Journal of Preventive Medicine and Public Health

Volume 18(1); October 1985

Original Articles

A Study on the Incidence of Carbon Monoxide Poisoning.: Soo Hun Cho, Young Soo Shin, Doek Hyoung Lee, Yong Ik Kim, Dork Ro Yun; Korean J Prev Med. 1985;18(1):1-11.

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Abstract PDF: A decade ago a survey on the population-base incidence rate of anthracite coal gas(mainly carbon monoxide) poisoning in Seoul area was investigated, resulting in the incidence rate of 306/10,000 risk population and 1 death/10,000. Another survey on the carbon monoxide poisoning was investigated during 1 year period from Apr. 1983 to Mar. 1984. Total subjects of risk population were 67,740 households covering 353,287 persons. The major findings of this survey are as follows: 1. Household-base incidence rate was 8.4%; spell-base 10.4%. 2. The incidence rate was the highest in houses having each of slate roof, cement wall, vinyl floor of bedroom and direct 'ondol' heating system. 3. Average 2.1 person was attacked from one incidence of the poisoning; severity-wise person-base incidence rates per 10,000 were 352 in mild poisoning, 54 in severe poisoning and 1.4 in death-overall incidence rate 407. Several facts were identified which supported that this figure was moderately underestimated. As the incidence of the poisoning is affected by socioeconomic and environmental factors, it is natural that one expects the incidence will decrease in proportion to general improvement of the above factors. Thus the results of these two surveys seemed preposterous. But further study suggested that the incidence rate (306/10,000) decade before had been significantly underestimated and corrected-rate should have been 478/10,000 level. 4. Age and sex distribution by the degree of the poisoning was uniform with little statistical difference; overall incidence rates by sex were 339/10,000 in male and 475/10,000 in female with significant statistical difference(p<.01). 5. 5.3% of the patients were treated at hospital or local clinic; 3.0% of the patients were hospitalized. Admission rate in comatose patient(severe poisoning) was 14.2%. In conclusion, carbon monoxide poisoning remains a major health problem by now.; Summary

On Determinants of Physician Utilization: A causal analysis.: Sang Soo Bae; Korean J Prev Med. 1985;18(1):13-24.

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Abstract PDF: This study seeks to provide a framework for understanding differential access to medical care. The framework is provided by Andersen Model, a model of health services utilization which suggests a sequence of predisposing, enabling, illness-morbidity characteristics that determine the number of times people will visit a physician. The framework in this study is composed of two models, one is for Adults and the other is for Non-Adults. Models are operationalized using stepwise multiple regression analysis and path analysis. The data come from a national health survey conducted in 1983. The findings of the analysis can be summarized as follows: First, the casual models used in this study are able to explain only a small amount of the variance in medical care utilization(Adjusted R2 is. 144 in the Model for Adults and .243 in that for Non-Adults). This finding suggests that we reconsider the utility of such existing model using the predisposing, enabling, and illness-morbidity characteristics in light of their poor correspondence with these data. Second, while small amount of the variance in medical care utilization is explained, most of the explained variance is due to the illness-morbidity characteristics. The path coefficients of study variables except illness-morbidity variables show these characteristics to be substantially unrelated to medical care utilization, and the indirect effects of the predisposing and enabling characteristics on medical care utilization are also negligible. This casts doubt on the importance of the predisposing and enabling characteristics in explaining medical care utilization. Third, among the predisposing and enabling characteristics, Medical Security variable is the only one having significant direct effect on medical care utilization in both models for Adults and for Non-Adults. Fourth, the amount of the variance explained in the Model for Non-Adults is more than in the Model for Adults. This suggests that medical care utilization of adults is more influenced by behavioral factors than that of children.; Summary

Morbidity Patterns and Health Care Behavior of Residents in Urban Low Income Area.: Kuck Hyeun Woo; Korean J Prev Med. 1985;18(1):25-40.

