Journal of Preventive Medicine and Public Health

Volume 38(2); May 2005

English Abstract

Changing Patterns of Communicable Diseases in Korea.: Hyun Sul Lim; J Prev Med Public Health. 2005;38(2):117-124.

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Abstract PDF: Before twentieth centuries and during early twentieth centuries, communicable diseases were the major cause of morbidity and mortality in Korea. But reliable data are not available. After 1975, the overall morbidity and mortality from communicable diseases, rapidly declined. Recently many new pathogenic microbes were recognized: L. monocytogenes, Hantaan virus, Y. pseudotuberculosis, P. multocida, L. pneumophilia, Human immunodeficiency virus (HIV), G. seoi, H. capsulatum, C. burnetii, V. cholerae O139, C. parvum, F. tularensis, E. coli 0157: H7, B. burgdorferi, S. Typhimurium DT104, Rotavirus, hepatitis C virus and so on. Since the first HIV infection recognized in 1985, the reported cases of infection and deaths from HIV/AIDS have been steady increased each year. Legionnaire's disease, E. coli O157: H7 colitis, listeriosis and crytosporidiasis have been occurring just sporadically among immunocompromized cases. Many re-emerging communicable diseases were occurred in Korea: leptospirosis, malaria, endemic typhus, cholera, tsutsugamushi disease, salmonellosis, hepatitis A, shigellosis, mumps, measles, acute hemorrhagic conjunctivitis, brucellosis and so on. Leptospirosis and tsutsugamushi diseases have been noticed as major public health problems since 1980s. The malaria that had been8 virtually disappeared for a decade has reappeared from 1993 with striking increase of patients in recent 3-4 years. The distributions of salmonella and shigella serotypes have been changed a lot in recent few decades. Furthermore rapid emergence of antibiotic-resistant bacterial strains induces more difficult and complex problems in control of communicable diseases. We must recognize on the importance of environment and ecosystem conservation and careful prescription of anti-microbial agent in order to prevent communicable diseases.; Summary

Comparative Study

Epidemiology and Control of Injury.: Soonduck Kim; J Prev Med Public Health. 2005;38(2):125-131.

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Abstract PDF: Injury has recently become a major world-wide health problem. Injury related deaths occur in many actively working young people and produce major social and economical losses. However health related specialists do not recognize the importance of injury and there have not been many studies related to this problem. This research studied the trends of injury related research in Korea, mortality rate and prevalence rate, socio-economical losses and control in Korea and out of the country, based on literature from Korea and without such as statistical yearly reports on causes of deaths and OECD health reports, as well as WHO web sites. Studies in Korea about injury were very few, with 9 in the 1960's, 5 in the 1980's, 4 in the 1990's and 5 in 2000's. Mortality rate of injury was higher in Korea than in England, USA or Japan, especially in car accidents, suicide and falls. In Korea, the yearly trends in mortality rates were highest in car accidents but those rates are falling, suicide is steadily rising, with highest rate in 2003. Falls is in second rank with no change in rates. In 2003, the ten causes of death in Korea were suicide in 5th rank, transport accidents in 7th rank, and falls in 10th rank. Considering age groups, in the teens, transport accidents were 1st rank, in the 20's and 30's, suicide was 1st rank, and although there were some differences, falls, drowning, assault, fire were in the top 10. Prevalence rates of injury could not be known, but in 2001, according to the National Health and Nutrition Survey, lifelong injury was 10%, and yearly major injury was 1.3%, major injury for two weeks was 0.1%, and minor injury was 10%. In other foreign countries, injury has become to be recognized as a major health related problem, and much programs are being set up to reduce injury related deaths and injuries. WHO is putting much effort in prevention of violence and transport accidents, and in the USA, Canada and Europe, there are injury surveillance systems. Recently, as suicide is increasing rapidly and providing much problems, each country are managing suicide prevention programs. In Korea, Ministry of Construction and Transportation is managing and guiding the policies for prevention of transport accidents. In September of 2004, the Ministry of Health and Welfare has set up a 5 year plan of suicide prevention.; Summary

English Abstracts

Impact of Risk Adjustment with Insurance Claims Data on Cesarean Delivery Rates of Healthcare Organizations in Korea.: Kwang Soo Lee, Sang Il Lee, Kyung Seo, Young Mi Do; J Prev Med Public Health. 2005;38(2):132-140.

