Journal of Preventive Medicine and Public Health

Volume 19(2); November 1986

Original Articles

A Study on the Normal Values of Lead Exposure Indices.: Hai Rim Shin, Joon Youn Kim; Korean J Prev Med. 1986;19(2):167-176.

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Abstract PDF: For the purpose of determination the normal values of some parameters relevant to lead exposure, a study was carried out from April to June 30, 1986 on 258 healthy Korean adults who have had no apparent lead exposure. The lead indices subjected to this study were as follows; blood lead (PbB), hemoglobin (Hb), zinc protopprphyrin in blood (ZPP), delta-aminolevulinic acid dehydratase (ALAD) activity in blood, coproporphyrin in urine (CPU), delta-aminolevulinic acid in urine (ALAU). 1) The mean value of PbB was 17.17+/-7.87 microgram/100ml, and there was no statistically significant difference by age & sex. The distribution of PbB fitted to the log-normal distribution (chi-square=7.38, p>0.1). 2) The mean value of Hb in male (15.17+/-1.56g/100ml) was higher than in female (13.22+/-1.51 g/100ml)(p<0.01). The distribution of Hb fitted to the normal distribution (chi-square=9.40, p>0.1). 3) The mean value of ZPP was 32.61+/-8.78 microgram/100ml, and there was no statistically significant difference by age & sex. The distribution of ZPP fitted to the normal distribution (chi-square=13.93, p>0.05). The correlation of ZPP & ALAD (r=-0.229), CPU (r=0.183) was statistically significant respectively. 4) The mean value of ALAD was 30.20+/-10.96 mol ALA/min/L of R.B.C., and there was no statistically significant difference by age & sex. The distribution of ALAD activity did not fit to the normal distribution. The correlation between ALAD & PbB (r=-0.219) was statistically significant. 5) The mean value of CPU was 36.10+/-24.54 microgram/L, and there was no statistically significant difference by age & sex. The distribution of CPU did not fit to the normal distribution. The correlation between CPU & PbB (r=0.185), ZPP (r=0.183) was statistically significant respectively. 6) The meant value of ALAU was 1.94+/-0.96 ml/L, and there was no statistically significant difference by age & sex. The distribution of ALAU fitted to the normal distribution (chi-square=9.76, p>0.1).; Summary

Health Impairment among Toluene exposed Workers.: Young Hahn Moon, Jae Hoon Roh; Korean J Prev Med. 1986;19(2):177-183.

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Abstract PDF: Subjective symptoms, counts of blood cells and liver function test were conducted on 198 male workers who were exposed to toluene in Kyungin area from September to November, 1986. According to level of urinary hippuric acid concentration, the total sample was classified into the high exposure group (concentration > or = 3g/l) and the low exposure group(concentration < 3g/l). The following findings were obtained by comparing the two group: 1) Contrary to the previous findings, the urinary hippuric acid concentration of toluene exposed workers showed bimodal distribution. It meant that the toluene exposed workers were mixed with the non-exposed or minimal exposed workers. 2) The high exposure group showed a lower level of leucocccytes counts (6,630+/-1,860/microliter) than the low exposure group (6,340+/-1,960/microliter). 3) The high exposure group showed a higher level of SGOT, SGPT and r-GTP than the low exposure group(P<0.05). 4) The high exposure group complained much more subjective symptoms (e.g. skin rash, loss of appetite, palpitation) than the low exposure group.; Summary

An Experimental Study on the Efficacy of Vitamin E against Oxygen Toxicity.: Sung Gyu Lee, Sang Il Lee, Soo Hun Cho, Dork Ro Yun; Korean J Prev Med. 1986;19(2):184-192.

