Journal of Preventive Medicine and Public Health

Original Articles

An Important Strategy to Improve Adolescent Health Literacy: COVID-19 Modules in High School in Indonesia: Nurina Hasanatuludhhiyah, Visuddho Visuddho, Abdul Khairul Rizki Purba, Annette d’ Arqom, Ancah Caesarina Novi Marchianti; J Prev Med Public Health. 2023;56(6):523-532. Published online November 1, 2023; DOI: https://doi.org/10.3961/jpmph.23.113

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Abstract Summary PDF: Objectives
During the second coronavirus disease 2019 (COVID-19) surge, cases increased sharply due to low awareness and compliance with measures to limit disease spread. Health literacy (HL) is an important component of public health initiatives, and schools are potential sources of health education to increase HL via the presentation of COVID-19 educational modules.
Methods
This cross-sectional study involved an online questionnaire administered to students from 5 high schools in Surabaya and Sidoarjo, Indonesia, 6-7 weeks after the start of government-issued directives restricting public gatherings. We collected data on each respondent’s age, gender, parental education, and socioeconomic variables. HL was determined by the Health Literacy Measure for Adolescents. We additionally measured their attitudes and behaviors related to preventing the spread of COVID-19. The students were asked if they watched the COVID-19 module at school, their feelings about vaccination, and preferred online sources of COVID-19-related information.
Results
Most of the 432 respondents had viewed COVID-19 modules at school. Module exposure was associated with significantly higher total and domain-specific HL and more positive attitudes toward government-issued COVID-19 restrictions on travel and public gatherings (p<0.05). However, behaviors to prevent COVID-19 spread and vaccine acceptance were not associated with module exposure. Most students chose social media as their source of COVID-19-related information.
Conclusions
Schools can provide information to increase adolescents’ HL and the public’s support for health initiatives to prevent or limit the spread of COVID-19.; Summary

Key Message
A cross-sectional study carried out on high school students during the second surge of COVID-19 in Indonesia revealed that they benefitted from the COVID-19 module. Students who viewed the module had higher scores on health literacy measures of adolescents (HELMA), had a more favorable attitude toward government-issued restrictive policies, and were more likely to have adequate health literacy, in regard to the ability to use health information. These imply schools as part of the public health response by providing education to increase adolescents’ health literacy and the public’s support for health initiatives to prevent and limit the spread of COVID-19.

Effectiveness of a Social Marketing Mix Intervention on Changing the Smoking Behavior of Santri in Traditional Islamic Boarding Schools in Indonesia: Ismail Ismail, Teuku Tahlil, Nursalam Nursalam, Zurnila Marli Kesuma, Syarifah Rauzhatul Jannah, Hajjul Kamil, Fithria Fithria, Kintoko Rochadi; J Prev Med Public Health. 2022;55(6):586-594. Published online November 17, 2022; DOI: https://doi.org/10.3961/jpmph.22.231

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Abstract PDF: Objectives
This study investigated the effectiveness of the social marketing mix approach in increasing students’ knowledge about smoking, promoting positive attitudes toward smoking cessation, and decreasing smoking behavior.
Methods
This quantitative research study incorporated a quasi-experimental method with a pretest-posttest non-equivalent group design. Using the purposive sampling technique, 152 smoking students were selected as participants. They were divided into 2 equal groups, with 76 students in the control group and 76 in the intervention group. The data were collected using questionnaires and analyzed with the chi-square test, independent t-test, Wilcoxon signed-rank test, and Mann-Whitney U-test.
Results
The social marketing mix intervention was effective in increasing the students’ knowledge about smoking (p<0.001), improving their attitude toward smoking cessation (p<0.001), and reducing their smoking behavior (p=0.014).
Conclusions
This approach should be implemented by local governments to reduce smoking behavior in the community, especially among teenagers, in addition to instituting a smoking ban and applying fines.; Summary