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Abstract PDF: This study was conducted to assess the morbidity and medical facilities utilization patterns of the residents in urban low income area. Study population included 2,002 family members of 468 households in the low income area(LA) of Nam-san 4 Dong, JungGu of Taegu city and 1,709 family members of 374 households in surrounding neighbourhood control area(CA). Well trained nursing school students interviewed mainly with housewives according to the pretested questionnaire between July 1 and July 30, 1984. Age-sex distribution of the study population in LA was similar to that in CA. The average monthly income of a household in LA was 236,000 won and 356,000 won in CA. Educational level of the residents in LA was lower than that in CA; average years of school education of the 20 years old or above in LA was 6.9 years compared with 8.5 years in CA. The average family members per room in LA was 2.6 and 2.2 in CA, and proportion of Medicaid program beneficiary was 29.4% in LA and 1.9% in CA. Prevalence rate of illness during 15-day period was 131 per 1,000 population in LA and 71 in CA(p<0.01) and that of the chronic illness for 1 year was 134 per 1,000 population in LA and 89 in CA (p<0.01). The most common illness experienced during 15 days was respiratory disease(24.0% in LA and 29.8% in CA) and followed by gastro-intestinal disorders(21.0% in LA, 20.6% in CA). Injury or poisoning was 10.3% in LA and 3.3% in CA. Gastro-intestinal disorder was the most common chronic illness in both LA (22.7%) and CA (21.7%), and followed by musculoskeletal disease in LA and neuralgia in CA. Mean activity restricted days among the persons with illness during 15-day period was 4.0 days in LA and 2.2 days in CA. Among persons with illness during 15 days, 17.9% in LA and 11.6% in CA did not seek any medical treatment and the most frequently utilized medical facility was pharmacy in LA (35.5%) and local clinic or hospital OPD in CA (42.1%). Among persons with chronic illness, 15.2% in LA and 9.2% in CA did not seek for medical treatment, and residents in LA as well as residents in CA utilized local clinic or hospital OPD more frequently than pharmacy or drugstores, especially those who have medical insurance. The most common reason for not treating illness experienced during 15-day period and chronic illness was economical constraint in both LA and CA. The higher prevalence rate of illness during 15-day period and chronic illness in LA than that in CA seems to be highly correlated with their lower economic status and educational level and crowded living condition. The utilization pattern of medical facilities was associated with the medical security status. A program to improve the economic status and living condition should be integrated with the health program to promote the health of the population in low income area.; Summary

A Comparison of Medical Care Services by Types of Medical Care Facility: In cases of normal spontaneous vaginal delivery and acute appendicitis.: Young Doo Lee; Korean J Prev Med. 1985;18(1):41-50.

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Abstract PDF: To find out the differences in medical practice according to the environment of patient care and managerial situation of the medical care institutions, normal spontaneous vaginal delivery and acute appendicitis were selected, which is suitable for comparison because of their high comparability. A total of 473 cases of normal spontaneous vaginal delivery and 408 cases of acute appendicitis was sampled from the claims to Korea Medical Insurance Cooperations during January to June 1984. Complicated cases were excluded from population and sampling was restricted from 40 to 60 percentile for total charges by the type of medical care facility in order to rule out the influence originating from case mix. Important items representing type and quantity of medical care service were compared by type of facility. Major findings are as follows: 1. University hospital shows the highest in charges per case and decrease in order of general hospital, and clinic. 2. In case of normal spontaneous vaginal delivery, average length of stay shows statistically significant difference by type of facility. 3. Charge amount for each service item affected by practice pattern shows statistically significant difference mostly by type of facility. It is suggested that medical practice pattern is different by type of facility for medical services. 4. Difference in total medical expenditure by type of facility is affected more with charges for materials, consumables and drugs than with fee for service activity. 5. In administering drugs to patients, hospital and clinic show higher injection rate than university and general hospital. 6. Clinical Laboratory tests were common in order of uninalysis, hemoglobin, hematocrit, white blood cell count, urine microscopic examination in cases of normal spontaneous vaginal delivery; white blood cell count, urinalysis, hemoglobin, hematocrit, urine microscopic examination, white blood cell differential count, in cases of acute appendicitis. 7. The result for Laboratory test and Radiologic study shows extreme difference by type of facility. Test rate is lowest in clinic and increase hospital, general hospital, and university hospital in order, both in type and frequency.; Summary

A Study on the Validity of "Hepa-S" Hepatitis B antibody Detecting Reagent after Vaccination of "Hepa-Vax".: In Sook Moon; Korean J Prev Med. 1985;18(1):51-58.

