Journal of Preventive Medicine and Public Health

Volume 25(3); September 1992

Original Articles

Health-Related Behaviors and Subjective Symptoms Associated with Smoking of Freshmen in a University.: Jong Park, Byong Woo Kim, Yang Ok Kim, Ki Soon Kim; Korean J Prev Med. 1992;25(3):223-237.

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Abstract PDF: This study was to examine the association of the health-related behaviors and subjective symptoms with smoking. Data were collected by questionnaire survey during regular health examination from Mar. 23 to Mar. 31, 1992 for 1,615 male freshmen of a university in Kwangju City. The results obtained were as follows; 1. Among the freshmen, 26.9% reported that they were smokers. 69.4% for smokers started smoking for the recent 4 years, and 63.4% for smokers smoked 10 cigarettes or more a day. 2. Meal regularity, meat eating, use of coffee or tea and alcohol drinking were positively associated with the status, the duration and the amount of smoking while the vegetable preference was negatively associated with the status and the duration of smoking. 3. There was no evidence of familial aggregation in smoking status except that of siblings. 4. Respiratory symptoms like cough or phlegm, dyspnea were positively associated with the status, the duration, and the amount of smoking. General symptoms like chest pain, fatigue, back pain, facial edema, and weight loss were positively associated with the duration and the amount of smoking. Other symptoms like headache, dizziness, and myalgia were not associated with smoking. 5. In multivariate' logistic regression analysis, cough or phlegm, dyspnea, chest pain, facial edema, and back pain were related to smoking status.; Summary

Case-Control Study on Effects of Alcohol Intake and Smoking to Gastritis of Korean Adult Men.: Yun Chul Hong, Chung Yill Park, Won Chul Lee, Kang Sook Lee; Korean J Prev Med. 1992;25(3):238-246.

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Abstract PDF: We performed case-control studies for the 1, 138 Korean adult men. According to the results of UGIS, we classified the gastritis into the erosive gastritis, superficial gastritis, and hypertrophic gastritis. And then, we selected controls among non-gastritis group after matching. Alcohol intake and smoking history was obtained by questionnaire. And we observed the effects of alcohol intake and smoking to the each gastritis. The results obtained were as follows; 1. Smokers had a risk of getting erosive gastritis more than twice (2.6) than non-smokers and there was dose-response relationships between smoking and erosive gastritis. Alcohol intake, however, had no significant relation with the erosive gastritis. 2. Both smoking and alcohol intake had no significant relations with superficial gastritis. 3. Smoking had no significant relation with hypertrophic gastritis, but dividing between those who drank more than 100gm of alcohol a week and those who drank less, we obtained the odds ratio of 3. 4 suggesting that there existed a significant relation between moderate or excessive alcohol intake and hypertrophic gastritis. 4. Among the gastritis patients, those who had erosive gastritis smoked most heavily, and those who had hypertrophic gastritis drank most excessively.; Summary

The Effect of VDT Work on Vision and Eye Symptoms among Workers in a TV Manufacturing Plant.: Kuck Hyeun Woo, Jung Han Park, Gwang Seo Choi, Young Yeon Jung, Jong Hyeob Lee, Gu Wung Han; Korean J Prev Med. 1992;25(3):247-268.