Sexual Intercourse and Its Correlates Among School-aged Adolescents in Indonesia: Analysis of the 2015 Global School-based Health Survey: Anissa Rizkianti, Iram Barida Maisya, Nunik Kusumawardani, Christine Linhart, Jerico Franciscus Pardosi; J Prev Med Public Health. 2020;53(5):323-331. Published online August 7, 2020; DOI: https://doi.org/10.3961/jpmph.20.028

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Abstract PDF

Objectives
This study aimed to determine the prevalence and correlates of sexual intercourse among junior secondary and high school students in Indonesia from the 2015 Global School-based Health Survey (GSHS).
Methods
The survey was conducted among 11 110 students from 75 schools in Indonesia using a self-administered questionnaire. Univariate and multivariate analyses were conducted to explore associations between sexual intercourse and socio-demographic variables, substance use, mental distress, and protective factors.
Results
Overall, 5.3% of students reported having ever had sex (6.9% of boys and 3.8% of girls). Of students who engaged in sexual intercourse, 72.7% of boys and 90.3% of girls had an early sexual debut (before reaching the age of 15) and around 60% had multiple sex partners. Sexual intercourse was associated with gender, school grade, smoking, alcohol consumption, drug use, suicidal ideation, truancy, peer support, and parental supervision.
Conclusions
These findings indicate a pressing need to develop more comprehensive sexual health education in the national curriculum. An effective strategy should also address other risky behaviours.

Summary

Citations

Citations to this article as recorded by

The Development and Initial Validation of the Youth Sexual Intention Scale: Indonesian Version
Rahmi Lubis, Zahrotur R. Hinduan, Ratna Jatnika, Baydhowi Baydhowi, Hendriati Agustiani
INQUIRY: The Journal of Health Care Organization, Provision, and Financing.2022; 59: 004695802210878. CrossRef
Factors Related to Sexual Intercourse Among Korean Middle and High School Students
Joohee Shim, Jihyun Baek, Seungwoo Han
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Şahika ŞİMŞEK ÇETİNKAYA, Esra DEMİRARSLAN
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The Effect of Prenatal Cadmium Exposure on Attention-deficit/Hyperactivity Disorder in 6-Year-old Children in Korea: Woosung Kim, Yoonyoung Jang, Youn-Hee Lim, Bung-Nyun Kim, Choong Ho Shin, Young Ah Lee, Johanna Inhyang Kim, Yun-Chul Hong; J Prev Med Public Health. 2020;53(1):29-36. Published online November 14, 2019; DOI: https://doi.org/10.3961/jpmph.19.175

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Abstract Summary PDF Supplementary Material

Objectives
Prenatal cadmium (Cd) exposure may be associated with attention-deficit/hyperactivity disorder (ADHD) in children. Therefore, the objective of this study was to examine the relationship between Cd exposure during gestation and ADHD at 6 years of age.
Methods
As part of an ongoing cohort study (the Environment and Development of Children study), 479 mother-child pairs from Seoul, Korea were included for analysis between 2008 and 2011. The whole blood concentration of Cd was analyzed using atomic absorption spectrophotometry. The parents were surveyed about ADHD behaviors in their children at age 6. Multivariable linear regression models were used to investigate the relationship between prenatal exposure to Cd and ADHD at 6 years of age.
Results
Increased prenatal Cd concentrations were associated with increased scores for ADHD for girls, but not for boys, at age 6. A 2-fold increase in the prenatal Cd level was significantly associated with a 22.3% (95% confidence interval, 11.6 to 34.1) increase in ADHD in girls at 6 years of age, as indicated by the linear regression model.
Conclusions
Our results identified significant associations between prenatal Cd exposure and ADHD scores in 6-year-old girls.