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Abstract PDF: Since the wide spread application of hyperbaric oxygenation in clinical setting, the problems of oxygen toxicity have been attracting a deep interest from the researchers on hyperbaric medicine as a practical issue. Among extensive research trials, the study on the protective agents against oxygen toxicity occupied one of the most challenging field. As the mechanisms of oxygen toxicity, the role of the oxygen free radicals produced by peroxidation process are strongly accepted by the leading researchers on oxygen toxicity, the probable protective effects of antioxidant against oxygen toxicity are sustaining a sufficient rationale. In this study, the author attempted to evaluate the effect of vitamin E as a protective agent against oxygen toxicity through the observation of death rate, convulsion rate, time to convulsion, and macroscopic and microscopic pathological changes of experimental rats exposed to 100% oxygen at 5 ATA for 120 minutes. The findings observed are as follows: 1) The death rate, convulsion rate, time to convulsion, organ/body weight ratio and microscopic pathological findings were identified as reliable objective and quantitative indices for oxygen toxicity. 2) Vitamin E showed excellent protective effects against CNS and pulmonary oxygen toxicity as a strong antioxidant. The most effective dose seemed to be around 400 mg/kg. 3) The results of this study are supporting the oxygen free radical hypothesis on oxygen toxicity.; Summary

Assessment of the Activities of General Physicians in Health Subcenters and a Scheme to Improve the Training Program.: Jung Han Park, Byung Yeol Chun, Kuck Hyeun Woo; Korean J Prev Med. 1986;19(2):193-202.

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Abstract PDF: The activities of general physicians (GPs) in health subcenters and their competency for clinical skills were assessed to develop a scheme to improve the training program. One hundred-twenty GPs in southern four provinces (Kyungpook Kyungnam, Chunpook, Chunnam) were randomly selected and 97 were interviewed between January 9 and February 10, 1984. Of the 97 GPs, 86 provided all the information we requested. Average number of patient visits per health subcenter in a day was 30-40 in the demonstration project area for the class II medical insurance whereas it was 3-4 visits in other area. The interviewees asked to rate their competency in 63 clinical skills. The skills in which over 50% of the interviewees rated themselves competent were only 12 items including IM injection, IV injection, wound dressing, etc. Less than 10% of the interviewees rated themselves competent in such skills as maternal health care, emergency medical care, preventive and promotive health services. Most part of the training program of the NIH for the GPs were not applicable to their field work as the training contents were unrealistic. Clinical training at a local general hospital was of great help in 38.8% and the rest of training was not much helpful as the training was inadequate due to lack of trainer or indifference of the trainer. For more effective training of the GPs, the training program of the NIH should be modified to be more realistic and utilize competent field workers as the instructors. It may be more effective if the training is carried out at several local centers. Ideal length of the clinical training for the GPs is 4 months. A pocketbook should be developed that includes specific skills to master during the clinical training and require the trainer to confirm the achievement. The Ministry of Health and Social Affairs should provide the training hospitals with a training guideline and evaluate the training activities and make sure that the training hospital has specialist for each of the 4 major clinical departments. The Ministry of Health and Social Affairs shuld provide the GPs with a continuing education to assist the problem solving in the field and motivate them to activitely carry out the health program. A province may be divided into several regions and a supervisory committee may be organized with specialists in each region. The committee may hold a meeting for the GPs periodically and respond to the specific questions of the GPs by mail.; Summary

A Study on Sick Role Behavior of Some Hypertensive Workers.: Eunil Lee, Soonduck Kim, Chulwhan Cha; Korean J Prev Med. 1986;19(2):203-212.

