Journal of Preventive Medicine and Public Health

Original Article

Socio-demographic Determinants of Low Physical Activity in Peruvian Adults: Results of a Population-based Survey Performed in 2017-2018: Akram Hernández-Vásquez, Rodrigo Vargas-Fernández; J Prev Med Public Health. 2021;54(6):461-470. Published online November 7, 2021; DOI: https://doi.org/10.3961/jpmph.21.418

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Objectives
The objective of this study was to determine the prevalence of low physical activity (PA) in Peruvian adults and to identify associated factors.
Methods
An analytical study was performed using data from the 2017-2018 Nutritional Food Surveillance by Life Stages survey. The outcome variable was low PA (yes or no), assessed using the International Physical Activity Questionnaire-short form. Prevalence ratios were estimated as a measure of association.
Results
Among the 1045 persons included in the analysis, the age-standardized prevalence of low PA was 61.9%. The adjusted model showed that being female and migrating from a rural to an urban area in the last 5 years were associated with a higher probability of having low PA than males and individuals who had not migrated, while residing in rural highlands and jungle areas was associated with a reduced probability of having low PA compared to people residing in other geographic domains.
Conclusions
Being a female and migration from a rural to an urban area in the last 5 years were associated with a higher likelihood of having low PA. Therefore, promotion and prevention strategies related to PA are required, especially in the female and migrant populations.

Summary

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Individualized Biological Age as a Predictor of Disease: Korean Genome and Epidemiology Study (KoGES) Cohort
Seokyung An, Choonghyun Ahn, Sungji Moon, Eun Ji Sim, Sue-Kyung Park
Journal of Personalized Medicine.2022; 12(3): 505. CrossRef
Association between Altitude and the Framingham Risk Score: A Cross-Sectional Study in the Peruvian Adult Population
Akram Hernández-Vásquez, Rodrigo Vargas-Fernández, Manuel Chacón-Diaz
International Journal of Environmental Research and Public Health.2022; 19(7): 3838. CrossRef
Prevalence of Prehypertension and Associated Cardiovascular Risk Profiles among Adults in Peru: Findings from a Nationwide Population-Based Study
Akram Hernández-Vásquez, Rodrigo Vargas-Fernández
International Journal of Environmental Research and Public Health.2022; 19(13): 7867. CrossRef

COVID-19: Perspective

Interpretation of the Basic and Effective Reproduction Number: Jun-Sik Lim, Sung-Il Cho, Sukhyun Ryu, Son-Il Pak; J Prev Med Public Health. 2020;53(6):405-408. Published online October 20, 2020; DOI: https://doi.org/10.3961/jpmph.20.288

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Abstract PDF

In epidemiology, the basic reproduction number (R0) is a term that describes the expected number of infections generated by 1 case in a susceptible population. At the beginning of the coronavirus disease 2019 (COVID-19) pandemic, R0 was frequently referenced by the public health community and the wider public. However, this metric is often misused or misinterpreted. Moreover, the complexity of the process of estimating R0 has caused difficulties for a substantial number of researchers. In this article, in order to increase the accessibility of this concept, we address several misconceptions related to the threshold characteristics of R0 and the effective reproduction number (Rt). Moreover, the appropriate interpretation of the metrics is discussed. R0 should be considered as a population-averaged value that pools the contact structure according to a stochastic transmission process. Furthermore, it is necessary to understand the unavoidable time lag for Rt due to the incubation period of the disease.

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Perspective

A New Measure for Assessing the Public Health Response to a Middle East Respiratory Syndrome Coronavirus Outbreak: Sung-il Cho; J Prev Med Public Health. 2015;48(6):277-279. Published online November 30, 2015; DOI: https://doi.org/10.3961/jpmph.15.069

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Abstract PDF

Contact monitoring is an essential component of the public health response to a Middle East respiratory syndrome coronavirus outbreak, and is required for an effective quarantine to contain the epidemic. The timeliness of a quarantine is associated with its effectiveness. This paper provides a conceptual framework to describe the process of contact monitoring, and proposes a new measure called the “timely quarantined proportion” as a tool to assess the adequacy of a public health response.