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Abstract PDF: This study was conducted to evaluate the effect of VDT work on eyes and vision among workers in a TV manufacturing plant. The study subjects consisted of 264 screen workers and 74 non-screen workers who were less than 40 years old male and had no history of opthalmic diseases such as corneal opacities, trauma, keratitis, etc and whose visual acuity on pre-employment health examination by Han's test chart was 1.0 or above. The screen workers were divided into two groups by actual time for screen work in a day; Group 1, 60 workers, lesser than 4 hours a day and group 11, 204 workers, more than 4 hours a day. From July to October 1992 a questionnaire was administered to all the study subjects for the general charateristics and subjective eye symptoms after which the opthalmologic tests such as visual acuity, spherical equivalent, lacrimal function, ocular pressure, slit lamp test, fundoscopy were conducted by one opthalmologist. The proportion of workers whose present visual acuity was decreased more than 0. 15 in comparison with that on the pre-employment health examination by Han's test chart was 20.6% in Group Ii, 15.0% in Group I and 14.9% in non-screen workers. However, the differences in proportion were not statistically significant. The proportion of workers with decreased visual acuity was not associated with the age, working duration, use of magnifying glass and type of shift work (independent variables) in all of the three groups. However, screen workers working under poor illumination had a higher proportion of persons with decreased visual acuity than those working under adequate illumination (P<0.05). The proportion of workers whose near vision was decreased was 27.5% in Group II, 18.3% in Group I, and 28.4% in non-screen workers and these differences in proportion were not statistically significant. Changes of near vision were not associated with 4 independent variables in all of the three groups. Six out of sever-subjective eye symptoms except tearing were more common in Group I than in non-screen workers and more common in Group II than in Group I (P<0.01). Mean of the total scores for seven subjective symptoms of each worker (2 points for always, 1 point for sometimes, 0 point for never) was not significantly different between workers with decreased visual acuity and workers with no vision change. However, mean of the total scores for Group II was higher than those for the Group I and non-screen workers (P < 0. 01). Total eye symptom scores were significantly correlated with the grade of screen work, use of magnifying glass, and type of shift work. There was no independent variable which was correlated with the difference in visual acuity between the pre-employment health examination and the present state, the difference between far and near visions, lacrimal function, ocular pressure, and spherical equivalent. Multiple linear regression analysis for the subjective eye symptom scores revealed a positive linear relationship with actual time for screen work and shift work(P<0.01). In this study it was not observed that the VDT work decreased visual acuity but it induces subjective eye symptoms such as eye fatigue, blurred vision, ocular discomfort, etc. Maintenance of adequate illumination in the, work place and control of excessive VDT work are recommended to prevent such eye symptoms.; Summary

The recognition and the attitude about the hazard materials and occupational disease in the asbestos related industry.: Gwan Hyeong Yi, Kyung Yong Rhee; Korean J Prev Med. 1992;25(3):269-286.

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Abstract PDF: The purpose of this study is to investigate the present state of worker's recognition and attitude about hazard materials and occupational disease in his workplace. In general worker's view of hazard materials and occupational disease that sis recognition and attitude is related to worker's health behavior for preventing occupational disease and improving his health status. The study subject is composed of workers in the asbestos related industry for example brake lining manufacturing industry, asbestos fiber manufacturing industry, and asbestos slate manufacturing industry. The result of the study are follows; 1. The most of workers in the asbestos related industry have taken health education and safety education, and the more than half of workers recognized the usefulness of preventive device, and ventilatory device in workplace. 2. About 70% of workers have always taken the preventive device. 3. About 80% of workers have recognized occupational disease in the asbestos related industry, and about 64% of workers have recognized that his workplace have harmful effect on his health. 4. Recognition about the usefulness of ventilatory device in work place has not related with any variables. But recognition about the usefulness of repiratory protector has related with recognition of hazard materials in his workplace, for example asbestos. 5. Attitude about severity and susceptability of occupational disease in the asbestos related industry have related with knowledge about hazard materials and occupational disease.; 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

The Projection of Medical Care Expenditure in View of Population Age Change.: Seung Hum Yu, Sang Hyuk Jung, Jeung Mo Nam, Hyohn Joo Oh; Korean J Prev Med. 1992;25(3):303-311.

