Journal of Preventive Medicine and Public Health

Original Articles

The Effects of Temperature on Heat-related Illness According to the Characteristics of Patients During the Summer of 2012 in the Republic of Korea: Wonwoong Na, Jae-Yeon Jang, Kyung Eun Lee, Hyunyoung Kim, Byungyool Jun, Jun-Wook Kwon, Soo-Nam Jo; J Prev Med Public Health. 2013;46(1):19-27. Published online January 31, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.1.19

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Objectives

This study was conducted to investigate the relationship between heat-related illnesses developed in the summer of 2012 and temperature.

Methods

The study analyzed data generated by a heat wave surveillance system operated by the Korea Centers for Disease Control and Prevention during the summer of 2012. The daily maximum temperature, average temperature, and maximum heat index were compared to identify the most suitable index for this study. A piecewise linear model was used to identify the threshold temperature and the relative risk (RR) above the threshold temperature according to patient characteristics and region.

Results

The total number of patients during the 3 months was 975. Of the three temperature indicators, the daily maximum temperature showed the best goodness of fit with the model. The RR of the total patient incidence was 1.691 (1.641 to 1.743) per 1℃ after 31.2℃. The RR above the threshold temperature of women (1.822, 1.716 to 1.934) was greater than that of men (1.643, 1.587 to 1.701). The threshold temperature was the lowest in the age group of 20 to 64 (30.4℃), and the RR was the highest in the ≥65 age group (1.863, 1.755 to 1.978). The threshold temperature of the provinces (30.5℃) was lower than that of the metropolitan cities (32.2℃). Metropolitan cities at higher latitudes had a greater RR than other cities at lower latitudes.

Conclusions

The influences of temperature on heat-related illnesses vary according to gender, age, and region. A surveillance system and public health program should reflect these factors in their implementation.

Summary

Citations

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Issues in Air Pollution Epidemiologic Studies.: Eun Hee Ha, Ho Jang Kwon; Korean J Prev Med. 2001;34(2):109-118.

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Abstract PDF: The purpose of this review is to discuss the debate concerning the interpretation of epidemiologic studies on particles and health effects. Study of the 1952 air pollution disaster in London established that very high levels of particulate-based smog can cause dramatic increases in daily mortality. However, recent epidemiologic studies have reported statistically significant health effects and mortality due to low levels of air pollution. The statistical significance does not prove causation in observational studies; therefore it is necessary to evaluate these associations. There are arguments for and against each of the numerous studies using Hill's criteria, however the body of accepted evidence supports the causal association. In particular, a high level of consistency in the estimated effect of PM10 has been observed across studies worldwide. The mechanism of the relationship between air pollution and health effects is not obvious. The mechanism of particle-induced injury may involve the production of an inflammatory response by the particulate. The harvesting and the threshold effect are also major concerns regarding the health effects of air pollution. However, current epidemiologic findings indicate that linear models lacking a threshold are appropriate for assessing the effect of particulate air pollution on daily mortality even at current levels.; Summary

Basic Study on the Hearing-threshold Levels of Workers with Noise-induced Hearing Loss in Korea.: Yeon Soon Ahn, Young Han Moon, Sang Yeal Lee, Kyung Nam Lee; Korean J Prev Med. 1999;32(1):17-29.

