Journal of Preventive Medicine and Public Health

Volume 33(2); June 2000

Original Articles

Factors Affecting Health Practice of Primary School Students: Based on Health Promotion Model.: Kyung Won Kwon, Sin Kam, Ki Soo Park; Korean J Prev Med. 2000;33(2):137-149.

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The purpose of this study was to examine the factors related to children's health behavior. METHODS: A self-administered questionnaire survey was carried out for 431 (boys; 227, girls; 204) children, 6th grade students, in Taegu from December 14 to 18 in 1998. This study employed health promotion model as a hypothetical model. Collected data were analysed through the chi-square test, ANOVA, and path analysis. RESULTS: By univariate analysis, in case of boys, health practice was related to perceived self efficacy, perceived health status, perceived benefits of health-promoting behaviors, and perceived barriers, and in girls, health practice was related to perceived self efficacy, perceived benefits of health-promoting behaviors, perceived barriers, and cues to action. By path analysis, in case of boys, the better economic status, the younger mothers' age, the higher score of family cohesion and adaptability, healthier, the more perceived benefits, and the less perceived barriers were, the more health behaviors were practiced. Girls did the more health practice, in case of living with parents only, the higher score of family cohesion and adaptability, the more perceived self-efficacy, the less perceived barriers, and the more cues to action. Family cohesion had the most important effect on health practice of primary school students. CONCLUSIONS: In order to promote health behavior of primary school students, a good family environment as well as health education might be very important. That is, we have to try together in home and as well as in school.; Summary

Factors Affecting the Participation Rate in the Health Screening Program of Medical Insurance.: Sung Tae Youn, Han Joong Kim, Sun Ha Jee, Il Suh, Heechoul Ohrr; Korean J Prev Med. 2000;33(2):150-156.

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To analyze the factors affecting the participation rate in the health screening program of medical insurance. METHOD: We investigated the factors associated with the participation rate in the health screening program in Korea. Data were collected at the aggregate level from 145 employee health insurance societies and 227 self-employed health insurance societies from 1995 to 1997. Data were also collected at the individual level from four health insurance societies. This study hypothesized that the participation rate of the health screening program was related to 1) the characteristics of its members and the size of the health insurance society; 2) the specifications of the health screening program; 3) the venue of the health screening institution and the interests of individuals in the health screening program; and 4) the activities of the health insurance society. We used bivariate and multiple regression models to examine the factors on the participation rate of the health screening program. RESULTS: First, in the case of dependents of on employee health insurance society, the ratio of dependents 40 years old and over, the average monthly contribution per household, the interest and satisfaction level of individuals in health screening, and the level of refunds for over-payment were all associated with the participation rate in the health screening program, accounting for 54.4% of the participation rate. Second, in case of those insured by the self-employed health insurance society, the interest and satisfaction level of individuals in health screening, the level of refunds for over-payment, and the performance level of on-the-spot health screening were statistically significant, accounting for 40.1% of the participation rate. CONCLUSION: The factors concerning the participation rate in the health screening program of medical insurance, in both a health insurance society and for individuals, were closely related to the age and gender of individuals and household contributions.; Summary

Blood Lead, Manganese, Aluminium and Silicon Concentrations in Korean Adults.: Jung Man Kim, Jung Mo Ahn, Won Sul Kim, Jung Il Kim, Hai Rim Shin, Kap Yeol Jung, Joon Youn Kim; Korean J Prev Med. 2000;33(2):157-164.

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This study was performed to determine the reference values of blood lead, manganese, aluminium, and silicon in healthy adults. METHODS: The subjects were 132 (67 male and 65 female), and classified to three age groups (< or =39, 40~49, and 50< or =). Blood lead, manganese and aluminium were analyzed by atomic absorption spectrophotometer, and blood silicon was analyzed by direct current plasma optical emission spectrometer. RESULTS: Blood lead levels(geometric mean, S.D) were (3.49, 1.70) microgram/dL in male and (3.04, 1.65) microgram/dL in female, but the difference is not significant, and there was no significant difference between age groups. Mean blood manganese level was 0.99+/-0.41 microgram/dL, and there was no significant difference between sex or age groups. Mean blood aluminium level was 0.59+/-0.35 microgram/dL, and there was no significant difference between sex or age groups. Mean blood silicon level was 54.41+/-27.64 microgram/dL in male and 43.34+/- 23.51 microgram/dL in female, and the level in male was significantly higher than that in female (p<0.05). There was significant difference between age groups, and the oldest showed the highest level in male (p<0.05), but no significant difference between age groups in female. CONCLUSIONS: Authors hope that this study would provide basic data for determining reference values and evaluating health effects.; Summary

Assessment of the Glycophorin A Mutant Assay as a Biologic Marker for Low Dose Radiation Exposure.: Mina Ha, Keun Young Yoo, Sung Whan Ha, Dong Hyun Kim, Soo Hun Cho; Korean J Prev Med. 2000;33(2):165-173.