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Abstract PDF: Hypertension is one of the most well known risk factors for cerebrovascular or coronary heart disease and is a major public health problem. Early detection and treatment of hypertension are essential, but the compliance of treatment on hypertension is not easy to archive. Hypertensive workers are being detected by the annual screening under the Labour Standard Law in Korea but the solidified control system for them is not existing. This study about workers' Motive- Belief-Action in non-drug and drug treatment of their hypertension would be worthwhile to interpret how the workers actually behave in coping with hypertension, and also would be advisable to construct the follow-up program in Korea. In the field research process two criteria were used to select sample group. The first criterion included the workers who were screened to be hypertensive with their blood pressure above 160/95 in this survey. The second one was used to classify study-group respondents who had known their hypertension by successive annual screening. From such criteria a total of 156 male workers were sampled in 21 industries, the author interviewed them using the structured questionnaire which consisted of Belief-Motive-Action items about non-drug and drug treatment for hypertension with open-ended question on symptom of hypertension. The summary is as follows: 1) Sixty-one percent of respondents had ever checked their blood pressure somewhere besides the annual screening. 2) Most respondents(97.2%) complained no symptoms of hypertension at all. 3) Belief level of non-drug treatment was relatively high (82.1%-64.7%), but motive (55.1%-28.2%) and action (38.5%-16.7%) levels were low. 4) Belief level of drug treatment was relatively lower than that of non-drug treatment, blue collar workers showed higher action level of drug treatment than white collar workers, and correlation coefficient between belief and motive on drug treatment was lower in group of not-recognizing their family history of hypertension than recognized group. Such findings indicated that belief on drug treatment of hypertensive workers would be problematic. 5) White collar workers showed significant lower correlation coefficients between Motive and Action of salt restriction, restriction of fatty diet and relaxation than blue collar workers. 6) Mild hypertension group showed low levels of Motive and Action of non-drug treatment (salt restriction, restriction of fatty diet and relaxation) and also showed low correlation coefficient between Belief and Motive of above non-drug treatment.; Summary

A Study on the Ratio Analysis as a Tool for Evaluating Financial Performance.: Young Moon Chae, Jung Hyun Yun, Hae Jong Lee; Korean J Prev Med. 1986;19(2):213-223.

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Abstract PDF: Ratio analysis allows a hospital to evaluate its own performance over time and to compare its performance with that of other hospitals. For this study, three types of ratio analysis were conducted based on some data on hospitals in Massachusetts. First, Key ratios influencing financial performance were identified using discriminant analysis. Second, the financial structures of the teaching and the non-teaching hospitals were compared using ratios and multiple comparison method. Third, the effects of the prospective reimbursement law of the state on financial performance were examined using ratios and paired t-test. The purpose of the law is to reduce hospital costs by setting the revenue ceiling prior to the effective budget year. The findings of this study were as follows: 1) When hospitals were divided into three groups, according to their operating income, only profitability ratios showed a consistent difference among the groups. 2) In the discriminant analysis, five ratios were selected: current ratio, operating margin, return on assets, fixed assets turnover, and inventory turnover. They are the key ratios to be monitored periodically for the purpose of evaluating the financial performance of hospitals. 3) When teaching hospitals were compared with non-teaching hospitals, acid ratio, days of cash on hand, and inventory turnover were statistically significant before the law went into effect, whereas only fixed assets turnover and inventory turnover were significant afterward. Contrary to previous studies, profitability ratios of teaching hospitals were higher than those of non-teaching hospitals, although the differences were not statistically significant. 4) When the ratios between the two periods (before and after the law) were compared, three profitability ratios (operating margin, return on assets, and return on equity) were significant for teaching hospitals, whereas three activity ratios (total assets turnover, fixed assets turnover, current assets turnover) were significant for non-teaching hospitals. Furthermore, while both total operating revenue and expenses were decreased, net operating income was increased, due to a greater decrease in total operating expenses. This shows that the law can indeed, simultaneously, achieve both a reduction in costs as well as improvement in the financial situation of hospitals.; Summary

Total Phenol Value in Urine for the Phenol Resin Workers.: Kyu Dong Ahn, Doo Hie Kim; Korean J Prev Med. 1986;19(2):224-232.