Summary

Korean summary
이 연구의 목적은 산모와 아이의 코호트 추적조사 상 임신 중 혈중의 중금속 카드뮴 농도가 6세 아이의 주의력결핍 과잉행동 장애(ADHD)와 연관이 있는지를 확인하는 것이다. 자료원으로는 환경부와 식약처 지원 어린이 코호트인 환경노출과 어린이 성장 코호트 (EDC)를 이용하였다. 총 479쌍의 산모-아이 쌍을 대상으로 다변수 선형 회귀분석을 통해 연관성을 살펴보았다. 연구 결과, 임신 중 산모의 혈중 카드뮴 농도가 2배 증가함에 따라 6세 여아의 한국어판 주의력결핍장애(ADHD) 평점척도 (K-ARS) 점수가 22.3% 증가하는 것으로 나타났다.

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Tsung-Lin Tsai, Chia-Jung Hsieh, Ming-Tsang Wu, Mei-Lien Chen, Po-Hsiu Kuo, Shu-Li Wang
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Somsiri Decharat, Piriyalux Phethuayluk
Environmental Analysis Health and Toxicology.2023; 38(4): e2023020. CrossRef
Developmental exposure to environmental levels of cadmium induces neurotoxicity and activates microglia in zebrafish larvae: From the perspectives of neurobehavior and neuroimaging
Yanyi Xu, Haiyu Zhao, Zuo Wang, Hao Gao, Junru Liu, Kemin Li, Zan Song, Cong Yuan, Xianyong Lan, Chuanying Pan, Shengxiang Zhang
Chemosphere.2022; 291: 132802. CrossRef
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Sonja Moore, Laura Paalanen, Lisa Melymuk, Andromachi Katsonouri, Marike Kolossa-Gehring, Hanna Tolonen
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Elena Sizova, Elena Yausheva, Olga Marshinskaia, Tatiana Kazakova, Yuriy Khlopko, Svyatoslav Lebedev
Veterinary World.2022; : 2565. CrossRef
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Journal of Preventive Medicine and Public Health.2021; 54(1): 37. CrossRef
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Effect of Cadmium on Children's Health in Prenatal and Postnatal Periods of Development
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Associations Between Preschool Education Experiences and Adulthood Self-rated Health: Jeehye Lee, Jinwook Bahk, Young-Ho Khang; J Prev Med Public Health. 2017;50(4):228-239. Published online May 10, 2017; DOI: https://doi.org/10.3961/jpmph.16.110

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Abstract PDF Supplementary Material

Objectives
This study aimed to examine the association between preschool education experiences and adulthood self-rated health using representative data from a national population-based survey. Methods: Data from the Korean Labor and Income Panel Study in 2006 and 2012 were used. A total of 2391 men and women 21-41 years of age were analyzed. Log-binomial regression analyses were conducted to examine the associations between preschool education experience and self-rated health in adulthood. Parental socioeconomic position (SEP) indicators were considered as confounders of the association between preschool education experience and adulthood subjective health, while current SEP indicators were analyzed as mediators. Age-adjusted prevalence ratios (PRs) and the associated 95% confidence intervals (CIs) were estimated. Results: Compared with men without any experience of preschool education, those with both kindergarten and other preschool education experiences showed a lower prevalence of self-rated poor health (PR, 0.65; 95% CI, 0.47 to 0.89). In women, however, such an association was not evident. The relationship of preschool education experiences with self-rated poor health in adulthood among men was confounded by parental SEP indicators and was also mediated by current SEP indicators. After adjustment for parental and current SEP indicators, the magnitude of the associations between preschool education experiences and adulthood subjective health was attenuated in men. Conclusions: Preschool education experience was associated with adulthood self-rated health in men. However, this association was explained by parental and current SEP indicators. Further investigations employing a larger sample size and objective health outcomes are warranted in the future.

Summary

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Self-rated health and its determinants in patients with hypertension in Isfahan in 2019
Asieh Mansouri, Alireza Khosravi Farsani, Noushin Mohammadifard, Fatemeh Nouri, Mahnaz Jozan, Ghazaal Alavi Tabatabaei, Rezvan Salehidoost, Hamed Rafiee
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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.

