Journal of Preventive Medicine and Public Health

Volume 1(1); October 1968

Original Articles

An Observation on the Mortality Rates of Transport Accidents in Korea.: In Ho Chu, Jung Ja Park, Suk Hwan Oh, Jae Hee Han; Korean J Prev Med. 1968;1(1):1-8.

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Abstract PDF: This paper describes the incidence of transport accident for the period, 1955-1965. Transport accidents were classified into three categories, viz. railway(WHO Classification of Diseases, E-802), watercraft(E850-E858) and motor vehicle accidents(E810-E835, E840-E841, E844-E845). Crude data on the subject were collected from the various sources of Government Statistical Books including Statistical Year Books edited by the Central Office of Economic Planning Board, Annual Police Reports by the Ministry of Home Affairs, and the national and local associations for road traffic safety. From the data incidence and mortality rates by year, month and local province were computed and other variables relevant to the epidemiology of accidents were observed. The following summary could be drawn: 1. Death rates due to transport accidents per 100,000 population were 12.3 for 1955 and 9.7 and 1965. The incidence of injury due to the same cause were 34.0 for 1955 and 35.9 for 1965. 2. Death rates by transportation vehicle showed 9.0 due to motor vehicle accidents, 1.7 due to water-crafts, and 1.6 due to railway trains for 1955. In 1965 death rates were 6.0 due to motor vehicles, 1.2 to water-crafts and 2.4 to railway. 3. Seasonal distribution of transport accidents revealed that car accidents occur more frequently in spring and fall seasons while ship accidents do in winter and train accidents more in summer. 4. Both car and ship accidents slightly decreased during the past decade, 1955-1965, whereas the accidents of railway trains showed a tendency of increase. 5. Although the survey on railway accidents excluded the injuries of passengers or railway employees corresponding to WHO classification of diseases, E801, due to inaccuracy of data, it is roughly estimated that the same number of causalities as the incidence among pedestrians or any other than passengers or employees assumed to be at work(E 802).; Summary

On Pattern of Birth and Death in Seoul City.: E Hyock Kwon, Tae Ryong Kim, Hyung Jong Park, Do Suo Koo, Yong Wook Lee, Soon Young Park; Korean J Prev Med. 1968;1(1):9-24.

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Abstract PDF: A survey was conducted by the staff of the College of Medicine and School of Public Health, Seoul National University in cooperation with Seoul Special City from 1 December 1967 through 28 February 1968, on such events as delivery, death, abortion and pregnancy. The survey directed to a total population of 47,811 residing in 9,157 households led us to the following findings: 1. Two year averages of crude birth rate, crude death rate and natural increase rate were 30.1, 5.6 and 24.5, respectively. 2. Of all deliveries, home and hospital deliveries constituted 61.1 per cent and 35.5 per cent, respectively. 3. Deliveries other than hospital deliveries were found to be attended more often by mother-in-laws(26.5 per cent) than by doctors or midwives(23.4 per cent). 4. About 52 per cent of all women having experiences in pregnancy during the last two years had an experience of consulting a doctor at least one time throughout whole period of pregnancy. 5. In most cases scissors were used to cut umbilical cords, of which 71.0 per cent were not sterilized and only 28.3 per cent sterilized. 6. In many cases placenta was incinerated(48,2 per cent) and on many other occasions it was thrown away into water(28.3 per cent). 7. Cement page(37.4 per cent), gauze and absorbent cotton(29.8 per cent)were found to be most frequently used to receive new-born babies. 8. In 1966 8.8 per cent of the women had at least one abortion induced and in 1967 the percentage was 9.2 per cent. 9. Nearly all(95.8 per cent) of the induced abortions reportedly were done at doctor's clinics. 10. Of all the abortions induced 65.3 per cent were done by specialists in obstetrics, 30.3 per cent by general practitioners and 2.7 per cent by midwives. 11. Those who experienced spontaneous abortions were 1.9 per cent of all women both in 1966 and 1967. 12. About 9.2 per cent of women investigated were found to be currently pregnant. 13. Age specific death rate turned out to be highest among those under 1 year of age. 14. Ten major causes of death in their order of frequency were: 15. Places of death can be classified into homes(75.3 per cent) and hospitals(13.2 per cent). 16. Method of disposing of corpses comprised burials(54.2 per cent) and cremations(44.6 per cent). 17. Infant, neonatal and hebdomadal mortality rates have been computed at 32.2, 18.9 and 13.7, respectively. 18. Infants were found to have died either at homes(81.5 per cent) or at hospitals(18.5 per cent). 19. Birth registrations had been done for about 18.5 per cent of the dead infants.; Summary

