Published online January 14, 2015; DOI: https://doi.org/10.3961/jpmph.14.037

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Abstract PDF

Objectives
An outbreak of acute febrile illness occurred in the Republic of Korea Air Force boot camp from May to July 2011. An epidemiological investigation of the causative agent, which was of a highly infective nature, was conducted.
Methods
Throat swabs were carried out and a multiplex reverse transcriptase-polymerase chain reaction (RT-PCR) assay was performed to identify possible causative factors.
Results
The mean age of patients who had febrile illness during the study period was 20.24 years. The multiplex RT-PCR assay identified respiratory syncytial virus (RSV) as the causative agent. The main symptoms were sore throat (76.0%), sputum (72.8%), cough (72.1%), tonsillar hypertrophy (67.9%), and rhinorrhea (55.9%). The mean temperature was 38.75°C and the attack rate among the recruits was 15.7% (588 out of 3750 recruits), while the mean duration of fever was 2.3 days. The prognosis was generally favorable with supportive care but recurrent fever occurred in 10.1% of the patients within a month.
Conclusions
This is the first epidemiological study of an RSV outbreak that developed in a healthy young adult group. In the event of an outbreak of an acute febrile illness of a highly infective nature in facilities used by a young adult group, RSV should be considered among the possible causative agents.

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Respiratory syncytial virus infection and the need for immunization in Korea
Hye Young Kim, Ki Wook Yun, Hee Jin Cheong, Eun Hwa Choi, Hoan Jong Lee
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COVID-19 outbreak in a military unit in Korea
Chanhee Kim, Young-Man Kim, Namwoo Heo, Eunjung Park, Sojin Choi, Sehyuk Jang, Nayoung Kim, Donghyok Kwon, Young-Joon Park, Byeongseop Choi, Beomman Ha, Kyounghwa Jung, Changbo Park, Sejin Park, Heeyoung Lee
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Comparative Study

Body Weight at Birth and at Age Three and Respiratory Illness in Preschool Children.: Yoolwon Jeong, Kyunghee Jung-Choi, Jin Hwa Lee, Hwa Young Lee, Eun Ae Park, Young Ju Kim, Eunhee Ha, Se Young Oh, Hyesook Park; J Prev Med Public Health. 2010;43(5):369-376.; DOI: https://doi.org/10.3961/jpmph.2010.43.5.369

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Abstract PDF

OBJECTIVES
The purpose of this study was to examine the associations of current body weight and body mass index (BMI) at age three and birth weight in developing chronic respiratory illness in childhood and identify possible interaction underlying its mechanism. METHODS: The study was carried out with 422 children who were enrolled in a hospital-based birth cohort. Birth related anthropometric data were collected at birth. At age 3 years, the presence of respiratory symptoms was evaluated by using the Korean version of core questionnaire for wheezing and asthma from the International Study of Asthma and Allergies in Childhood (ISAAC). Physical examination was carried out to measure the child's weight and height. RESULTS: Children in the lowest birth weight tertile (aOR = 3.97, 95% CI = 0.94-16.68) or highest BMI tertile (aOR = 3.68, 95% CI = 1.24-10.95) at three years of age were at an increased risk of chronic respiratory illness. Children who were initially in the lowest birth weight tertile but now belong in the highest weight tertile had higher risk of chronic respiratory illness compared to those who had remained in the middle tertile (OR=16.35, 95% CI=1.66-160.57). CONCLUSIONS: Children with lower birth weight or higher BMI were at an increased risk of chronic respiratory illness. In addition, children who were initially in the lowest birth weight tertile but are now in the highest weight tertile had higher risk of chronic respiratory illness compared to those who remained in the middle tertile.

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Sari Törmänen, Eero Lauhkonen, Antti Saari, Petri Koponen, Matti Korppi, Kirsi Nuolivirta
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Evaluation Studies

Association between Hypertension and Pulmonary Function in Rural Adults in Korea.: Joo Young Lee, Song Vogue Ahn, Dong Phil Choi, Mina Suh, Hyeon Chang Kim, Young Sam Kim, Il Suh; J Prev Med Public Health. 2009;42(1):21-28.; DOI: https://doi.org/10.3961/jpmph.2009.42.1.21

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Abstract PDF

OBJECTIVES
Whilst hypertension exerts a negative effect on several organs there have been few studies regarding its effect on pulmonary function. The objective of this study was to examine the relationship between hypertension and pulmonary function in rural Korean adults. METHODS: In 2006, 2534 people were recruited, aged 40 to 70, in Kangwha County. We selected 1454 (male: 624, female: 830) participants whose pulmonary function results were repeatable. Blood pressure (BP) was measured twice and the average calculated. Participants were divided into two groups (hypertensive group and non-hypertensive group) in accordance with The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Pulmonary function was measured by dry rolling seal spirometry. Forced expiratory volume in the one second and forced vital capacity were converted into percent-predicted values based on average pulmonary function amongst Koreans. RESULTS: The number of hypertensive participants in the present study was 460 (male: 205, female: 255) and the number of non-hypertensive participants was 994 (male: 419, female: 575). Our findings have shown that the mean values for expiratory volume in the one second and forced vital capacity were significantly lower for hypertensive people than for non-hypertensive people, among women (P=0.002 for forced expiratory volume in the one second, P<0.001 for forced vital capacity volume). Odds ratio analysis revealed that hypertensive participants were more likely to have lower pulmonary function than non-hypertensive participants, again significantly among women. CONCLUSIONS: The pulmonary function of hypertensive women was significantly lower than that of non-hypertensive women aged 40-70.