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Abstract PDF: OBJECTIVES
This study was carried out to analyze the hearing-threshold levels and relating factors of 1,048 workers with noise-induced hearing loss(D1). METHODS: We analyzed the hearing-threshold levels and relating factors of 1,048 workers with noise-induced hearing loss(D1) examined by the summary reports of specific health examination results of industries and personal reports of specific health examination results reported by 58 specific health examination institutes and 8 secondary pneumoconiosis examination institutes in 1996. RESULTS: Among 1,048 workers at 510 workplaces, male workers were 1,009 (96.3%) and female workers were 39 (3.7%). The mean ages of workers initially exposed to noise and at present were 28.7 and 47.2, respectively. The duration of total exposure was 16.5 years. Average hearing-threshold levels analyzed by three-divided classification of the study subjects were 43.7dB(Lt) and 42.6dB(Rt). Those analyzed by six-divided classification were 50.5dB(Lt) and 48.6dB(Rt). Among workers with noise-induced shearing loss(D1), 16.3% was unilateral hearing loss and 84.6% was classified to compensation case. 8.8%(Rt) and 10.2%(Lt) of them were suspected to be conductive hearing loss by differences of air-bone hearing-threshold levels. Hearing-threshold levels of workers in manufacturing industry were significantly increased during the short exposure compared with the levels in mining industry. Among manufacturing industries, hearing-threshold levels of workers in trailer and other transportation equipment manufacturing industry were significantly increased. Age and duration of total noise exposure were not significantly related to the average hearing-threshold levels analyzed by three-divided classification. Hearing-threshold levels of female workers were significantly increased during the short exposure compared with those of male workers. Hearing-threshold levels of workers at the high risk group, ages of 20s, 30s and total exposure duration of less than 10 years, were not significantly increased compared with those of the other groups. However, they were exposed at young ages. The 3 leading industries of workers at high risk group were trailer and other transportation equipment manufacturing, automobile manufacturing and assemble-metal manufacturing industries. CONCLUSIONS: This study was the first nationwide analysis of the hearing-threshold levels and relating factors of workers with noise-induced hearing loss(D1). We found the differences of the real number by the statistics of the department of labour and the expected number of worker's compensations for occupationally-induced hearing loss estimated by this study. According to the results of this study, we should carefully examine the methods to narrow this difference.; Summary

Effect of cigareet smoking on air-conduction hearing threshold level in adult men.: Jin Seok Kim, Min Hae Yeh, Byung Yeol Chun, Kuck Hyeun Woo, Yune Sik Kang, Keon Yeop Kim, Young Sook Lee; Korean J Prev Med. 1998;31(2):285-292.

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Abstract PDF: To investigate the effect of smoking on the hearing threshold, l,887 adult male workers who visited health care center during the period l January 1996 - 31 July 1997 were selected. Air-conduction hearing threshold level, diastolic blood pressure(DBP), total cholesterol, fasting blood sugar(FBS), hematocrit and obesity, were measured. The data on age, occupation, and smoking were collected. Air-conduction hearing threshold in smoker was significantly higher than non-smoker in categories of 250, 500, 1000 and 4000 Hz(p<0.05). Mean values of PTA-low, PTA-mid, and PTA-high in smoker were also significantly higher than non-smoker(p<0.05). In multiple regression analysis, smoking is likely to play a significant role after controlling age, occupation, DBP, FBS, total cholesterol, hematocrit, and obesity,(p<0.05). The hearing threshold was significantly increased with increasing age(p<0.05), the manufacturing worker may have higher hearing threshold(p<0.05). The higher hematocrit and the more obese, the higher hearing threshold(p<0.05). However, DBP, total cholesterol and FBS were not significantly related with hearing threshold level. In conclusion, smoking was significantly related with the hearing threshold level in adult men.; Summary

Association between Myofascial Pain Syndrome and the Assessment of Pain and the related Function tests in female telephone directory assistance operators using BDT.: Sang Chul Roh, Soo Jin Lee, Jae Cheol Song, Hung Bae Park; Korean J Prev Med. 1997;30(4):779-790.