A Basic Health Survey of the Yonsei Community Health Service Area, Seoul.: Jae Mo Yang, Myung Ho Kim; Korean J Prev Med. 1968;1(1):25-36.

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Abstract PDF: INTRODECTION: In order to improve medical education through the introduction of a concept of comprehensive health care of a community, an area surrounding the University Campus was chosen for the Community Health Service Project. It has been on operation for last 4 years with its major emphasis on family planning services, and maternal and child health care. The major objectives of this survey at the area are to obtain: 1) The demographic data, 2) The health need and trend of medical care. 3) The attitude and practice in maternity care to be used for further improvement of the planning and the services of the project. Population and Survey Method: Out of three Dongs of the Community Health Service Area, only two Dongs namely Changchun and Yonhee were selected for the survey. Total number of households and population in the area studied was 3.683 and 21,857 respectively. An interview was performed with questionnaire schedule which was recorded by interviewers. This includes the degree of utilization of health services provided by the Community Health Service Program such as family planning, prenatal care during their last pregnancy, delivery history and complications of the delivery as well as the incidence of illnesses in general. Prior to the interview, all interviewers were trained for interviewing technique for two days. The survey was carried out during the period from October December 1967. RESUTLS: 1) Demographic Data : 41.3% of the population studied were children under age 15 and only 3.5% were over 60 years of age. Crude birth rate and crude death rate of this area studied during the period of November 1966-October 1967 were 20.5 and 7.7 respectively. Infant mortality rate during the same period was 35.9. 50.4% of the 2,832 households fell into the category of middle class, 39.8% to the lower class and 9.5% to the upper class in economic condition. 19.8% of 2,832 householders had no formal education, 22.7% primary school, and 57.5% middle or higher school education. 2) Health Status and Utilization of the Community Health Service: Those who suffered from many illnesses during the month of October, 1967 were 690(4.6% of 14,891 persons). Classification of these patients into the type of disease shown respiratory diseases 27.4%, gastrointestinal diseases 18.1%, tuberculosis 10.9%, skin and genitourethral diseases 4.5% and gynecologic patients 4.5%. Only 55.9% of the patients received medical care at hospital or doctor's clinic. But among TB and gynecologic patients, 70.7% and 72.4% were treated at medical facilities. 10.6% of 2,832 householders interviewed has ever utilized the Community Health Service Program provided by the Yonsei Medical School. Classifying these clients into the type of service, 35.9% utilized the wellbaby clinic, 31.0% the family planning clinic, 14.7% the home delivery care, and the rest utilized other services such as the premarital guidance clinic and the sanitary inspection service. 3) Maternity Care: 23.6% of 2,151 deliveries were done at medical facilities such as hospital, private clinic, while 76.4% were done at home. Acceptance rate of prenatal care was 32.6% as whole, but 49.6 of 774 women who had the prenatal care service had their deliveries at medical facility. 45.1% of total deliveries were attended by medical and or paramedical personnel. 75.8% of the deliveries of those received prenatal care were attended by medical and or paramedical personnel while only 27.8% of the deliveries of those who did not have prenatal care attended by medical and or paramedical personnel. 49.8% of deliveries of the upper class, 29.8% of the middle class and 9.9% of the lower class were attended by medical and or paramedical personnel. 6.2, 3.3% and 24.8% of mothers reported about their experience of edema, coma and fever during the period of trimester of pregnancy and puerperium. 4) Family Planning: The rate of practice of family planning was 27.9%. 31.7% of them were by IUD, 20.9% by oral pill, 15.2% by sterilization and the rest by traditional methods. Those women who had 3 to 4 children had highest(30.2%). Practice rate among the various methods of family planning, oral pill was the most popular method to whom had 2 or less children. In relation between the practicing rate of family planning and living standard, the upper, middle and lower class practiced 37.5, 29.4 and 19.9% respectively.; Summary