Summary

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Sari Törmänen, Eero Lauhkonen, Antti Saari, Petri Koponen, Matti Korppi, Kirsi Nuolivirta
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Teumzghi F Mebrahtu, Richard G Feltbower, Darren C Greenwood, Roger C Parslow
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Finn Rasmussen, Robert J. Hancox
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Yueh-Hsiu Mathilda Chiu, Brent A. Coull, Michelle J. Sternthal, Itai Kloog, Joel Schwartz, Sheldon Cohen, Rosalind J. Wright
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Constantina Papoutsakis, Kostas N. Priftis, Maria Drakouli, Stamatina Prifti, Eva Konstantaki, Maria Chondronikola, Georgios Antonogeorgos, Vasiliki Matziou
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Hye Ah Lee, Hyesook Park
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S. G. Tedner, A. K. Örtqvist, C. Almqvist
Clinical & Experimental Allergy.2012; 42(10): 1430. CrossRef
Prenatal and Postnatal Maternal Stress and Wheeze in Urban Children
Yueh-Hsiu Mathilda Chiu, Brent A. Coull, Sheldon Cohen, Alana Wooley, Rosalind J. Wright
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Research Support, Non-U.S. Gov't

The Korean Prediction Model for Adolescents' Future Smoking Intentions.: Sungkyu Lee, Ji Eun Yun, Ja Kyoung Lee, Il Soon Kim, Sun Ha Jee; J Prev Med Public Health. 2010;43(4):283-291.; DOI: https://doi.org/10.3961/jpmph.2010.43.4.283

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Abstract PDF

OBJECTIVES
The purpose of this study was to develop a prediction model for future smoking intention among Korean adolescents aged 13 to 15 in order to identify the high risk group exposed to future smoking. METHODS: The data was collected from a total of 5940 students who participated in a self-administrated questionnaire of a cross-sectional school-based survey, the 2004 Korea Global Youth Tobacco Survey. Chi-square tests and logistic regression analyses were carried out to identify the relevant determinants associated with intentions of adolescents' future smoking. Receiver Operation Characteristic (ROC) assessment was applied to evaluate the explanation level of the developed prediction model. RESULTS: 8.4% of male and 7.2% of female participants show their intentions of future smoking. Among non-smoking adolescents; who have past smoking experience [odds ratio (OR) 2.73; 95% confidence interval (CI) 1.92 - 3.88]; who have intentions of smoking when close friends offer a cigarette (OR 31.47; 95% CI = 21.50 - 46.05); and who have friends that are mostly smokers (OR 5.27; 95% CI = 2.85 - 9.74) are more likely to be smokers in the future. The prediction model developed from this study consists of five determinants; past smoking experience; parents smoking status; friends smoking status; ownership of a product with a cigarette brand logo; and intentions of smoking from close friends' cigarette offer. The area under the ROC curve was 0.8744 (95% CI=0.85 - 0.90) for current non-smokers. CONCLUSIONS: For efficiency, school-based smoking prevention programs need to be designed to target the high risk group exposed to future smoking through the prediction model developed by the study, instead of implementing the programs for all the students.

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Original Articles

A Survey of the Prevalence of Rubella Antibodies in Teachers of Child Bearing Age on Cheju Island .: Jong Myon Bae, Hyun Jong Yang, Seong Chul Hong; Korean J Prev Med. 2000;33(3):280-284.