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Abstract PDF: The Association between myofascial pain syndrome and some tests was assessed in a cross-sectional study of 904 female telephone operators using video display terminals(VDTs). 105 cases were diagnosed as Myofascial pain syndrome with symptom questionnaire, laboratory examination and physician's physical examination and 550 controls were defined to show only musculoskeletal symptoms using NIOSH symptom criteria. Data on demographics, musculoskeletal symptom and visual analogue scale(VAS) were obtained by questionnaire. Anthropometric measurements, pressure pain threshold, Grip and Pinch strength and laboratory test were conducted. No significant difference between case and control at comparing of demographics, occupational history and body measurements were observed. But, Grip strength, pressure pain threshold and VAS showed the statistical difference between case and control. Age, pressure pain threshold of Rt. Upper trapezius and VAS were associated with myofascial pain syndrome in multivariate logistic regression analysis. This results suggest that, to diagnose of myofascial pain syndrome, the consideration of the objective aspects among patients' subjective symptom complaints through the VAS and pressure pain threshold is required.; Summary

Association between air conduction hearing threshold and blood viscosity in normal adult males.: Sang Woo Kim, Jong Young Lee, Wan Seup Park, Kuck Hyeun Woo; Korean J Prev Med. 1997;30(3):623-629.

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Abstract PDF: This is cross-sectional study a potential relationship between air conduction hearing threshold and blood viscosity in normal adult males(n=1677). We measure hearing threshold in frequency level at 500, 1000, 2000, 4000Hz by pure-tone audiometry and RBC profiles contains red cell number, hemoglobin, hematocrit. Blood viscosity replaced by hematocrit that are one major factor of influencing blood viscosity. PTAs(pure-tone averages) measured by hearing threshold averages level at 500Hz, 1000Hz, 2000Hz by pure-tone audiometry. Grades of PTAs(pure-tone averages) are less then 10.0dB group, between 10.0-19.9dB group and excess 20.0dB. The results are significantly association among hematocrit, red cell number and hearing loss(age adjust by ANACOVA).; Summary

Comparison of Weighted Needle Pinprick Sensory Thresholds and Sensory Nerve Conduction Studies in Diabetic Patients.: Jae Kwan Yoo, Seong Ah Kim, Jong Young Lee; Korean J Prev Med. 1995;28(4):899-910.

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Abstract PDF: This study was conducted to determine the correlation between weighted needle pinprick sensory threshold(PPT) and sensory nerve conduction tests. The subjects were 53 healthy controls, 31 diabetic patients without peripheral neuropathic symptoms(DM) and 36 diabetic patients with peripheral neuropathic symptoms(DN). PPT was measured on the index and little fingers, bilaterally, as well as under the lateral malleolus, bilaterally. In electrophysiologic assessment the left and right median, ulnar and sural nerves were studied. Each mean PPTs was high in order of controls, DM and DN. Age adjusted PPT was significantly different among three groups on right little finger(p<0.05) and left malleolus(p<(0.05), but not significantly different between DN and DM on other sites. Each sensory nerve conduction velocity and amplitude was statistically significantly different among three groups(p<0.05). Correlations of PPT with sensory nerve conduction velocity and amplitude were statistically significant on each site and ranged from -0.4203(left malleolus) to -0.5649(right index finger) and from -0.3897(left index finger) to -0.6200(right index finger), respectively. When electrophysiological study is not feasible, measurement of PPT may be helpful for the assessment of peripheral sensory neurological function.; Summary

Temporary Threshold Shift of Vibration Sensation by Dental Handpiece.: Seong Ah Kim, Jong Young Lee, Doohie Kim, Soon Woo Park; Korean J Prev Med. 1995;28(4):765-772.

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Abstract PDF: This study was performed to investigate the possibility of temporary threshold shift (TTS) of vibration sense could induced by exposure to high-frequency vibration or by work position taking by dentists in drilling or polishing. The vibratory perception thresholds (VPT) of 28 healthy men were measured on the index fingertip pulp of dominant hand at 250Hz. The vibrating tool used in test was a low-speed handpiece of 34,000 rpm. For the TTS test, the dominant hand was exposed to high-frequency vibration and to work position for five minutes, respectively. The VPTs before and after vibratory exposure were 23.5+/-3.5 dB, 30.8+/-4.2 dB, respectively and VPT after work position was 23.7+/-4.6 dB. The difference between before and after vibartory exposure was statistically significant (P<0.001). The correlation of height, weight and BMl with baseline VPTs was not statistically significant. Also, there was no difference of VPTs by smoking. These results suggest that high-frequency vibration from dental handpieces might cause the impairment of vibration sensation.; Summary

A Study on the Effect of Improvement in Work Environment and of Segregation in a Fluorescent Lamp Manufacturing Factory.: Soung Hoon Chang, Kwang Jong Kim; Korean J Prev Med. 1989;22(4):474-479.