Epidemiology Studies on the Mites in Food.: Don Kyun Kim, Soo Bok Song; Korean J Prev Med. 1968;1(1):37-42.

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Abstract PDF: Authors studied on the Acaroid mite in the food, and the following results were obtained. 1) 6 species of Acaroid mite were found among twelve kinds different types of food. a. Tyrophagus dimidiatus, b. Glycyphagus destructor, c. Glycyphagus domesticus, d. Hoshikadania konoi, e. Acarus siro, f. Carphoglyphus lactis. 2) Acaroid mite were not found in the wheat flour and magalin among the twelve different kinds. 3) Acaroid mit were distributed at higher rate in the pollack(94%), cuttle fish(77%) and anchovy(50%).; Summary

An Epidemiological Observation of Fire Accident in Korea.: Chong Dae Lee, Seong Un Han, Soon Duk Bin, In Ho Chu; Korean J Prev Med. 1968;1(1):43-50.

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Abstract PDF: Epidemiological and statistical observations were made of fire hazards that occurred during the past 18 years, 1948 to 1965. Injury and mortality rates for all ages were computed chronologically. For the years of 1955, 1961 and 1965, all fire accidents were epidemiologically analysed to draw characteristic pattern in relation to the seasonal and 24 hour distribution, causes and sites of accidents etc.. Fire hazards observed herein are the categorys E 916 of the International Classification of Causes of Death, 1955, and includes all accidents caused by fire and explosion of combustible materials. The following conclusion was made: 1. The average umber of annual deaths due to fire was 183 and the number of the injured due to the same cause was 335. The mortality rate per 100,000 population was 0.8 and the ratio of injures per death was 1.8. 2. The casualty rate including both the dead and injured was 5.0 per 100,000 in Seoul, the highest among the provinces and followed by 3.4 in Cheju-Do, 2.1 in Kangwon-Do, 1.7 in Kyunggi-Do accordingly. The other provinces had a range of 0.6 to 1.2. 3. The monthly distribution of fire accidents showed that the winter months, December through February, had more frequent accidents, while the summer season, June through August had less. The 24 hour distribution of accidents showed more cases from 12:00 to 18:00 and less from 4:00 to 10:00 hours. 4. The per cent distribution of causes of accidents showed; 90.0% for careless, 10.0% for arson. The cause of carelessness was further breakdown into; 15.0% for kitchen fire places, 13.8% for fire playing, 9.4% for electrical heating and wires, 8.3% for fuels, 6.3% for matches, 5.2% for ash dumps and the remaining for others. 5. The accidents as classified by place revealed that 56.8% of the total occurred at the common dwelling houses, 11.3 at various industrial workshops, 9.3% at the street shops and the remaining at the miscellaneous places.; Summary

Study on the Acceptability and Effectiveness of an Oral Contraceptive Among Iud Drop-outs in Rural Korea.: J M Yang, S Bang, S W Song, B B Youn; Korean J Prev Med. 1968;1(1):51-66.