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Abstract PDF: BACKGROUND
Congenital rubella syndrome (CRS) can be controlled by vaccination. Because rubella is typically a childhood disease, occurring predominantly in the 5 to 14 year age group, female school teachers may be a high-risk population for CRS. CONCLUSIONS: To determine the prevalence rate of rubella antibodies in school teachers of child bearing age. METHODS: The study population consisted of primary, middle and high school teachers of child bearing age. The subjects were aged 35 years and younger, and consented to immunoglobulin (Ig) level testing using the ELISA method. RESULTS: The positive rate of IgG was 77.9% in the study subjects (n=314). Sixty-three teachers (21.4%) were susceptible to rubella infection. Thirty-seven teachers (11.8%) had a history of rubella vaccination. Among the female teachers with no vaccination history, the proportion of negative IgM and IgG was 21.7%, and the proportion of positive IgM was 2.9%. Seventy-nine percent of the study subjects did not know that they should not become pregnant for three months after receiving the rubella vaccine. CONCLUSION: School teachers of child bearing age should be considered a high risk group for CRS, and should be vaccinated if they are found to be seronegative.; Summary

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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Abstract PDF: OBJECTIVES
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

Characteristics of Traffic Accident for the Primary School Students and Its Affecting Factors.: Am Park, Yeon Kyung Lee, Jeong Yun Kim, Tae Yong Lee, Sok Goo Lee, Young Chae Cho, Dong Bae Lee; Korean J Prev Med. 1998;31(3):372-383.

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Abstract PDF: For the purpose to analysis the characteristics of traffic accidents(TA) and investigate the relationship between traffic accidents and children attention problem rating scale(CAP) and, family environment scale(FES), this questionnaire survey was conducted to the 16 primary school students in Taejon from July 14 to August 26, 1997. The number of study subjects who had an experience of traffic accidents from July 1, 1996 to June 30, 1997 were 195, and the number of control subjects were 512. The main results were as follows; 1. The traffic accident rates was 0.9% as a whole, but those were 1.4% in boys, 0.7% in girls, 1.3% in low (1st-3rd) grade, and 0.8% in high (4th-6th) grade. 2. The rates of traffic accidents were high in spring, friday, afternoon and a driveway around home. TA occurred during walking with friends most frequently. 3. In CAP the score of inattention was lower in TA group than control group, and hyperactivity was higher in TA group but they didn't showed significantly different. In FES, cohesion score was higher in TA group than control group, but Conflict score and Expressiveness score were in control group, but they didn't showed significantly different. 4. In CAP the odds ratio of inattention score for TA group was 0.84, but that of hyperactivity score was 1.15. In FES, the odds ratio of cohesion score was 1.06, but that of expression score and conflict score was 0.94 and 0.96, respectively. In conclusion, the relationships between TA and CAP, TA and FES in this study were not clear to explain personal characteristics and environmental conditions.; Summary

Drug Abuse Status and Its Determinants of Male High School Students in Taegu.: Jung Rak Nam, Sin Kam, Jae Yong Park, Chang Hyun Han, Young Ae Ha; Korean J Prev Med. 1996;29(3):451-470.

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Abstract PDF: To identify the drug abuse status and its determinant factors in high school boys in Taegu, the study was performed from April to May, 1995. Study population were selected by cluster sampling method and total 5,665 students replied to the self-administered questionnaire survey(2,207 in academic high school, 3,458 in business high school). The major findings were as follows; The proportion of drinking, smoking experience was 55.0%, 45.8%, respectively, and the proportion of current drinker, current smoker was 27.2%, 27.5%. The drinking, smoking experience rate of second grade students was higher than first grade and it was higher in business high school boys. The proportion of a stimulant, a hallucinogen, hemp leaf cigarets experience was 3.2%, 1.6%, 0.1%, respectively. Drug abuse had significant association with home environment(lower economic status, frequent move, death of father or mother, apart from family), parents environment(parents' indifference, parents' drinking and smoking, etc.), school life(lower school grades, intimate friend's drug abuse, etc.), generous attitude to drug abuse, higher level of stress. Students who replied that the law prohibited immature person(students) from drinking and smoking showed lower drug abuse rate. In multiple logistic regression analysis, second grade students, business high school students, parents' indifference, lower school grades, intimate friend's drug abuse, no recognition of the fact that the law prohibits high school students from drinking and smoking, generous attitude to drug abuse, higher level of stress were significantly related with alcohol abuse and smoking. Other drugs abuse were related with above factors. On consideration of above findings, to prevent students from drug abuse, we have to try together in house, school, and society.; Summary

Cost-Benefit Analysis of Back School Program for Occupational Low Back pain Patients.: Yeong Su Ju, Mi Na Ha, Sang Hwan Han, Ho Jang Kwon, Soo Hun Cho, Chang Yup Kim, Sun Min Kim; Korean J Prev Med. 1996;29(2):347-358.