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Abstract PDF: This research was conducted to evaluate the effect of improvement in work environment and of segregation in a fluorescent lamp manufacturing factory. Among the total of 80 workers, 8 workers whose mercury concentration in urine reached a hazardous level (200-299 microgram/l) were moved to mercury free workplace. The follow-up examination for their mercury concentration in urine was done three times; on May 3, 1988, September 1, 1988 and April 3, 1989. The results were as follows: 1. Mercury concentration in the air was reduced from 0.140 to 0.107 mg/m3 in 4 months, and to 0.087 mg/m3 in one year after environmental improvement in workplace. However the level still exceeded the Threshold Limit Value. 2. The geometric mean of urinary mercury concentration among 80 workers was 173.0 microgram/l (5.1~458.6 microgram/l). The distribution of workers according to urinary mercury concentration showed that 9 workers (11.2%) were above the mercury poisoning level (300 microgram/l), 24 workers (30.0%) were 200-299 microgram/l, 35 workers (43.8%) were 50-199 microgram/l, and 12 workers (15.0%) were below 50 microgram/l. 3. Among the 24 workers whose urinary mercury concentration was 200-299 microgram/l, 8 were able to be followed up. Their mean urinary mercury concentration before segregation was 244.9 microgram/l, but decreased to 151.4 microgram/l in four months, 128.8 microgram/l in six months, and 46.8 microgram/l in one year after segregation.; Summary

English Abstract

A Study on Scheduling Periodic Examinations for the Early Detection of Breast Cancer in Korea.: Seong Hwa Jeong, Dae Ryong Kang, Nam Wook Hur, Jinheum Kim, Soon Young Lee, Sang Hyuk Jung, Chung Mo Nam; J Prev Med Public Health. 2006;39(4):346-352.

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Abstract PDF: OBJECTIVES
The purposes of this study were to propose a screening schedule for the early detection of breast cancer among Korean women, as based on the statistical model, and to compare the efficacy of the proposed screening schedule with the current recommendations. METHODS: The development of the screening schedule for breast cancer closely followed the work of Lee and Zelen (1998). We calculated the age-specific breast cancer incidence rate from the Korea Central Cancer Registry (2003), and then we estimated the scheduling of periodic examinations for the early detection of breast cancer, using mammography, and based on the threshold method. The efficacy of the derived screening schedule was evaluated by the schedule sensitivity. RESULTS: For estimating the screening schedule threshold method, we set the threshold value as the probability of being in the preclinical stage at age 35, the sensitivity of mammography as 0.9 and the mean sojourn time in the preclinical stage as 4 years. This method generated 14 examinations within the age interval [40, 69] of 40.0, 41.3, 42.7, 44.1, 45.4, 46.7, 48.0, 49.3, 51.0, 53.2, 55.3, 57.1, 59.0 and 63.6 years, and the schedule sensitivity was 75.4%. The proposed screening schedule detected 85.2% (74.5/87.4) of the cases that could have been detected by annual screening, but it required only about 48.7% (14.0/30.0) of the total number of examinations. We also examined the threshold screening schedules for a range of sensitivities of mammography and the mean sojourn time in the preclinical stage. CONCLUSIONS: The proposed screening schedule for breast cancer with using the threshold method will be helpful to provide guidelines for a public health program for choosing an effective screening schedule for breast cancer among Korean women.; Summary

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