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Abstract PDF: During a period of about one year(November '66 an December '167), the Yonsei University, College of medicine conducted a field trial of the oral contraceptive (Ovulen) in order to study its acceptability and use-effectiveness among IUD drop-outs in Koyang country. we can summarize the outstanding finding from this investigation as follows; 1. 61.4% of the IUD drop-outs interviewed (911 women) wanted to use the pill. Host of the reasons for not wanting to use it(359 women) pertained to either use of other contraceptive methods(98) or subfecundity(150) following IUD terminations. Only 83 out of 911 women gave reasons related to the difficulty of obtaining pills. Therefore, we can state that most IUD drop-outs If still in need of a contraceptive methods ,are in favor of trying the pill, and especially so if this method is conveniently available. 2. The 467 women or 37% of those who terminated IUD use actually visited the clinic for medical screening, and only 11 of them or 2.4% were rejected because of pregnancy and other medical reasons such as cervical erosion, myoma, breast mass, etc. 5.5% or 25% of the 456 women who received the first cycle did not take a single pill during the study period. 3. When we defined those 431 women who accepted and took once or more tables we tales we found that women over age 30, with 4 or more children, and/or with a higher educational level were the best prospects for recruitment. 4. In accuracy of use, about two thirds of the users started taking the pill on the 5th day as directed for the first three cycles, but the percentages rose sharply to about 80% on later cycles. Tardiness in starting pill use in the first cycle may have occurred partly because they had to return to the clinic monthly to get each new cycle. Among accepters who did not quit between cycle, 80 to 90% were regular users, missing two or less tablets in each cycle. 5. More than 60% of the users felt well and sometimes lost their pre-acceptance systems, especially dymenorrhea. However, 27.4%(58 women) had side effects attributable to the pill compound as nausea, vomiting, indigestion, breast tenderness, decreased lactation or break through bleeding 25.0% (53 women) also complained of medical diseases or symptoms not related to the pill, especially during the first three cycles. However, as the confidence and experience of the client and the field workers grew, the incidence of unrelated medical complaints quickly fell to a lower level in the later cycles. 6. As of the end of this study, on December 31, 1967, 492%(212 women) had discontinued the use of the pill for medical reasons as well as for the non medical reasons. Only one case terminated use due to a pregnancy after taking pills. The cumulative continuation rates (by the life table method), were 58.9%, 51.9%, 41.0% at the end of 3 months. 6 months and one year, respectively. These rates are lower than in the U S. students. Even when we add the retaking group to the first segment, the continuation rate goes up only about 5% above the first segment rates mentioned above. Possible explanations are different dosages, the newerness of the method and the use of only one point for pill distribution in the country together with a monthly return for cycle 1, 2, 3, and 4-6.; Summary

A Study on the Physical Growth and Health Status in University Students.: E Hyock Kwon, Chul Hwan Cha; Korean J Prev Med. 1968;1(1):67-78.