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English Abstracts

Syndromic Surveillances based on the Emergency Department.: Joon Pil Cho, Young Gi Min, Sang Cheon Choi; J Prev Med Public Health. 2008;41(4):219-224.; DOI: https://doi.org/10.3961/jpmph.2008.41.4.219

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Abstract PDF

Due to heightened concerns regarding possible bioterrorist attacks, the Korea Center for Disease Control and Prevention introduced syndromic surveillance systems, which have been run by emergency departments in hospitals throughout Korea since 2002. These systems are designed to identify illness clusters before diagnoses are confirmed and reported to public health agencies, to mobilize a rapid response, and thereby to reduce morbidity and mortality. The Korea Center for Disease Control and Prevention performed drop-in syndromic surveillance successfully during the World Cup Football Games in 2002, the Universiad games in 2004, and the Asian Pacific Economic Cooperation meeting in 2005. In addition, sustainable syndromic surveillance system involving the collaborative efforts of 125 sentinel hospitals has been in operation nationwide since 2002. Because active data collection can bias decisions a physician makes, there is a need to generate an automatic and passive data collection system. Therefore, the Korea Center for Disease Control and Prevention plans to establish computerized automatic data collection systems in the near future. These systems will be used not only for the early detection of bioterrorism but also for more effective public health responses to disease.

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Weirong Yan, Lars Palm, Xin Lu, Shaofa Nie, Biao Xu, Qi Zhao, Tao Tao, Liwei Cheng, Li Tan, Hengjin Dong, Vinod K. Diwan, Alessandro Vespignani
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Analysis of Policies in Activating the Infectious Disease Specialist Network (IDSN) for Bioterrorism Events.: Yang Soo Kim; J Prev Med Public Health. 2008;41(4):214-218.; DOI: https://doi.org/10.3961/jpmph.2008.41.4.214

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Abstract PDF

Bioterrorism events have worldwide impacts, not only in terms of security and public health policy, but also in other related sectors. Many countries, including Korea, have set up new administrative and operational structures and adapted their preparedness and response plans in order to deal with new kinds of threats. Korea has dual surveillance systems for the early detection of bioterrorism. The first is syndromic surveillance that typically monitors non-specific clinical information that may indicate possible bioterrorismassociated diseases before specific diagnoses are made. The other is infectious disease specialist network that diagnoses and responds to specific illnesses caused by intentional release of biologic agents. Infectious disease physicians, clinical microbiologists, and infection control professionals play critical and complementary roles in these networks. Infectious disease specialists should develop practical and realistic response plans for their institutions in partnership with local and state health departments, in preparation for a real or suspected bioterrorism attack.

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The Current Status of Bioterrorism Education in Health-related Colleges -In the Professors of the Health-related Colleges-
Byung-Chul Chun, Kyeong-Uoon Kim, Jee-Hee Kim, Jin-Woo Kim, Sang-Gyun Roh
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Preparedness of Young Male Physicians for Biological Terrorism and Warfare in South Korea
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The Strategic Plan for Preparedness and Response to Bioterrorism in Korea.: Hyun Soon Hwang; J Prev Med Public Health. 2008;41(4):209-213.; DOI: https://doi.org/10.3961/jpmph.2008.41.4.209

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Abstract PDF

Following the Anthrax bioterrorism attacks in the US in 2001, the Korean government established comprehensive countermeasures against bioterrorism. These measures included the government assuming management of all infectious agents that cause diseases, including smallpox, anthrax, plaque, botulism, and the causative agents of viral hemorrhagic fevers (ebola fever, marburg fever, and lassa fever) for national security. In addition, the Korean government is reinforcing the ability to prepare and respond to bioterrorism. Some of the measures being implemented include revising the laws and guidelines that apply to the use of infectious agents, the construction and operation of dual surveillance systems for bioterrorism, stockpiling and managing products necessary to respond to an emergency (smallpox vaccine, antibiotics, etc.) and vigorously training emergency room staff and heath workers to ensure they can respond appropriately. In addition, the government's measures include improved public relations, building and maintaining international cooperation, and developing new vaccines and drugs for treatments of infectious agents used to create bioweapons.