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Abstract PDF: It is very important to estimate the future medical care expenditure, because medical care expenditure escalation is a big problem not only in the health industry but also in the Korean economy today. This study was designed to project the medical care expenditure in view of population age change. The data of this study were the population projection data based on National Census Data (1990) of the National Statistical Office and the Statistical Reports of the Korea Medical Insurance Corporation. The future medical care expenditure was eatimated by the regression model and the optional simulation model. The significant results are as follows; 1. The future medical care expenditure will be 3,963 billion Won in the year 2000, 4,483 billion Won in 2010, and 4,826 billion Won in 2020, based on the 1990 market price considering only the population age change. 2. The proportion of the total medical care expenditure in the elderly over 65 will be 10. 4% in 2000, 13.5% in 2010, and 16.9% in 2020. 3. The future medical care expenditure will be 4,306 billion Won in the year 2000, 5,1101 billion Won in 2010, and 5, 699 billion Won in 2020 based on the 1990 market price considering the age structure change and the change of the case-cost estimated by the regression model. 4. When we consider the age-structure change and inflation compared with the preceding year, the future medical care expenditurein 2020 will be 21 trillion Won based on a 5% inflation rate, 42 trillion Won based on a 7.5% inflation rate, and 84 trillion Won based on a 10% inflation rate. Consideration of the aged (65 years old and over)will be essential to understand the acute increase of medical care expenditure due to changes in age structure of the population. Therefore, alternative policies and programs for the caring of the aged should be further studied.; Summary

Regional Variations in the Cesarean Section Rate and It's Determinants in Korea.: Hye Kyung Kim, Jeon Un Lee, Kang Won Park, Ok Ryun Moon; Korean J Prev Med. 1992;25(3):312-329.

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Abstract PDF: The purpose of this study is to estimate cesarean section rate in Korea and analyze the socioeconomic variables and health resources which affect regional variation in the rate. Samples were drawn from the record of vaginal and cesarean section deliveries based upon insurance claim bills which have been submitted to the National Federation of Medical Insurance for the first three months, January through March, 1991. The results are obtained as follows: It was found that, cesarean section rate was increasing rapidly up to 23.1% in 1991. Cesarean section per 10 thousand insured people was 4.8 and the number of cesarean section per 10 thousand insured eligible(15-49 years old) female was 7.6. The fee for normal delivery was 109,489 won and that for cesarean section was 390,024 won. The average days of hospitalization in normal delivery was 2.3 days, and those in cesarean section was 7.6 days. On the average cesarean section has a longer of stay as much as by 4.3 days and cost 3.6 times more than normal deliveries. Cesarean section rates vary among medical facilities: 19.8% at clinics 37.6% in small-scale hospitals, and 29.1% in general hospitals. The regional variation of cesarean section rates was also fairly prominent. The South Cheju Gun has the highest rate of cesarean section, 56.2%. Meanwhile no cesarean section cases has been reported in Sunchang Gun during the period of this study. The variation is noted among provinces. The rate for Cheju province has been 3.4 times higher than that for Chunnam. The number of cesarean section per 10 thousand insured people vary greatly among regions, too. This study has found that there exists significant regional variations among various geographic units in terms of average length of stay, average cost, number of obsretricians and number of beds. Multiple regression analysis was done to identify factors explaining the regional variance of various cesarean section rates: In the urban areas, no significant explaining variables were noted except the number of beds for the dependent variable of cesarean section cases per 10 thousand insured eligible females. The smaller the number of bed, the more cases of cesarean section was noted for an urban area. The is mostly because the rate of cesarean section is higher in medium-size hospitals than in large general hospitals. In the rural areas, the factor of education has been found significant for all three dependent variables. The higher the educational level, the rate of cesarean section is most likely to rise. An income variable measured by the amount of monthly insurance contribution has been identified a powerful predictor in explaining the variance of cesarean section rates. The same has been noted for the number of obstetricians. Similar findings are observed for the country as a whole. The income level has been found as the most powerful explaining factor in the regional variance of cesarean section rates. In general the rate is higher in the urban areas, and lower in the area with more small hospitals. As this is the initial attempt to identify the factors relevant to the regional difference in the rates of cesarean section, more elaborated study is urgently required.; Summary

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