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Original Articles

Factors Affecting the Use of Medical Services by Workers with Respiratory Diseases.: Yeon Soon Ahn, Jae Seok Song, Seong Kyu Kang, Ho Keun Chung; Korean J Prev Med. 2002;35(1):49-56.

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Abstract PDF: OBJECTIVES
To identify the relationship between the use of medical services by workers with three types of respiratory diseases (total respiratory diseases, acute upper respiratory infections and chronic lower respiratory diseases) and exposure to hazardous agents after controlling for other factors affecting medical services use, such as characteristics of the enterprises (scale, industry type) and employee demographics (sex, age). METHODS: The study population comprised 28,882 workers who had undergone general or special medical examinations at the industrial health center at least once between Jan 1995 and Dec 1997 and had possessed medical insurance during the period. We combined medical examination data with medical insurance data in order to analyze the relationship between exposure to hazardous agents and respiratory diseases. RESULTS: Among the 28,882 study subjects, 17,454 employees (60.4%) used medical services more than once during 3-year study period, owing to more than one kind of respiratory diseases. In logistic regression analysis, sex, age and the size of the enterprises proved to be significant variables on the use of medical services for all three types of respiratory disease: The use of medical services increased with employee age. Women used more medical services than men and the employees in the large-scale enterprises used more services than employees in small-scale enterprises. However, exposure to dust or organic solvents did not affect medical service use due to total respiratory diseases or acute upper respiratory infections. Only in the case of chronic lower respiratory diseases did workers exposed to dusts (OR=1.12, 95% CI=1.01 -1.24) or organic solvents (OR=1.19, 95% CI=1.05-1.35) use more medical services than those not exposed. CONCLUSIONS: Workers exposed to dusts or organic solvents are particularly apt to suffer from chronic lower respiratory diseases and use medical services more often than those not exposed. That is, chronic exposure to hazardous agents such as dusts and organic solvents is believed to be harmful and to cause respiratory symptoms and diseases.; Summary

Correlation of Fit Factors for Respirators and Anthropometric Dimension.: Don Hee Han; Korean J Prev Med. 1998;31(3):440-448.

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Abstract PDF: In many developed countries, for example, USA, respirator fit testing is required before entering specific work environment to ensure that the respirator worn satisfies a minimum of fit and that the user knows when the respirator fits properly. Unfortunately because we have not fit test regulation in Korea, a lot of workers wearing respirators may be potentially exposed to hazards. This study was conducted to evaluate the fitting performance for respirators and correlation fit factors with facial dimensions of wearers. 110 subjects (70 males, 40 females) were fit tested for three quarter masks, i.e., two domestic-made Mask Z, and Y and one foreign-made Mask T using PortaCount 8020. A facial dimension survey of the same subjects was conducted to develop a facial dimension grids for correlation fit factors with facial dimension parameters. A facial dimension grid was developed on the basis of face length and lip length for quarter masks. The results obtained were as follows: 1. Fit factors of Mask T were much higher than those of Masks Z, and Y. 2. Males were fitted more properly than females. 3. Male in box "f" of grid would be adequately fitted Mask Y and male in box "b", "e", "f", "h" of grid would be sufficiently fitted Mask T. Female in box "h" of grid may have a good fitting performance for both Mask Y, and T. But subjects in all boxes of grid would be inadequately fitted Mask Z.; Summary

Respiratory symptoms of workers exposed to the fume containing manganese.: Sun Hee Yu, Doo Hie Kim, Hyun Sul Lim, Ji Yong Kim, Byung Soon Choi; Korean J Prev Med. 1997;30(4):752-763.

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Abstract PDF: To evaluate the effect of manganese on the respiratory system, we investigated the respiratory symptoms of 63 male workers exposed to fume containing manganese (Mn), iron (Fe), and silica (Si), and compared them with those of 66 male workers not exposed to the fume in a manganese alloy smelting factory. The prevalence ratios of the seven respiratory symptoms were not different between two groups. The presence of any respiratory symptom was not related with the age, duration of employment, smoking status of workers, and exposure to fume. In furnace workers, it was not related with the airborne Mn, Fe, and Si concentration in the total or respirable fume. Airborne Mn concentrations of all 4 furnaces in the respirable fume were below 1 mg/m(3). There were two suspicious cases of pneumoconiosis among furnace workers and one definite case(1/2) among casting workers who were not exposed to fume. The above results suggest that the exposure to the low airborne Mn concentration is not related with respiratory symptoms and pneumoconiosis. However, it is necessary to study the respiratory effects of Mn using the symptom questionnaire with consideration of the severity and persistence of symptoms and the time interval from exposure.; Summary

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