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Abstract PDF: OBJECTIVES
To propose a risk-adjustment model from insurance claims data, and analyze the changes in cesarean section rates of healthcare organizations after adjusting for risk distribution. METHODS: The study sample included delivery claims data from January to September, 2003. A risk-adjustment model was built using the 1st quarter data, and the 2nd and 3rd quarter data were used for a validation test. Patients' risk factors were adjusted using a logistic regression analysis. The c-statistic and Hosmer-Lemeshow test were used to evaluate the performance of the risk-adjustment model. Crude, predicted and risk-adjusted rates were calculated, and compared to analyze the effects of the adjustment. RESULTS: Nine risk factors (malpresentation, eclampsia, malignancy, multiple pregnancies, problems in the placenta, previous Cesarean section, older mothers, bleeding and diabetes) were included in the final riskadjustment model, and were found to have statistically significant effects on the mode of delivery. The c-statistic (0.78) and Hosmer-Lemeshow test (chi2=0.60, p=0.439) indicated a good model performance. After applying the 2nd and 3rd quarter data to the model, there were no differences in the c-statistic and Hosmer-Lemeshow chi2. Also, risk factor adjustment led to changes in the ranking of hospital Cesarean section rates, especially in tertiary and general hospitals. CONCLUSION: This study showed a model performance, using medical record abstracted data, was comparable to the results of previous studies. Insurance claims data can be used for identifying areas where risk factors should be adjusted. The changes in the ranking of hospital Cesarean section rates implied that crude rates can mislead people and therefore, the risk should be adjusted before the rates are released to the public. The proposed risk-adjustment model can be applied for the fair comparisons of the rates between hospitals.; Summary

Field Study of Concentrations and Emissions of Particulate Contaminants by Types of Swine Houses in Korea.: Ki Yeon Kim, Kyung Jong Lee, Jae Beom Park, Chi Nyon Kim; J Prev Med Public Health. 2005;38(2):141-146.

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Abstract PDF: OBJECTIVES
Particulate contaminants, such as total and respirable dusts, can harm the health of farm workers via several routes. The principal aims of this field study were to determine the concentrations and emissions of particulate contaminants: total and respirable dusts, in the different types of swine houses used in Korea, and allow objective comparison between Korea and the other countries in terms of swine housing types. METHODS: The swine houses investigated in this research were selected with respect to three criteria: the manure removal system, ventilation mode and growth stage of pigs. Measurements of total and respirable dust concentrations and emissions in the swine houses were carried out on 5 housing types at 15 different farm sites per housing type. The swine houses investigated were randomly selected from farms situated within the central districts in Korea: province of Kyung-gi, Chung-buk and Chung-nam. RESULTS: The total and respirable dust concentrations in the swine houses averaged 1.88 and 0.64 mg/m3, ranging from 0.53 to 4.37 mg/m3 and from 0.18 to 1.68 mg/m3, respectively. The highest concentrations of total and respirable dusts were found in the swine houses with deep-litter bed systems: 2.94 mg/m3 and 1.14 mg/m3, while the lowest concentrations were found in the naturally ventilated buildings with slats: 0.83 mg/m3 and 0.24 mg/m3, respectively (p< 0.05). All the swine houses investigated did not exceed the threshold limit values (TLVs) for total (10 mg/m3) and respirable (2.5 mg/m3) dusts. The mean emissions of total and respirable dusts, per pig (75 kg in terms of live weight) and area (m2), from the swine houses were 97.33 and 9.55 mg/h/pig and 37.14 and 12.83 mg/h/m2, respectively. The swine houses with deep-litter bed systems showed the highest emissions of total and respirable dusts (p< 0.05). However, the emissions of total and respirable dusts from the other swine houses were not significantly different (p> 0.05). CONCLUSION: The concentrations and emissions of total and respirable dusts were relatively higher in the swine houses managed with deep-litter bed systems and ventilated naturally of the different swine housing types tested. In further research, more farms than the number used in this research should be investigated, which will present objective and accurate data on the concentrations and emissions of total and respirable dusts in Korean swine houses. In addition, personal sampling should be performed to objectively assess the exposure level of farm workers to particulate contaminants.; Summary

Census Population vs. Registration Population: Which Population Denominator Should be used to Calculate Geographical Mortality.: Young Ho Khang, In A Hwang, Sung Cheol Yun, Moo Song Lee, Sang Il Lee, Min Woo Jo, Min Jung Lee; J Prev Med Public Health. 2005;38(2):147-153.

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Abstract PDF: OBJECTIVES
Studies on the geographical differences in mortality tend to use a census population, rather than a registration population, as the denominator of mortality rates in South Korea. However, an administratively determined registration population would be the logical denominator, as the geographical areas for death certificates (numerator) have been determined by the administratively registered residence of the deceased, rather than the actual residence at the time of death. The purpose of this study was to examine the differences in the total number of a district population, and the associated district-specific mortality indicators, when two different measures as a population denominator (census and registration) were used. METHODS: Population denominators were obtained from census and registration population data, and the numbers of deaths (numerators) were calculated from raw death certificate data. Sex- and 5-year age-specific numbers for the populations and deaths were used to compute sex- and age-standardized mortality rates (by direct standardization methods) and standardized mortality ratios (by indirect standardization methods). Bland-Altman tests were used to compare district populations and district-specific mortality indicators according to the two different population denominators. RESULTS: In 1995, 9 of 232 (3.9%) districts were not included in the 95% confidence interval (CI) of the population differences. A total of 8 (3.4%) among 234 districts had large differences between their census and registration populations in 2000, which exceeded the 95% CI of the population differences. Most districts (13 of 17) exceeding the 95% CI were rural. The results of the sexand age-standardized mortality rates showed 15 (6.5%) and 16 (6.8%) districts in 1995 and 2000, respectively, were not included in the 95% CI of the differences in their rates. In addition, the differences in the standardized mortality ratios using the two different population denominators were significantly greater among 14 districts in 1995 and 11 districts in 2002 than the 95% CI. Geographical variations in the mortality indicators, using a registration population, were greater than when using a census population. CONCLUSION: The use of census population denominators may provide biased geographical mortality indicators. The geographical mortality rates when using registration population denominators are logical, but do not necessarily represent the exact mortality rate of a certain district. The removal of districts with large differences between their census and registration populations or associated mortality indicators should be considered to monitor geographical mortality rates in South Korea.; Summary