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To assess the availability of the glycophorin A (GPA) assay to detect the biological effect of ionizing radiation in workers exposed to low-doses of radiation. METHODS: Information on confounding factors, such as age and cigarette smoking was obtained on 144 nuclear power plant workers and 32 hospital workers, by a self-administered questionnaire. Information on physical exposure levels was obtained from the registries of radiation exposure monitoring and control at each facility. The GPA mutant assay was performed using the BR6 method with modification by using a FACScan flow cytometer. RESULTS: As confounders, age and cigarette smoking habits showed increasing trends with GPA variants, but these were of no statistical significance. Hospital workers showed a higher frequency of the GPA variant than nuclear power plant workers in terms of the NO variant. Significant dose-response relationships were obtained from in simple and multiple linear regression models. The slope of the regression equation for nuclear power plant workers was much smaller than that of hospital workers. These findings suggest that there may be apparent dose-rate effects. CONCLUSION: In population exposed to chronic low-dose radiation, the GPA assay has a potential to be used as an effective biologic marker for assessing the bone marrow cumulative exposure dose.; Summary

Respiratory Health of the Children Living near the Petrochemical Estate in Ulsan.: Choong Ryeol Lee, Cheol In Yoo, Ji Ho Lee, Yangho Kim; Korean J Prev Med. 2000;33(2):174-183.

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To evaluate the effect of low-level exposure of air pollutants on the respiratory tract of the children living near the petrochemical estate in Ulsan. METHODS: The study design was cross-sectional, and the study subjects consisted of 150 children(76 boys, 74 girls) living near the petrochemical estate and 100 children(53 boys, 47 girls) living in a suburban area. We investigated respiratory health using self-administered questionnaires(ATS-DLD-78), radiological examination, and pulmonary function test such as FVC and FEV1. RESULTS: There were higher prevalence rates of respiratory symptoms in the children living near the petrochemical estate than the children living in a suburban area. And the results of FVC and FEV1 of 11-years old children living near the petrochemical estate were lower than those of the children living in a suburban area. CONCLUSIONS: Chronic exposure of low-level air pollutants would affect respiratory health of the children. Therefore, further a longitudinal study of respiratory health will be needed for children living near the petrochemical estate in Ulsan.; Summary

Prevalence and Risk Factors of Myofascial Pain Syndrome on School Boys.: Duck Soo Kim, Hyun Sul Lim, Jong Min Lee; Korean J Prev Med. 2000;33(2):184-192.

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To inquire the prevalence and the risk factors for myofascial pain syndrome (MPS) on young boys in order to use these results as the fundamental data for the prevention of their MPS. METHODS: For 7 days in May 1999, this research was taken on 489 male students ranging from 6th to 12th grade. We randomly selected a class for every group and from these classes we operated physical examinations, self-reported questionnaires and from a rehabilitation doctor, MPS test was taken. Thoracic kyphosis and lumbar lordosis were also taken by using the inclinometer. We defined MPS as a regional pain complaint, palpable taut band that is painful on compression. RESULTS: The shoulder MPS prevalence of the subjects were 29.7 persons/100 persons. The statistics revealed that as grades went up, the percentage significantly increased in the MPS prevalence. As of case-control study, 145 students who were tested postive in all aspects were placed as cases, and 176 students who were perfectly normal as controls on risk factors. As a result of comparing the student groups who were satisfied with their chairs to the student groups were not satisfied, the latter showed a significantly higher odds ratio (p<0.01). By the multiple logistic regression test, we concluded that the MPS disease was prevailed far more in the students in the higher grades (Odds ratio: 1.16, 95% C.I.: 1.03-1.31), and also those who were dissatisfied with their chairs than in the ones who were satisfied (Odds ratio: 1.92, 95% C.I.: 1.17-3.17). CONCLUSIONS: Significant correlations showed between the MPS diagnosed group and the students who are dissatisfied with their chairs. As a result, more research and observation has to be made concerning this disease, and the desks and chairs should be adjusted to suit the student? physical standards.; Summary

The Risk Factors for the Development of Hypertension in a Rural Area - An 1-Year Prospective Cohort Study.: Hee Sook Oh, Byung Yeol Chun, Sin Kam, Min Hae Yeh, Yun Sik Kang, Keon Yeop Kim, Young Sook Lee, Ki Soo Park, Jae Hee Son, Sang Won Lee, Moon Young Ahn; Korean J Prev Med. 2000;33(2):199-207.

