- A Proposal of Study Designs and Methods for Evaluating the Adverse Health Effects of Agent Orange among Korean Vietnam Veterans.
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Sang Wook Yi, Jong Uk Won, Jae Seok Hong, Heechoul Ohrr
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Korean J Prev Med. 2001;34(3):228-236.
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- OBJECTIVES
To propose a feasible, valid and appropriate study designs and epidemiologic methods for evaluating the adverse health effects of Agent Orange-chemical defoliants used in Vietnam- in Korea. METHODS: A literature study was performed on Agent Orange, herbicides, pesticides and dioxins. The study subjects, study design, exposure assessment and health outcomes assessment were examined in each study. The potential data sources for the study subjects, study design, exposure assessment and health outcomes assessment in Korea were investigated. RESULTS AND CONCLUSION: In earlier Korean studies, research subjects for studying the effects of Agent Orange were identified from the patients or persons who claimed to have Agent Orange-related diseases due to the difficulties in identifying the entire population of Vietnam veterans in Korea. In this study, an attempt was made to identify the total number of Vietnam veterans in Korea. As a result, the addresses of 20,000 Vietnam veterans were obtained. It is proposed that a retrospective cohort design on a sample of the total number of Vietnam veterans is a feasible and appropriate study design. Self report questionnaires and military records were proposed to assess the exposure level. It is believed that measuring the plasma or tissue TCDD should be used only for a validation study assessing the level of exposure. For the health outcomes assessment, it is possible to obtain the mortality, cancer frequency, physical examination, screening and medical insurance record data.
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- Transient Effects on the Risk of Occupational Injuries as an Acute Events: a Case-crossover Study.
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Seon A Jeong, Jong Tae Lee, Jong Uk Won, Jaehoon Roh
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Korean J Prev Med. 2001;34(1):35-40.
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- OBJECTIVES
To elucidate the transient effects on the risk of occupational injuries as acute events and establish an alternative proposal. METHODS: The study population comprised a total of 302 workers randomly selected from applications for occupational injury compensation reported to the Inchon local labor office from January 1, 1999 to December 31. A case-crossover design, where each case serves its own control, was applied to this study. Through a telephone interview, workers provided useful data concerning five job related stressful events such as company transfer, work load change, overtime work, exchange duty, and work-part transfer. They were asked whether there were stressful events within a week of the occurrence of injury and the degree of stress. Exposure status from one year prior was used as control information. In the end, the data provided by 158 of selected persons was used for the analysis based on the quality of the data provided by the participants. A conditional logistic regression was used to discover the transient effects on the risk of occupational injuries as acute events. RESULTS: The effect of a company transfer and work load change on occupational injury was statistically significant on the risk of occupational injuries as an acute event(RR=5.5, 95% CI=2.501-12.428; RR=3.1, 95% CI=1.963-5.017, respectively). Other stressful events were found to elevate the risk factor for the occurrence of occupational injury, but were not significant. CONCLUSIONS: Our results suggested that transient stressful events elevated the risk factor for the occurrence of occupational injury.
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- Health Care Utilization of Workers with Skin Disease in Inchon.
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Yeon Soon Ahn, Jae Seok Song, Jong Uk Won, Jaehoon Roh
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Korean J Prev Med. 1999;32(2):206-214.
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This study was carried out to identify relation of health care utilization due to skin disease(ICD-10, L00-L99) and characteristics(sex, age, exposure status, type of industry, size of enterprise) of workers. METHODS: We made new database composed of 30,536 workers' health examination results in one specific health examination institute in Inchon and data of medical insurance utilization due to skin disease in 4 medical insurance associations for enterprise from January, 1995 to December, 1997. And we analyzed determinants of health care utilization due to skin disease of workers. RESULTS: Among 30,536 study subjects, 8,837(28.9%) workers and 4,181(13.7%) workers utilized medical insurance due to total skin disease(ICD-10, L00-L99) and contact dermatitis(ICD-10, L23-L25), respectively. Female workers(p<.001), workers exposed to organic solvents(p<.05), workers in manufacturing industries(p<.05, p<.01, respectively) and in large scale enterprises(p<.001) utilized more medical insurance due to total skin disease and contact dermatitis than male workers, workers not exposed to organic solvents, workers in non-manufacturing industries and small scale enterprises. With multiple logistic regression analysis, significant explanatory variables affecting workers' medical utilization due to total skin disease and dermatitis and eczema(ICD-10, L20-L30) in total workers were sex, age, specific chemicals and size of enterprises. And age, type of industries, organic solvents, specific chemicals and size of enterprises were significant explanatory variables related to medical insurance utilization due to dermatitis and eczema and contact dermatitis in male workers. CONCLUSION: From the above results, we found that workers exposed to organic solvents utilized more medical insurance due to skin disease than workers not exposed to. And, comparing to workers in large scale enterprises, workers in small scale enterprises may have unmet medical care utilization due to skin disease. Therefore we have to establish counterplan to manage occupational skin disease of high risk group(organic solvent exposure group) and to satisfy unmet medical care utilization of workers in small scale enterprises.