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Abstract PDF: This study was conducted to evaluate health consequences of phenol resin workers for 6 weeks from February 21, to March 28, 1986. The subject population was 26 in a factory with phenol resin and control group was 30 non-exposed workers who were working in the other factory. The biological parameters chosen for this study were phenol concentration in working room-air, total phenol level in urine and BUN of phenol resin workers. The phenol concentration in working room-air and total phenol in urine were significantly correlated (r=0.791, p<0.01). The frequency of symptom and sign in phenol resin workers were higher than control group. The frequent symptom and sign were coughing, weight loss, poor appetite, headache, dyspnea, eye irritation and tinnitus, in order. Total phenol in urine was not reversed to normal range in spite of interruption of exposure for 4 days. The BUN value in blood and total phenol in urine were not correlated.; Summary

Mental Health Status among Users of Medical Facilities in Mining Area.: Bong Suk Cha, Jong Ku Park; Korean J Prev Med. 1986;19(2):233-243.

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Abstract PDF: Our study was designed to identify the difference in the mental health status among hospitalized patients due to occupational diseases and accidents and pre-employment physical examinees, and to identify the relationship between mental health status and socio-demographic variables, and to provide information useful to non-psychiatric clinicians in caring of such patients. Samples were comprised of 189 pneumoconiotic patients, 132 industrial accident-induced patients and 122 pre-employment physical examinees who were interviewed with 90-item symptom cheklist(SCL-90). The following results were obtained: 1) Mean scores of symptom dimension on socio-demographic subgroup showed higher tendencies in older aged, male, lower educated, miner, married, mining residence, and pnemoconiotic patients. 2) Mean scores of total samples on all symptom dimensions were as follows in the order of their magnitudes; Depression, Somatization, Obsessive-compulsive, Anxiety, Psychoticism, Interpersonal sensitivity, Phobic-anxiety, Hostility, and Paranoid ideation. 3) The highest mean scores on each socio-demographic subgroup were as follows; Depression in younger aged and Somatization in older aged; Depression in male Somatization in female; Somatization in lower educated and depression in higher educated; Somatization in miners and depression in non-miners; Somatization in married and Depression in unmarried; Depression in all kind of residences; Somatization in patients and Depression in pre-employment physical examinees(normal). 4) In consequence of stepwise multiple regression, the important socio-demographic variables were age, occupation, diagnostic classification, and residence. Age was the most important variables in Somatization, Depression, Obsessive-compulsive, Anxiety, Phobic ideation, and Psychoticism. Occupation was the most important one in Interpersonal sensitivity and Hostility and also had significant relationships with all symptom dimensions.; Summary

Effects of Mitomycin C on Sister Chromatid Exchanges in Cultured Human Lympocytes.: In Dam Hwang, No Suk Ki, Jeong Sang Lee, Nam Song Kim, Tae ll Mun; Korean J Prev Med. 1986;19(2):244-251.

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Abstract PDF: Sister chromatid exchanges(SCEs) and cell cycle kinetics were proposed as a sensitive and quantitative assay for mutagenicity and cytotoxicity in short-term cultures of phytohemagglutinin(PHA)-stimulated human lymphocytes. Therefore, this study was performed to investigate the relation between the cytotoxic effects and sister chromatid exchanges. The results are summarized as follows: 1) The frequency of SCEs per cell are 13.1+/-2.8 in the lower concentration of 6.25x10(-9) M and 75.8+/-8.2 in the highest concentration of 1.00+/-10(-7) M. Mitotic index is decreased in the higher concentration of mitomycin C. The result indicates that mitomycin C led to a dose dependent increase in SCE frequency, but decrease in mitotic index. 2) Chromosomal analysis was performed on metaphase cells that have divided one, two, and three or more times for cell cycle kinetics by fluorescence-plus-Giemsa(FPG) technique. According to the increased but the cells of third division are greatly decreased. 3) The frequency of SCEs per chromosome by chromocomal group are decreased gradually from A group to G group. But relationships between specific chromosomal group and SCEs frequency are not found.; Summary

Survey on Ambient Air Quality in Pusan Areas.: Y W Kim, J Y Kim, J H Lee, D H Moon, H R Shin, J T Lee, M C Lee; Korean J Prev Med. 1986;19(2):252-262.