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Environmental Health Surveillance of Low Birth Weight in Seoul using Air Monitoring and Birth Data.: Ju Hee Seo, Eun Hee Ha, Ok Jin Kim, Byung Mi Kim, Hye Sook Park, Jong Han Leem, Yun Chul Hong, Young Ju Kim; J Prev Med Public Health. 2007;40(5):363-370.; DOI: https://doi.org/10.3961/jpmph.2007.40.5.363

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Abstract PDF

OBJECTIVES
The principal objective of this study was to determine the relationship between maternal exposure to air pollution and low birth weight and to propose a possible environmental health surveillance system for low birth weight. METHODS: We acquired air monitoring data for Seoul from the Ministry of Environment, the meteorological data from the Korean Meteorological Administration, the exposure assessments from the National Institute of Environmental Research, and the birth data from the Korean National Statistical Office between January 1, 2002 and December 31, 2003. The final birth data were limited to singletons within 37~44 weeks of gestational age. We defined the Low Birth Weight (LBW) group as infants with birth weights of less than 2500g and calculated the annual LBW rate by district. The air monitoring data were measured for CO, SO2, NO2, and PM10 concentrations at 27 monitoring stations in Seoul. We utilized two models to evaluate the effects of air pollution on low birth weight: the first was the relationship between the annual concentration of air pollution and low birth weight (LBW) by individual and district, and the second involved a GIS exposure model constructed by Arc View 3.1. RESULTS: LBW risk (by Gu, or district) was significantly increased to 1.113(95% CI=1.111~1.116) for CO, 1.004 (95% CI=1.003~1.005) for NO2, 1.202(95% CI=1.199~ 1.206) for SO2, and 1.077(95% CI=1.075~1.078) for PM10 with each interquartile range change. Personal LBW risk was significantly increased to 1.081(95% CI=1.002~1.166) for CO, 1.145(95% CI=1.036~1.267) for SO2, and 1.053(95% CI=1.002~1.108) for PM10 with each interquartile range change. Personal LBW risk was increased to 1.003(95% CI=0.954~1.055) for NO2, but this was not statistically significant. The air pollution concentrations predicted by GIS positively correlated with the numbers of low birth weights, particularly in highly polluted regions. CONCLUSIONS: Environmental health surveillance is a systemic, ongoing collection effort including the analysis of data correlated with environmentally-associated diseases and exposures. In addition, environmental health surveillance allows for a timely dissemination of information to those who require that information in order to take effective action. GIS modeling is crucially important for this purpose, and thus we attempted to develop a GIS-based environmental surveillance system for low birth weight.

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Review

Adverse Drug Reaction Surveillance System in Korea.: Nam Kyong Choi, Byung Joo Park; J Prev Med Public Health. 2007;40(4):278-284.; DOI: https://doi.org/10.3961/jpmph.2007.40.4.278

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Abstract PDF

Despite extensive researches and pre-market clinical trials, only limited information on the adverse drug reactions (ADRs) of a drug can be collected at the time of market approval from regulatory agency. ADRs constitute a major public health problem. Post-marketing surveillance of drugs is important to detect signals for ADR. In Korea, one of the main methods for monitoring the safety of marketed drugs is spontaneous reporting system of suspected ADRs. Re-examination and re-evaluation system are in force for monitoring safety of new market approval drugs and currently under marketing drugs, respectively. Recently, regional pharmacovigilance centers were designated from Korean Food and Drug Administration for facilitating ADR surveillance. Over recent years, with the development of information technology, there has been an increased interest in establishing data mining system for detecting signals from Health Insurance Review Agency database. The purpose of this paper is to review the current status of Korean ADR surveillance system and suggest the possible solutions for developing active pharmacovigilance system in Korea.