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Abstract PDF: To attempt to measure the effect of domestic product P.H.A. kit "Hepa-S" after completion of "Hepa-Vax" vaccination schedule, P.H.A. test and R.I.A. test on the 330 healthy adults were carried out. The results obtained were as follow; 1. The positive anti HBs rate after completion of "Hepa-Vax" vaccination were; in P.H.A. test with domestic product P.H.A. kit 81.2%, in P.H.A. test with foreign product P.H.A. kit 82.7%, and in R.I.A. test 95.8%. 2. Using the result of R.I.A. test as the standard, sensitivity of P.H.A. test with domestic product P.H.A. kit was 84.8% and specificity was 100.0%. 3. Using the result of R.I.A. test as standard, sensitivity of P.H.A. test with foreign P.H.A. kit was 86.4% and specificity was 100.0%. 4. The concordance rate of P.H.A. test with domestic product and foreign product kit was 98.5%. On the result of this study, there was no significant difference in the validity between the domestic product P.H.A. kit "Hepa-S" and the foreign P.H.A. kit "HebsgencellTM". So that it is recommendable to use domestic product P.H.A. kit instead of foreign product P.H.A. kit.; Summary

Dustfalls and Various Ion Concentrations in Their Filtrates in an Urban and in a Rural Districts.: Yeon Pyo Hong; Korean J Prev Med. 1985;18(1):59-72.

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Abstract PDF: During a period from February 1st to November 30th in 1983, measurements were made twice a month on dustfalls and concentrations of various cations and anions in their filtrates in an urban (Heuksuk-dong, Seoul) and in a rural (Ansung) districts. Standard British Deposit Gauge method was applied for collection of dustfalls and ion chromatographic method using Ion Chromatograph 10 (Dionex, U.S.A.) for determination of cation and anion concentrations. The results obtained were as follows: 1. Annual mean values of dustfalls were 8.30+/-5.09 tons/km2/month in an urban and 6.20+/-0.82 tons/km2/month in a rural districts. And annual mean values of pH of filtrates of the collected samples were 5.3+/-0.76 in an urban and 6.0+/-0.82 in a rural districts. 2. Annual mean concentrations of common cations and anions in their filtrates were as follows: Some of anions such as Br-, PO4-3 and NO2 were scarcely detected and F was measured at very low concentrations ranging from 0.1 to 0.5 ppm in Feb., Oct. and Nov. in an urban and in Feb. in a rural districts. 3. By two-way analysis of variance with 4 replications for dustfalls, pH and concentrations of various ion by district and month of a year, statistically significant differences were noted in dustfalls (p<0.01), pH (p<0.01) and concentrations of various ion (p<0.01) by month of a year, and in dustfalls (p<0.05) and concentrations of various ion such as NH4, Ca, NO3 and SO4 (p<0.01) by district. 4. There were statistically significant differences pH in Spring (Feb., Mar. and Apr.) (p<0.01) and in SO4 in Autumn (Aug., Sept., Oct. and Nov.) (p<0.05) between the two districts.; Summary

A Survey on the Dietary Intake of the Elderly in an Urban Area and on Analysis of the Related Factors.: Sun Hee Kim; Korean J Prev Med. 1985;18(1):73-82.