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Abstract PDF: In order to assess the degree of atmospheric pollution and to contribute the health improvement of residents in Pusan, the authors measured CO, SO2, NO2 and TSP level at 3 places by season and time from July, 1985 to April, 1986. The places were S my n, Sasang and Daeshin-dong, which were known as the commercial, industrial and residental area in Pusan, respectively. The Obtained results were as follows: 1) The average concentration of CO was highest with 2.19+/-0.52(3.5-1.0)ppm at Sasang area, and lowest with 1.32+/-0.55(3.0-0.5)ppm at Daeshin-dong areas. 2) The average concentration of SO2 was highest with 0.092+/-0.073(0.378-0.028)ppm at Sasang, and lowest with 0.041/-0.014(0.083-0.019)ppm at Daeshin-dong. 3) The average concentration of NO2 was highest with 0.069+/-0.012(0.090-0.050)ppm at Somyon, and lowest with 0.043+/-0.010(0.061-0.032)ppm at Daeshin-dong. 4) The average concentration of TSP was highest with 300+/-130(780-130) microgram/m3 at Sasang, and lowest with 160+/-80(390-70) microgram/m3 at Daeshin-dong. 5) The level of CO and TSP were highest in summer at Somyon and Daeshin-dong, and in winter at Sasang, respectively. The level of SO2 and NO2 were highest in winter and spring at all areas. 6) The level of all air pollutants were highest in the afternoon or night than in the morning.; Summary

A Study on the Degree of Impairment of Whole Person in Leprosy Patients.: Wook Hee Yoon, In Dam Hwang; Korean J Prev Med. 1986;19(2):263-272.

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Abstract PDF: During the 8 months from October 1985 to May 1986, the survey was performed on 211 leprosy patients over fifty years old, settled in the four villages of Iksan country, North of Chulla province. In that observation, we investigated the frequency and the degree of impairments according to sex, age, and anatomical location by the "guides to the evaluation of permanent impairment". The noticeable findings were made as follows: 1) Frequency of impairment by anatomical location was significantly higher in hand than eye and foot (p<0.01). 2) Frequency of impairment was significantly increased in eye according as age increase (p<0.01). 3) The degree of impairments of all patients was the highest in hand as 28.7%. 4) By the kinds of impairments, the flextion and the amputation were most common in hand and foot, and loss of central vision was common symptom in eye. 5) The degree of impairments of 211 leprosy patients was shown as 44.1% and increased according as age increase.; Summary

A Sanitary Survey on the Medicinal Water Springs Located near Taegu City (1986).: Sang Duk Cha, Bong Ki Chang, Byung Yeol Chun, Doo Hie Kim; Korean J Prev Med. 1986;19(2):273-280.

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Abstract PDF: 'Medicinal water' have been used for the treatment of disease and the promotion of health. To study the quality and health effect of 'medicinal water', the eleven springs located near Taegu City during the period of March 27-February 17, 1986 were tested for biological and physiochemical examination and were checked for sanitary environment around the spring. Among them three springs (27.3%) had a good sanitary equipments and only one was negative for biological examination. Three 'medicinal water' were accepted as potable by physicochemical examination. According to above findings, all of the 'medicinal water' sampled from the springs located near Taegu City were not potable by this sanitary survey adopted Drinking Water Standard in Korea. Kachang and Youngchum 'medicinal water' were more contaminated by heavy metals and bacteria than those of other springs. To solve the problem of contamination by heavy metals that originated from uncertain sources, we should search for the sources of water contamination, remove it completely and also support the environmental equipments and management system in protection of safe 'medicinal water' supply.; Summary

Incidence of Hepatitis B Virus Infection of the School Children in a Rural Area of Korea.: Bo Youl Choi; Korean J Prev Med. 1986;19(2):281-292.