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English Abstracts

Circulatory Disease Surveillance System in Korea.: Byung Yeol Chun; J Prev Med Public Health. 2007;40(4):273-277.; DOI: https://doi.org/10.3961/jpmph.2007.40.4.273

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Abstract PDF: The purpose of establishing the circulatory disease surveillance system in Korea is to ensure that the problems of circulatory disease importance are being monitored efficiently and effectively. The goals of circulatory disease surveillance system are to monitor the epidemiological trends of circulatory disease and to evaluate the outcome of health activity for controlling circulatory diseases. Surveillance system are being updated to achieve the needs for the integration of the surveillance and information system, the establishment of data standards, the electronic exchange of data, and changes in the goals of circulatory disease surveillance system to facilitate the response of this system to manage the national health problem effectively. This article provides the target diseases and determinant indicators to be monitored, structure of circulatory disease surveillance system, and many tasks and related activities that should be applied to this system.; Summary

Introduction and Evaluation of Communicable Disease Surveillance in the Republic of Korea.: Ok Park, Bo Youl Choi; J Prev Med Public Health. 2007;40(4):259-264.; DOI: https://doi.org/10.3961/jpmph.2007.40.4.259

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Effective communicable disease surveillance systems are the basis of the national disease prevention and control. Following the increase in emerging and re-emerging infectious diseases since late 1990s, the Korean government has strived to enhance surveillance and response system. Since 2000, sentinel surveillance, such as influenza sentinel surveillance, pediatric sentinel surveillance, school-based sentinel surveillance and ophthalmological sentinel surveillance, was introduced to improve the surveillance activities. Electronic reporting system was developed in 2000, enabling the establishment of national database of reported cases. Disweb, a portal for sharing communicable disease information with the public and health care workers, was developed. In general, the survey results on usefulness and attributes of the system, such as simplicity, flexibility, acceptability, sensitivity, timeliness, and representa-tiveness, received relatively high recognition. Compared to the number of paid cases of national health insurance, reported cases by national notifiable disease surveillance system, and various sentinel surveillance system, the result of the correlation analysis was high. According to the research project conducted by KCDC, the reporting rate of physicians in 2004 has also greatly improved, compared with that in 1990s. However, continuous efforts are needed to further improve the communicable disease surveillance system. Awareness of physicians on communicable disease surveillance system must be improved by conducting education and information campaigns on a continuous basis. We should also devise means for efficient use of various administrative data including cause of death statistics and health insurance. In addition, efficiency of the system must be improved by linking data from various surveillance system.

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Original Articles

The Accuracy of ICD codes for Cerebrovascular Diseases in Medical Insurance Claims.: Jong Ku Park, Ki Soon Kim, Chun Bae Kim, Tae Yong Lee, Kang Sook Lee, Duk Hee Lee, Sunhee Lee, Sun Ha Jee, Il Suh, Kwang Wook Koh, So Yeon Ryu, Kee Ho Park, Woonje Park, Seungjun Wang, Hwasoon Lee, Yoomi Chae, Hyensook Hong, Jin Sook Suh; Korean J Prev Med. 2000;33(1):76-82.

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Abstract PDF: OBJECTIVES
We attempted to assess the accuracy of ICD codes for cerebrovascular diseases in medical insurance claims (ICMIC) and to investigate the reasons for error. This study was designed as a preliminary study to establish a nationwide surveillance system. METHODS: A total of 626 patients with medical insurance claims who indicated a diagnosis of cerebrovascular diseases during the period from 1993 to 1997 was selected from the Korea Medical Insurance Corporation cohort (KMIC cohort: 115,600 persons). The KMIC cohort was 10% of those insured who had taken health examinations in 1990 and 1992 consecutively. The registered medical record administrators were trained in the survey technique and gathered data from March to May 1999. The definition of cerebrovascular diseases in this study included cases which met one of two criteria (Minnesota, WHO) or 'definite stroke' in CT/MRI finding. We questioned the medical record administrators to explain the error if the final diagnoses were not coded as stroke. RESULTS: The accuracy rate of the ICMIC was 83.0% (425 cases). Medical records were not available for 8.2% (51 cases) due to the closing of hospitals, the absence of a computer system or omission of medical record, etc. Sixty-three cases (10.0%) were classified as impossible to interpret due to insufficient records in 'major clinical symptoms' or 'neurological deficits'. The most common reason was 'to meet review criteria of medical insurance benefits (52.9%)'. The department where errors in the ICMIC occurred most frequently was the department for medical insurance claims in the hospital. CONCLUSION: The accuracy rate of the ICMIC was 83.0%.; Summary

Development of Work-related Musculoskeletal Disorder Questionnaire Using Receiver Operating Characteristic Analysis.: Jaiyong Kim, Ho Jang Kwon, Yeongsu Ju, Soo Hun Cho, Daehee Kang, Joohon Sung, Seong Woo Choi, Jae Wook Choi, Jae Young Kim, Don Gyu Kim; Korean J Prev Med. 1999;32(3):361-373.