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- Study of repuirements and conditions to be improved for voluntary occupational health program in worksite.
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Jae Seok Song, Jong Uk Won, Myong Sei Son, Bong Suk Cha, Jae Hoon Roh
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Korean J Prev Med. 1997;30(4):840-851.
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- To perform voluntary occupational health program in worksites, regulational supports are necessary. The regulational supports include assessment of current occupational health program and appropriate incentives. The purpose of this study is to find out the requirements of voluntary occupational health program and conditions to be improved. Study population was industrial health managers of both industries with less than 300 workers and over 300 workers, and the member of labor union who is responsible for safety and health in worksite. Two different questionnaire were used to find out the requirements and conditions to be improved respectively. The results were; 1. The category which prevalence rate of occupational injuries and occupational disease should be lower than national average was most important in health managers employed in industries over 300 workers and followed by reporting system, education, worksite policy, work environment assessment, protective equipment, consequently. But those employed in industries less than 300 workers showed high importance in prevalence rate of occupational injuries and disease, reporting system, worksite policy, work environment assessment, protective equipment, education, consequently. 2. The members of labor union thought that worksite policy was most important and the next is education, reporting system, work environment assessment, protective equipment, prevalence rate of occupational injuries and disease. 3. There were difference in importance of education and worksite policy according to the size of industries. Reporting system, prevalence rate of occupational injuries and disease, and worksite policy had different importance between members of labor union and health managers. 4. In the results of questionnaire for conditions to be improved, the most important condition was top manager's willingness except personal protective equipments, and followed by financial support, legal support. The limitations of this study were the problems of representativeness of study population. but voluntary health program should be performed in worksites which have relatively good occupational health system. So, this selection bias could not disrupt our results.
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- An Analysis of Health Examination Outcome in the Special Health Examination Institute.
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Yeon Soon Ahn, Sang Hyuk Jung, Dong Chun Shin, Jong Uk Won, Jae Hoon Roh
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Korean J Prev Med. 1995;28(3):663-677.
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- Special health examination institute has done periodic health examination for workers who have worked in the hazardous workplace. However, assessment on outcome in special health examination institute about detection ability of occupational disease has not been. In this circumstances, we studied on the differences of health examination outcome among special health examination institutes and identified related factors which affected outcome of special health examination in the special health examination institutes. The summary of the results were as follows. 1. 50 special health examination institutes were examined in this study. Among them, university institutes were 13 cases(26.0%), hospitals were 20 cases(40.0%), a corporation aggregates were 9 cases(18.0%) and an auxiliary organs of company were 8 cases(16.0%). There were 29(58.0%) institutes with a preventive medicine specialist, but 21 institutes(42.0%) were not. 2. Total workers examined in 50 institutes were 606,948 and workers diagnosed as occupational disease(D1) were 3,156. The rate of occupational disease was 6 workers per 1,000 examined workers. Workers needed for close observation(C) were 95,809 and the rate of workers needed for close observation was 141 per 1,000 examined workers. 3. The rate of occupational disease of university institutes was highest(11.3 per l,000 examined workers) and followed by hospitals(6.0 per 1,000 examined workers), a corporation aggregates(4.2 per 1,000 examined workers), and an auxiliary organs of company(l.2 per 1,000 examined workers.). The difference of the rate of occupational disease between university institutes and an auxiliary organs of company was statistically moderate significant(p<.1).The rate of occupational disease in special health examination institutes with establishment duration was more than 10 years was statistically higher than institutes with establishment duration was less than 10 years(p<0.l). 4. The results of multiple regression, R2 was 0.3394(adjusted R2 was 0.2109), F-value was 2, fi41ft(p<0.5), and statistically significant variables were establishment duration(p<0.1), number of examined workers per one doctor(p<.l), and auxiliary organs of company(p<0.l), which dependent variable was the rate of occupational disease and independent variables were number of examined workers per one doctor, classification of institute, the rate of working environment exceeding TLV, duration of institute establishment, presence of a preventive medicine specialist.
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- The effects of age adjustment on the diagnosis of noise induced hearing loss.
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Jong Uk Won, Yeon Soon Ahn, Jae Hoon Roh
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Korean J Prev Med. 1995;28(3):651-662.
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- In Korea there is no specific method of age adjustment in noise induced hearing loss(NIHL). we attempted the age adjustment to understand the effects of age on the diagnosis of NIHL. We used the International Standard Organization 1999 as an age adjustment method. We used the 1,617 otologically normal person's hearing data from a health examination center, and 206 workers diagnosed as NIHL. we concluded as follows; 1. The ISO 7029 function used for age specific hearing loss is not suited to Korean people. 2. The mean of age specific hearing loss is 11.0 6.2dB, and the older of age, the more decrease on hearing loss, especially in 4000Hz. 3. The difference of NIHL between before age adjustment and after age adjustment in the 3rd decade is 5.4dB, in the 4th decade is 6.7dB, in the 5th decade is 8.5dB, in the 6th decade is 10.4dB, and in the 7th decade is 12.9dB. The older, the more is the difference. 4. After age adjustment, the number of workers diagnosed as NIHL decreases to 60% of unadjusted.
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