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Abstract PDF: Although occupational low back pain accounts for 20~40% of all occupational illness and injury, there are limited numbers of studies regarding the effectiveness of back school program. The objective of this study was to evaluate the economic benefit of back school program for early return to work of occupational low back pain patients in the current occupational injury compensation and management system. The cost-benefit analysis in this study was conducted to evaluate the relative magnitude of benefit to cost. The total cost was estimated by calculating the value of components in back school program according to governmental budget protocol. The back school program was consisted of three major approaches, pain center, work-hardening program and functional restoration program and each of components had various facilities and experts. The total amount of cost was estimated as 250,866,220 won per year. The most promising type of back school program were quite intensive (a 3 to 5-week stay in a specialized center), therefore, if we adopted the 5-week stay course, 10 courses could be held in a year. Following to the medical act, 20 patients per doctor could participate in a each course, ie, total 200 patients in a year. As a result, we could estimate the cost of 1,254,331 won a patient. we estimated the benefit by using data of a few local labor offices about average medical treatment beneficiary and off-duty beneficiary of 46 occupational low back pain patients in 1994. Ullman and Larsson(1977) mentioned that the group of chronic low back pain patients who participated in back school program needed less time to recover by 48.4% of beneficiary duration. And in the trying to estimate the benefit, we asked 10 rehabilitation board certificate doctors about reduction proportion of treatment cost by introducing back school program. The answered reduction proportions were in the range of 30~45%, average 39%. As a final result, we could see that the introduction of back school program in treatment of chronic occupational low back pain patients could produce the benefit to cost ratio as 3.90 and 6.28. And we could conclude that the introduction of back school program was beneficial to current occupational injury compensation and management system.; Summary

Factors related to poor school performance of elementary school children.: Jung Han Park, Gui Yeon Kim, Kyu Sook Her, Ju Young Lee, Doo Hie Kim; Korean J Prev Med. 1993;26(4):628-649.

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Abstract PDF: This study was conducted to investigate the factors related to the poor school performance of the elementary school children. Two schools in Taegu, one in the affluent area and the other in the poor area, were selected and a total of 175 children whose school performance was within low 10 percentile(poor performers) and 97 children whose school performance were within high 5 percentile(good performers) in each class of 2nd, 4th and 6th grades were tested for the physical health, behavioral problem and family background. Each child had gone through a battery of tests including visual and hearing acuity, anthropometry(body weight, height, head circumference), intelligence(Kodae Stanford-Binet test), test anxiety(TAI-K), neurologic examination by a developmental pediatrician and heavy metal content(Pb, Cd, Zn) in hair by atomic absorption spectrophotometry. A questionnaire was administered to the mothers for prenatal and perinatal courses of the child, family environment, child's developmental history, and child's behavioral and learning problems. Another questionnaire was administered to the teachers of the children for the child's family background, arithmatic and language abilities and behavioral problem. The poor school performance had a significant correlation with male gender, high birth order, broken home, low educational and occupational levels of parents, visual problem, high test anxiety score, attention deficit hyperactivity disorder(ADHD), poor physical growth(weight, height, head circumference) and low I.Q. score. The factors that had a significant correlation with the poor school performance in multiple logistic regression analysis were child's birth order(odds ratio=2.06), male gender(odds ratio=5.91), broken home(odds ratio=9.29), test anxiety score(odds ratio=1.07), ADHD(odds ratio=9.67), I.Q. score(odds ratio=0.85) and height less than Korean standard mean-1 S. D.(odds ratio=11.12). The heavy metal contents in hair did not show any significant correlation with poor school performance. However the lead and cadmium contents were high in males than in females. The lead content was negatively correlated with child's grade(p<0.05) and zinc was positively correlated with grade(p<0.05). Among the factors that showed a significant correlation with the poor school performance, high birth order, short stature and ADHD may be modified by a good family planning, good feeding practice for infant and child, and early detection and treatment of ADHD. Also, teacher and parents should restrain themselves from inducing excessive test anxiety by forcing the child to study and over-expecting beyond the child's intellectual capability.; Summary