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Abstract PDF: Infection by hepatitis B virus is one of the major health problems of this nation. HBsAg positive rates of general population and school children were known to be as about 8 percent and 3.9 to 5.9 percent respectively. To study the incidence rate of hepatitis B infection in school children of rural area, author had examined 475 school children of relatively isolated agricultural area for baseline prevalence of hepatitis B virus serologic markers and followed up 415 school children during 10 months to determined the frequency of serologic conversion. The major results are summarized as followings: 1) Among the 278 susceptible children who were followed up, 26 had seroconversion for HBsAg or Anti-HBs. Therefore, the cumulative incidence rate during 10 months is estimated 9.4%. 2) The incidence rate of hepatitis B infection tends to increase with age (6-9yrs:3.2%, 10-14yrs:9.5%, 15-17yus:18.9%), and the incidence rate in male (13.0%) was higher than in female (5.7%). 3) The incidence rates of hepatitis B virus infection were not different statistically between visitors and non-visitors of clinic or hospital, dental clinic, person received IV and not received IV, and persons with familial history and without familial history of liver diseases. Therefore all of these factors were not identified as risk factor of hepatitis B virus infection. And the transmissibility within the class of school was not recognized, too. 5) Among the 25 children who were HBsAg positive when enrolled, 15 (60%) were still HBsAg positive, who were identified as chronic carrier. 15 of 415 school children were chronic carriers, then chronic carrier rate was estimated 3.6%, and there was no difference between sexes. 6) Of 38 children who had been Anti-HBs positive when enrolled, 5 (13.2%) lost Anti-HBs. Therefore, the loss rate of Anti-HBs per year is estimated to be 15.8%.; Summary

A Study on Morbidity of Chuncheon Citizen.: Sung Joo Hwang; Korean J Prev Med. 1986;19(2):293-306.

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Abstract PDF: A Health Interview Survey at Chuncheon city was conducted to assess level of illness by stratified random sampling method. Sample size was 6,007 and the prevalence of illness in period of 15 days was studied. 1) Prevalence rate of illness among Chuncheon citizen was 20.8 percent, and that of acute condition was 10.8 percent and chronic condition, 10.0 percent. 2) There was significant difference in prevalence rate by sex, especially the prevalence rate of chronic illness. 3) High positive correlation was noted between aging and prevalence rate of chronic illness. But negative correlation was noted in case of acute illness. 4) Multiple regression analysis on morbid state by socioeconomic variables was not seen to be appropriate for this survey, especially the analysis of acute illness. 5) Estimation of annual prevalence rate could not be possible because of seasonal variation of disease prevalence.; Summary

Residual Mercury in Soy-Bean Sprouts by Steps of Cooking.: Jun Yong Chung, Jung Duck Park, Kyou Chull Chung; Korean J Prev Med. 1986;19(2):307-313.

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Abstract PDF: This study was carried out in order to estimate the residual amount of mercury in soy-bean sprouts in each steps of cooking. Samples were taken at markets and also cultured at home without applying the mercury containing pesticides as control. Mercury was determined by dithizone method. It was disclosed that soy-bean sprouts purchased at markets contained 1.32+/-0.274 ppm, 13 times as high as the maximal allowable concentration of mercury in food recommended by Ministry of Health and Social Affairs. Mercury contents, however, dropped off steadily by steps of cooking: rinsed with distilled water and boiled in distilled water showing concentrations of 0.11+/-0.025 ppm in boiled sprouts and 0.03+/-0.022 ppm in sprout-soup. These values were not statistically different from those in control samples, and not exceeded the maximal allowabled levels of mercury in food. It can be concluded that the use of mercury containing pesticides in the cultivation of soy-bean sprouts is not so serious problem as it has been suspected in respect of food contamination, but careful attention must be paid to indiscriminate use of mercury containing pesticides as they may contaminate air, water and soil and secondarily bring harm to human health through food chains.; Summary

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