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Abstract PDF: This study was conducted to evaluate nutritional status with the analysis of the factors which might influence on the prevalent condition of nutrients-intake. 373 persons who are above 60 years old in Chung-Gu, Seoul were surveyed from March 15 to March 30 in 1985. Results were as follows; 1. General Characteristics. 1) Male respondents among the entire respondents comprised 54.3% and female respondents comprised 45.7%, As for age, male and female respondents comprised 55.0% and 37.2% respectively. 2) As for the educational level of the respondents, illiteracy was 49.9% which was the highest rate, and those who graduated elementary school was 28.1% which was the second highest. And as for the comparison of the education of the male and female respondents, the educational level of male respondents was much higher than that of female respondents. 3) As for the final occupation of the respondents, those who were engaged in commerce comprised 30.8% which was the highest rate, and who were engaged in agriculture comprised 20.1% which was the second highest rate. And those who were engaged in labor comprised 12.3%. 2. The State of Nutrients-intake. The energy of the male respondents was 61.4% of RDA and the protein was nothing but 66.8% of RDA. Except vitamin A, vitamin B1 and niacin, calcium, iron, vitamin B2, vitamin C were lower than RDA (the range: 67.5%-97.3%). The energy of the female respondents was 70.0% of RDA and the protein was 58.8% which were lower than RDA. Except vitamin A and vitamin B1, calcium, iron, vitamin B2, vitamin C, niacine were lower than RDA (the range: 68.2%-98.9%). 3. The various factors related to nutrients-intake. 1) The composition of family and the food environment those who were living with their spouses comprised 44.8% which was the highest rate, and those who were living with their son's family comprised 33.5% which was the second highest rate and those who were living with their daughter's family comprised only 4.6%. Those who were living alone comprised 16.4%. The correlation with nutrient intake didn't show a clear relation. 2) Socio-economic state. Those who said that they lacked in living expense comprised 32.7% and those who said that they lacked in pocket-money comprised 23.9%. The female respondents outnumbered the male respondents in lacking living expense or pocket-money. In the correlation with socio-economic, there was no striking relation with education level. However, it was shown that little relation in energy, fat in male and also fat and iron in female. The living expense and the satisfaction in pocket-money had also little relation with energy fat and vitamin C in male. 3) Nutrition knowledge and food habit. (a) The state of nutrition knowledge and food habit. In nutrition knowledge, those who scored less than 60 points were 32.9%, and those who scored more than 90 points were 21.0%. In food habit, those who scored less than 60 points were 26.5% and those who scored more than 80 points were 45%. (b) The correlation with nutrition knowledge and food habit. In case of female respondents, nutrition knowledge had a little relation with the intake of cabohydrate, iron, and vitamin C. And we couldn't see a distinct phenomenon in food habit.; Summary

Health Status by Cornell Medical Index of Working Students of High School Attached to Industry.: Sook Lee; Korean J Prev Med. 1985;18(1):83-89.

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Abstract PDF: The result of the close analysis of the health status of 549 working students (the experimental group) of a high school attached to an industry and that of 1,259 non-working students (control group) based on the question provided by CMI from 1st, June to 31st, July 1984 has been revealed as follows: 1. In contrast with the control group, the experimental one is statistically noticeably higher (p<0.01) in their average complaints both in terms of the whole items(A-R) and the physical items(A-L). 2. In the experimental group, particularly the item(L) for habits has the highest rate of average complaints, followed by the item(B) for the respiratory system and the item(E) for the musculoskeletal system. 3. The average complaints of the individual class in both the experimental group and the control group have the tendency to be on the increase accordingly as the school year goes up, and the increasing rate of the experimental group has turned out to be higher than that of the control group. 4. The average complaints of the experimental group based on residential types are the highest(34.7%) in the case of cooking food for oneself, followed by a dormitory(30.3%), and one's own house(28.5%). 5. The average complaints based on the individual working place has been found out to be higher than the rest in the item of the miscellaneous disease of the blowing and roving parts, the respiratory system of the carding part, the fatigability of the spinning part, the tension of inspecting part.; Summary

Complement Activation by Tobacco Infusion.: Myung Ho Chung, Doo Hie Kim, Tae Ho Chung; Korean J Prev Med. 1985;18(1):91-98.

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Abstract PDF: The capacity of tobacco infusions of Korean cigarettes to activate the complement pathway was investigated in vitro by hemolytic assay. Complement activity was studied using samples of normal rabbit serum incubated at 37 degrees C with tobacco infusions. In all mixtures containing tobacco infusion A, B, C, D, E, F, G, H and I at a concentration of 0.1 : 1, total hemolytic complement showed a progressive decrease of 55.92%, 48.62%, 42.89%, 49.12%, 42.26%, 52.26%, 71.96%, 60.90%, and 61.14% respectively, after 60min of incubation. This study suggests that all tobacco infusions of Korean cigarettes are activators of complement.; Summary

Contents of Health Education for Pupils and the Perceptibility after Graduation of Primary School.: Bo Yoon Jeon, Doo Hie Kim; Korean J Prev Med. 1985;18(1):99-112.