The levels of blood lead and zinc protoporphyrin for healthy urban population in Korea.: Dong Il Kim, Yong Kyu Kim, Jung Man Kim, Kap Yull Jung, Joon Youn Kim; Korean J Prev Med. 1992;25(3):287-302.

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Abstract PDF: Hemoglobin(Hb), zinc protoporphyrin(ZPP) and blood lead(PbB) levels were determined for 1,851 blood samples collected from healthy urban population to establish reliable baselines for Hb, ZPP and PbB levels by age and sex. ZPP values were analyzed with a Hmatofluorometer and PbB determinations were concurrently carried out using flameless atomic absorption spectrophotometry. The blood sampling period was about 6 months from May, 1991 and the summarized results were as follows; 1. The mean value of Hb in male female were 14.55+/-1.81 g/dl and 12.61+/-1.81 g/dl respectively and there was statistically significant difference(p<0.05). 2. The mean value of ZPP in pre-schoolchildren was 37.49+/-13.31 microgram/dl for male, 35.77+/-11.85 microgram/dl for female and that of ZPP in after 7 years groups was 31.91+/-8.23 microgram/dl for male, 30.11+/-9.11 microgram/dl for female and there was statistically significant difference(p<0.05). 3. The mean value of PbB in pre-schoolchildren was 25.10+/-5.21 microgram/dl for male, 24.45+/-4.18 microgram/dl for female and that of PbB in after 7 years groups was 24.28+/-3.00 microgram/dl for male, 21.99+/-5.05 microgram/dl for female and there was statistically significant difference(p<0.05).; Summary

Assessment of safety of playground equipments in elementary schools in Taegu.: Jung Han Park, Soon Gil Yun; Korean J Prev Med. 1991;24(3):414-427.

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Abstract PDF: To assess the safety of playground equipments in the elementary schools of Taegu, a site visit was made to 117 elementary schools out of 119 schools between 1st and 30th April 1991. Safety criteria were developed on the bases of Massachusetts' Playground Safety Check List, standard height of Korean children of 6-12 years old, and source book for designing playground equipments. There were eleven different kinds of playground equipments installed in 117 schools but the number of equipments was about 50-60% of the minimum requirement set by the Ministry of Education except chin-up bar. Among the installed equipments, 47.3% of swings, 16.6% of parallel bars, 20.0% of monkey bars, and 16.0% of slides were broken down. None of the swings, slides, seesaws, monkey bars, and sandboxes met the safety criteria to the full but 59.0 of chin-up bars, 31.4% of parallel bars, and 13.5% of stumps met the criteria fully. The proportions of equipments that were dangerous for children to play on were 26.4% for slides, 20.0% for monkey bars, 11.6% for seesaws, 10.4% for parallel bars, 9.85 for sandboxes, 7.4% for swings and stumps, and 3.9% for chin-up bars. The rests were either in need of repair of broken down. It was revealed by this survey that the playground equipments were too short in number to meet the minimum requirement, designs and size were not standardized, and many of the equipments were involved with the risk of child accidents. Therefore, a safety standard for the playground equipments should be developed and the existing equipments should be repaired immediately.; Summary

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