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This study was performed to identify the risk factors related to the development of hypertension in a rural area. METHOD: Total of 3,573 subjects in Chung-Song County were interviewed and examined in 1996. The study cohort comprised 2,580 hypertension-free subjects aged above 20. One-year follow up was completed for 1,781 subjects(69.0%) in 1997. General characteristics(age, gender, education level, economic status, marital status), the family history of hypertension, diet, alcohol, smoking, coffee, stress, past history of oral contraceptive and menopausal status in female, height, weight, waist and hip circumference, baseline blood pressure, and serum total cholesterol were considered as risk factors. RESULTS: Multivariate analysis using logistic regression model indicated that age(RR=1.50, 95% CI; 1.15-1.96), the family history of hypertension(RR=2.11, 95% CI; 1.04-4.26), waist-hip ratio(WHR) (RR=2.09, 95% CI; 1.15-3.79), and baseline systolic blood pressure(130-139/<120mmHg)(RR=3.34, 95% CI; 1.47-7.60) were significant risk factors associated with the development of hypertension above the borderline level in male. In female, age(RR=1.06, 95% CI; 1.03-1.09), change in menopausal status(no--> yes/no-->no) (RR=3.32, 95% CI; 1.01-10.87), baseline systolic blood pressure(120-129/<120mmHg: RR=2.00, 95% CI; 1.02-3.90)(130-139/<120mmHg: RR=2.64, 95% CI; 1.34-5.20) and baseline diastolic blood pressure(85-89/<80mmHg)(RR=4.09, 95% CI; 1.86-8.96) were identified as risk factors. CONCLUSIONS: Age and high normal blood pressure were significant risk factors for the development of hypertension above the borderline level. In addition, the family history of hypertension and WHR in men, and the change of menopausal status in women might be significant risk factors in Korea.; Summary

Relationship between Blood Pressure and Impairment of Cognitive Function In Some Rural Residents Aged 60-64.: Choong Won Lee, Moo Sik Lee, Jong Chan Chun; Korean J Prev Med. 2000;33(2):208-214.

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Face-to-face interviews were conducted to investigate the relationship between blood pressure and the impairment of cognitive function in rural elderly (N=932) aged 60-64 in Dalsung County, April to September in 1996 METHODS: Impairment of cognitive function was defined as a score of less than 23 by the Korean version of the Mini-Mental State Examination (MMSEK). Blood pressure was measured once in each subject using a portable automatic sphygmomanometer. RESULTS: By univariate logistic regression on males, no category of systolic blood pressure bore statistical significance. Groups with diastolic blood pressures of, less than 80 mmHg, 90-94 mmHg, and more than 95mmHg had odds ratios of more than one compared with the reference group (80-89 mmHg). This was most significant in the group with blood pressures lower than 80 mmHg, which had a statistically significant odds ratio of 1.68 (95 % confidence interval Cl; 1.02-2.75). No category of blood pressure was statistically significant in females. Multivariate logistic regression for males, with adjustment for age, educational attainment, smoking, alcoholic drinking, body mass index, atherosclerotic disease, and antihypertensive medication use, did not alter the odds ratios significantly in terms of systolic blood pressure. However, the group with diastolic blood pressure of less than 80 mmHg had an increased odds ratio of 2.01 (95 % Cl; 1.15-3.52) compared with the reference group. In females, systolic blood pressure did not alter the odds ratio, but the group with a diastolic blood pressure of less than 80 mmHg had a statistically significant odds ratio of 0.57 (95% Cl; 0.37-0.89). CONCLUSIONS: These results suggest that the relationship between blood pressure and cognitive function status is stronger diastolic than systolic blood pressure and that there is a complex relationship between blood pressure and cognitive function by sex.; Summary

Therapeutic Compliance and Its Related Factors of Patients with Hypertension in Rural Area.: Sang Won Lee, Sin Kam, Byung Yeol Chun, Min Hae Yeh, Yun Sik Kang, Keon Yeop Kim, Young Sook Lee, Ki Soo Park, Jae Hee Son, Hee Sook Oh, Moon Young Ahn, Pu Dol Lim; Korean J Prev Med. 2000;33(2):215-225.