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Abstract PDF: It was measured to check the state of health education by the survey of the items related to the health with first grade of students in middle school who mastered elementary courses. Totally 50 questions, which were selected from Standard and Dong-A reference books, were given to teachers and have got answered by the students who were totally 959(491 from urban areas and 468 from rural areas). It's done just after they entered middle school for a month, from April 10 to may 10, 1984. There were totally 782 items of health in all subjects of all grades. In contents, the most cases were about mental and emotional health(17.7%), exercise and rest(15.1%), environmental health, health life, personal health care, nutrition and foods, social health and organization, physiology and anatomy, statistics of public health population problem, disease and care, food sanitation, school health, parasitic and communicable disease control, eugenics and heredity(0.4%), etc were followed. In subjects, Korean language had 44.7% of mental emotional health in 114 cases, arithmetics 46.4% of statistics of public health in 26, sociology, 23.1% of environmental health in 118, natural science, 60.1% of physiology and anatomy in 30, ethics, 40.3% of mental and emotional health in 176, music, 21.8% of mental and emotional health and accidents in 23, art, 42.9% of exercise and rest in 28, physical education, 38.6% of exercise and rest in 201, practical course, 36.2% of nutrition and foods in 61, and there was nothing but only one case in Korean history. Subjects in total cases of health informing items are below: Physical education 25.8%, ethics 22.5%, sociology 15.1%, Korean language 14.6%, practical course 7.8%, natural science 3.8%, art 3.6%, arithmetics 3.3%, music 2.9%, Korean history 0.6%. Grades in total cases of health informing items are belows: the sixth grade 29.1%, the fourth grade 21.2%, the fifth grade 18.9%, the third grade 11.6%, the first grade 11.5%, the second grade 7.7%. The sections related to health matters were average 35.4%. According to the grades, the fourth and the sixth grade were 38.2% each other, the highest, and the second grade was 29.3%, the lowest. All sections in physical education included them. The acceptability to the knowledge for health was belows: 56.3% in urban students and 53.9% in rural students. There was some difference in acceptability between two parties (p<0.005).; Summary

Comparison of Respiratory Symptom between Urban and Rural Residents.: Jung Suk Yoon, Doo Hie Kim; Korean J Prev Med. 1985;18(1):113-128.

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Abstract PDF: This paper was carried out for comparison of respiratory symptoms between urban and rural residents that is somewhat related to air pollution. And as urban residents, 470 persons of Daegu (Taegu) and 364 of Pohang were selected and 472 rural residents were also, in Eus ng-Gun, those who were responded to questionnaire distributed from April 10, 1984 to April 30 through students of middle or high school. The subjects were families of the student. The questionnaire was appropriately modified the item B of Cornell Medical Index by author. Looking into the rate of complaints about each part, generally, the rate in urban is higher than that in rural. Particularly it is higher to 'feeling a choking lump or swelling of throat', 'the sputum' and 'the asthma' in the city (p<0.05). On the contrary, women in the farm village, to 'caught a severe cold' as compared with the city. In men under nineteen years of age, it is higher than the farm village to 'feeling a choking lump or swelling of throat' of Pohang (p<0.05). But in men forties, it is higher than the city that farm people are 'soaking sweat at night' and 'foreign body sensation on throat'. Students hardly differ between the two ares, while the group having occupation in Pohang felt more in 'feeling a choking lump or swelling of throat' than the farm residents. As the result, I consider that the rural residents were much affected by physical fatigue and pesticides, and the urban, by some problems of industrial fuel, traffic gas and various dusts.; Summary

A Comparison of Gases and Heavy Metals in Blood between Urban and Rural Teenager.: Sang Sook Lee, Doo Hie Kim; Korean J Prev Med. 1985;18(1):129-136.

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Abstract PDF: This paper is carried out to determine the venous blood gas components and heavy metals, such as lead, cadmium and copper, in blood between urban and rural teenager. The subjects were 34 in urban, Taegu city and 37 in rural, Euisung-Gun. But smokers were excluded. The specimens were sampled in May, 1985. The heavy metals were analyzed by atomic absorption spectrophotometry (IL. 551) and carboxy-Hb, Met-Hb, Hb, O2 and CO2, blood gas analyzer (IL. 1301) and CO-oximeter (IL. 282). In urban group, PO2 and O2-Hb were significantly lower than in rural (p<0.01, p<0.03, respectively), and HCO3 and TCO2 were significantly higher than in rural (p<0.01, p<0.01, respectively). CO-Hb concentration was rather higher in the rural group than the urban (p<0.03), other Met-Hb was higher in urban group than in the rural (p<0.01). Lead and cadmium were also significantly higher in the urban group (p<0.03, p<0.02, respectively).; Summary

A Comparison Study of childhood Immunizational level between Urban and Rural Areas.: Jung Han Park, Jung Nam Kim, Kuck Hyeun Woo; Korean J Prev Med. 1985;18(1):137-147.