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Abstract PDF: For the purpose of ascertaining the status of physical growth and health status of the University students, a intensive survey was conducted by the authors towards a total of 2,638(male; 2,228, female;410) who passed the written entrance examination at the Seoul National University. The items included the measurements on physical growth, various physical indexes, visual acuity, tuberculosis and dental status. The findings and results can be summarized as follows : 1. Physical Growth. No signigicant difference was found in the physical growth between classes(literature and science) and by ages. In males, the means of body height, body weight, chest-girth and sitting height were 168.0+/-5.07cm, 55.7+/-5.71kg, 85.8+/-4.4cm and 91.5+/-2.21cm, respectively. In females, these were 157.4+/-4.57cm, 00.4+/-5.75kg, 80.3+/-4.51cm and 86.1+/-3.30cm, respectively. Basing on the above measurements several physical indexes were calculated as follows ; Relative body weigh 33.15 in males and 32.02 in females. Relative chest-girth 51.07 and 51.01, relative sitting-height 54.46 and 54.70 Rohrer index 1.00 and 1.02, Kaup index 1.97 and 2.04, Vervaeck index 83.63 and 83.03, and Pelidisi index 89.94 and 92.45. 2. Visual Acuity. Among the students of science classes those of 0.8 and below in vision on left and right occupied 46.4% and 45.0%, those of 0.6 and below 39.1% and 41.2%, respectively. Among the students of literature classes those of 0.8 and below occupied 46.3% and 42.9%, and those of 0.6 and below occupied 41.4% and 39.0, respectively. In males those of 0.8 and below occupied 46.8% and 44.5% and 0.6 and below occupied 41.9% and 39.7%, while in females 0.8 and below occupied 43.9%, and 42.4%, and 0.6 and below occupied 38.3%% and 37.3%, respectively. In males those of 0.8 and below in corrected vision occupied 12.1% and 10.3%, while in females 12.9% and 12.2%, respectively. More students of abnormal vision were found among science classes and the proportions of corrected vision were 38.9% and 37.4% in males, and 33.9% and 33.2% in females, respectively. 3. Tuberculosis. Among the total, 55 students were diagnosed as tuberculosis, of whom 50 were minimal cases, 2 were moderately advanced cases and 3 were far advanced cases. 4. Dental Status. Among the total, 81.2% were of decayed teeth, 20.8% filled, 9.5% missed, 5.0% extraction needed, 9.1% sunplatinum bridges, 3.3% golden bridges and 5.5% golden inaly. Regarding tartar on teeth moderate, heavy and light grades occupied 49.5%, 29.7% and 20.3%, respectively and 0.8% had none. 5. Comprehensive evaluation. According to the criteria 4 grades were applied to comprehensive evaluation as follows : A---excellent in physical status B---with some physical defects but no difficulties in study C---need treatment D---need treatment and rest. Out of the total, A grade occupied 21.6%, B 76.2% and C. and D 2. 2.; Summary

An Observation on the Incidence of Drowning Death in Korea.: Chang Yong Chee, Young Chun Kim, Byung Joo Lee, In Ho Chu; Korean J Prev Med. 1968;1(1):79-86.

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Abstract PDF: This paper describes the incidence and some epidemiological features of drowning accident out of a series of our study on the epidemiology of various accidents in Korea. By the daily press it is apparent from the frequent reporting of swimming accidents that the incidence would be high. In the rural areas, there are, at present about 1,250 artificial lakes and farm ponds to be utilized for rice production. The reservoirs, irrigation ditches and riversides are also used for recreation. In most places facilities for aquatic activities is meager, and safety measures for the prevention of drowning is not sufficiently enforced. In the survey crude data on drowning were collected from the concerned governmental statistic books for the period 1955 to 1967 which were compiled not in a uniform way. Drowning were classified into two categories, one is accidental drowning, E929 and the other is due to cataclysm, E934, according to the WHO international classification of diseases. Epidemiological variables in relation to drowning accident were obtained through qualitative analysis of informations from the popular newspapers. The following summary may be drawn; 1. The average number of deaths due to accidental drowning totaled 1,088 annually and the mortality rate per 100,000 population was 3.4. The 42.0% of all drowning were rescued and the remaining were not saved. 2. The sex ration(M/F) of the victims for all ages was 5 to 1, which had a wide range of difference among the age groups. The young ages less than 20 years occupied 68.0% of all deaths. 3. The percentage distribution of the causes of accidents revealed 31.9% for careless swimming, 45.5% for unskilled, 16.6% for swimmer's cramp and 6.0% for drunken. The distribution of places where accidents occurred showed 88.0% for rivers, water reservoirs, irrigation ditches and 12.0% for regular swimming pools. The seasonal distribution of cases indicated 85.0% of the total were seen during the summer months, June-August, and 50.0% of them occurred on Sundays. 4. The average annual deaths due to cataclysm were 402 and mortality rate per 100,000 population was 1.6, but the number of victims due to cataclysm varied greatly each year. 5. The accident cases due to cataclysm were classified into 60.0% for injuries, 40.0% for deaths. The 26.8% of all deaths were missing cases. 6. The deaths due to either accidental drowning or cataclysm totaled 1,490, and the death rate per 100,000 for the whole country was 5.0.; Summary

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