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Abstract PDF: OBJECTIVES
Receive Operating Characteristic(ROC) curve with the area under the ROC curve(AUC) is one of the most popular indicator to evaluate the criterion validity of the measurement tool. This study was conducted to develop a standardized questionnaire to discriminate workers at high-risk of work-related musculoskeletal disorders using ROC analysis. METHODS: The diagnostic results determined by rehabilitation medicine specialists in 370 persons(89 shipyard CAD workers, 113 telephone directory assistant operators, 79 women with occupation, and 89 housewives) were compared with participant's own replies to 'the questionnair on the worker's subjective physical symptoms'(Kwon, 1996). The AUC's from four models with different methods in item selection and weighting were compared with each other. These 4 models were applied to 225 persons, working in an assembly line of motor vehicle, for the purpose of AUC reliability test. RESULTS: In a weighted model with 11 items, the AUC was 0.8155 in the primary study population, and 0.8026 in the secondary study population(p=0.3780). It was superior in the aspects of discriminability, reliability and convenience. A new questionnaire of musculoskeletal disorder could be constructed by this model. CONCLUSION: A more valid questionnaire with a small number of items and the quantitative weight scores useful for the relative comparisons are the main results of this study. While the absolute reference value applicable to the wide range of populations was not estimated, the basic intent of this study, developing a surveillance tool through quantitative validation of the measures, would serve for the systematic disease prevention activities.; Summary

Characteristics of Occupational Skin Disease Reported by Surveillance System.: Yeon Soon Ahn, Hyoung Ok Kim, Jun Young Lee, Ho Keun Jung; Korean J Prev Med. 1999;32(2):130-140.

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Abstract PDF: OBJECTIVES
This study was carried out to estimate the magnitude of skin disease related to occupation and to find out the characteristics of it. METHODS: We collected and analyzed the cases of occupational skin disease reported by surveillance system composed of doctors and nurses in 150 enterprises with dispensary or attached hospital and physicians in 92 specific health examination institutes and 150 dermatologists from May to November, 1998. RESULTS: Among members of surveillance system, 66 enterprises and 47 specific health examination institutes and 55 dermatologists reported 571 cases of occupational skin disease in 512 workers. Excepting 81 cases reported by dermatologists, We analyzed 490 cases reported by enterprises and specific health examination institutes. Among 490 cases, contact dermatitis was most common(368 cases, 75.1%) and the second was hyper or hypopigmentation(36 cases, 7.3%). When we analyzed the characteristics of workers with occupational contact dermatitis, male workers were 281(79.2%) and female were 74(20.8%). 165 workers(64.5%) had chronic skin disease with repeated cure and relapse. 245 workers(72.5%) answered positively that their coworkers had similar skin disease. 27 workers(8.7%) experienced absence due to contact dermatitis related to occupation. To analyze the type of industries of workers with occupational contact dermatitis, automobile and trailer manufacturing industry was most common(105 cases, 29.6%) and the second was manufacturing industry for image, sound and communication equipment(55 cases, 15.5%). Organic solvent(183 cases, 46.7%) was the most common treating material of workers with contact dermatitis and the second was various kinds of chemicals(59cases, 15.1%). CONCLUSIONS: This is the first study using nationwide surveillance system to collect data of occupational skin disease. We found that many workers had skin disease related to occupation and characteristics of occupational skin disease were chronic and clustering. Therefore, we had to establish counterplan to manage occupational skin disease and to operate surveillance system to identify trends of occupational skin disease, continuously.; Summary

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