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Abstract PDF: To assess the childhood immunization level of uran and rural areas, 250 mothers of 6-23 months old children residing in Namsan 1 Dong, Taegu, and 264 mothers of the same age children residing in five areas of Kyungsan Gun where community health practitioners are assigned were interviewed in March, 1984. Immunization rate for BCG was 98.0% in urban area and 95.8% in rural area. Among children who had BCG vaccination 91.4% of them were immunized within 1 month after birth in urban area and 88.1% in rural area. The percentage of children who received three doses of DPT vaccine was 83.2% in urban, and 87.5% in rural area and that for the polio vaccine was 80.8% in urban and 87.9% in rural area. Only a few children have never been immunized with either BCG or DPT or polio vaccine. Overall immunization rate for measles was 64.4% in urban area while it was 55.3% in rural area and that for mumps and rubella was 50.4% in urban area as compared with 36.0% in rural area. However, among children of 15 months old and above the percentage of measles vaccination was 85.3% in urban area and 73.7% in rural area. Mumps and rubella vaccination rate was 77.6% in urban area and 62.4% in rural area. These differences in measles, mumps and rubella vaccination rates between urban and rural areas were statistically significant (p<0.05). Such findings as improved immunization level, no significant differences in BCG, DPT and polio vaccination rate between urban and rural areas, and fewer mothers in rural area have not vaccinated their children than mothers in urban area because of their ignorance may be attributed to the general improvement of living standard and implementation of the maternal and child health services of the government. Nevertheless many of the mothers in rural as well as urban area have not immunized their children on time and measles, mumps and rubella vaccination rates are substantially lower than other childhood immunizations. Future immunization activity should be geared to reinforcing these areas.; Summary

Factor Analysis on the Variables Related to Workers Occupationally Exposed to Mixtures of Organic Solvents.: Young Hee Cheon, Ho Gun Chung, Young Hahn Moon; Korean J Prev Med. 1985;18(1):149-156.

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Abstract PDF: By using Factor analysis on the variables relating to the subjective symptoms of total 56 workers, who have exposed to mixture of organic solvents at the musical instrument manufacturing plant, as experimental group, and 70 workers, who worked in noisy working environment as control group, the study was performed. It was confirmed that the variables found in hematological figures, age specification, occupational history and physical examination have a influential factor on the subjective symptoms of both groups. It was explicated that the ratio of these to total Eigen Values showed 31.1 percent in experimental group and the control group revealed 37.7 percent.; Summary

Effect of Menopause on the Mental Health of Climacteric Women.: Wan Kyoon Shin, Im Won Chang; Korean J Prev Med. 1985;18(1):157-171.

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Abstract PDF: An attemption was made to estimate the effect of menopause on the mental health of climacteric women. The Minnesota Multiphasic Personality Inventory(MMPI) were questioned to 278 premenopausal women and 302 postmenopausal women. Data were analyzed by one-way analysis of variance in each variable of menopause, age, educational level, religion and partnership of husband, and two-way analysis of variance in two variables of menopause and one of other variables. The results were summarized as follows. 1. Menopause increased the scores of validity, psychopathic deviate, hypomania and paranoia scale, but conversely decreased the score of masculinity-femininity scale. 2. The older the climacteric women were, the lower scores of masculinity-femininity scale were observed. 3. The older the premenopausal women were, the higher scores of depression, hysteria, psychopathic deviate, psychasthenia and schizophrenia scale were observed, on the contrary, all scores of the postmenopausal women were decreased by the increment of their ages. 4. The higher the educational level of climacteric women were, the higher scores of correction and masculinity-femininity scale were observed, but the scores of hypochondriasis, hysteria, schizophrenia and social introversion scale were decreased by the increment of their educational level. 5. The scores of hypomania scale were higher in women of Buddhism than other religions. 6. The scores of validity, paranoia, psychasthenia, schizophrenia and social introversion scale were higher in windows than women with husband.; Summary

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