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The purpose of this study was to examine the therapeutic compliance and its related factors in the rural hypertensives. METHOD: A questionnaire survey and blood pressure measurement were performed to 3,876 residents of a rural area, and 660 hypertensives were selected as subjects of study. The study employed a hypothetical model which was composed of constructs from the health belief model and KAP model. The analysis techniques employed included contingency table analysis and structural equation modeling. RESULT: The proportion of those who were compliant to the treatment of hypertension was 44.2% of subjects. As the result of structural equation modeling, when patients had more favorable attitude toward treatment, higher perceived benefit, or lower perceived barriers to treatment, the therapeutic compliance was significantly higher(T>2.0). When patients had more knowledge about hypertension, or higher perceived severity of hypertension, the attitude toward the treatment of hypertension was more favorable significantly(T>2.0). And when patients had the support for treatment from family or neighbor, the attitude toward treatment was more favorable(T>2.0). When patients had experience of health education, they had more knowledge, higher perceived susceptibility of complication, perceived severity for hypertension, and perceived benefit of treatment, compare to patients without health education(T>2.0). CONCLUSION: In consideration of above findings, in order to improve the therapeutic compliance in the rural hypertensives, it would be necessary to change attitude, perception, knowledge about hypertension and its treatment, by various methods such as effective health education and programs for maintaining the supportive environment for hypertension treatment.; Summary

Comparison of Methods for the Detection of Anti-HBs for Hepatitis B Vaccination Program in Korea.: Hae Sook Sohn, Jeong Nyeo Lee, Sang Hwa Urm, Jong Tae Lee, Jin Ho Chun; Korean J Prev Med. 2000;33(2):226-230.

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The purpose of this study was to suggest a proper method for the detection of heaptitis B surface antibody(anti-HBs) in a screening program for hepatitis B vaccination. METHODS: Sensivitity, specificity and predictive values were compared between Immunochromatographic assay (ICA) and passive hemagglutination(PHA) in 978 subjects(565 males, 413 females, 19-78 years ranging in age, mean 46.5 years old). EIA was used as a standard method for the detection of HBsAb. RESULTS: Sensitivity in the detection of anti-HBs of PHA and ICA was 88.7% and 94.9%, specificity was 94.3% and 96.6%, negative predictive value was 96.5% and 98.0%, and positive predictive value was 82.3% and 91.3%, respectively. False negative rate(11.3%) of PHA was higher than that(5.1%) of ICA. The higher the titer of anti-HBs in EIA was, the lower the false negative rate was. There was no false negative result in the cases with 101mIU/ml or more in EIA. CONCLUSION: We suggest that ICA should be the choice of screening method in the detection of anti-HBs in Hepatitis B vaccination program.; Summary

Measuring the Burden of Major Cancers due to Premature Death in Korea.: Seok Jun Yoon, Yong Ik Kim, Chang Yup Kim, Hyejung Chang; Korean J Prev Med. 2000;33(2):231-238.

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Abstract PDF: OBJECTIVE
To estimate the burden of diseases in Korea especially caused by major cancers using the YLL(years of life lost due to premature death) measurement. METHODS: First, we determined the parameters: such as age-specific standard life expectancy, age on death, sex, cause of death by analyzing the national death certificate data and life table collected during 1996 provided by the National Statistical Office. Secondly, we estimated the age group-specific YLL by employing standard expected years of life lost(SEYLL). Thirdly, final burden of disease due to premature death was estimated by using YLLs measurement which developed by global burden of disease study group. RESULTS: The burden of premature death by cancer for male was attributed mainly to liver cancer(514.5 person-year), stomach cancer(436.4 person-year), and lung cancer(367.7 person-year). Each of these cancers was responsible for the loss of over 100 person-year based on our YLL measurement. The burden of premature death by cancer for female was attributed mainly to liver cancer(135.1 person-year), stomach cancer(252.1 person-year), and lung cancer(121.8 person-year). Each of these cancers was responsible for the loss of over 100 person year based on our YLL measurement. CONCLUSION: We found the YLL method employed in this study was appropriate to quantify the burden of premature death. Thereby, it would provide a rational bases to plan a national health policy regarding premature death caused by cancer.; Summary

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