The Relations of Socioeconomic Status to Health Status, Health Behaviors in the Elderly.: Sok Goo Lee, So Youn Jeon; J Prev Med Public Health. 2005;38(2):154-162.

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Abstract PDF: OBJECTIVES
To analyze the relationships of socioeconomic status (SES) to health status and health behaviors in the elderly. METHODS: Data were obtained from self-administered questionnaire of 4, 587 persons, older than 65 years, living in a community. We measured the sociodemographic characteristics, socioeconomic status, health status (subjective health status, acute disease, admission experience, dental state, chronic disease etc.), activities of daily living (ADL), instrumental activities of daily living (IADL), and mini-mental state examination-Korean (MMSEK). Binary and multinominal logistic regression analyses were employed to analyze factors affecting on the socioeconomic status of the elderly. RESULTS: With regard to the SES and health status, those with a low SES had poorer subjective health states and lower satisfaction about their physical health. Also, acute disease experiences, admission rates and tooth deciduation rates were higher in those of low SES. In the view of physical and cognitive functions, the ADL, IADL and MMSE-K scores were also lower in those of low SES. However, with regard to health behaviors, lower smoking and alcohol drinking rates were found in the low SES group, and a similar trend was shown with regular physical exercise, eating breakfast, and regular physical health check-up. From these findings, we surmise that those with low SES have a poorer health condition and less money to spend on health, therefore, they can not smoke or drink alcohol, exercise and or have a physical health check-up. CONCLUSION: This study suggests that socioeconomic status plays an important role in health behaviors and status of the elderly. Low socioeconomic status bring about unhealthy behavior and poor health status in the elderly. Therefore, more specific target oriented (esp. low SES persons) health promotion activities for the elderly are very important to improve not only their health status, but their health inequity also.; Summary

An Epidemiological Study for Child Pedestrian Traffic Injuries that Occurred in School-zone.: Sun Seog Kweon, Min Ho Shin; J Prev Med Public Health. 2005;38(2):163-169.

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Abstract PDF: OBJECTIVES
Pedestrian traffic injuries have been an important cause of childhood mortality and morbidity for decades. The aim of this study was to describe the epidemiological characteristics of child pedestrian traffic injuries that occurred during 2000 in one metropolitan city and its school-zones, and to determine the factors associated with those accidents. METHODS: A cross-sectional study was performed in 2001. Police records were used to identify the cases of pedestrian injury. Children aged between 6 and 15 years, injured during road walking, were included in this study. direct survey of the environmental factors within the schoolzones in study area (n=116) was also performed. Selfadministered questionnaires, via mail and telephone surveys, were used to assess the safety education programmes. The schools were divided into two groups according to the occurrence of pedestrian traffic injuries in their school-zone. RESULTS: Pedestrian injuries (n=597) were found to account for 3.2% of all traffic injuries in the subject area. The epidemiological characteristics were not significantly different between genders. There were some significant risk factors within the environmental factors, such as local road (OR: 2.3, 95% CI=1.05-5.35), heavy traffic volume (OR: 2.2, 95% CI=1.00-5.04), poor visibility of speed-limit signs (OR: 2.8, 95% CI=1.25-6.42), no separation of pedestrian routes from cars (OR: 2.6, 95% CI=1.02-6.75) and barriers on the pedestrian routes (OR: 2.2, 95% CI=1.01-5.08). Only one factor, that of education in a safety-park (OR: 0.3, 95% CI=0.09-0.96), was significantly associated in the traffic and pedestrian safety education factors. CONCLUSION: Significant associations with pedestrian injury risk were identified in some of the modifiable environmental factors than in the educational factors.; Summary

A Study of Immune Response to Hepatitis B Vaccine & HBV DNA in Isolated Anti-HBc Positive Subjects.: Hee Jeong Koh, Soon Duck Kim, Ji Ho Choi, Sung Ryul Kim, Jin Soo Lee; J Prev Med Public Health. 2005;38(2):170-174.

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Abstract PDF: OBJECTIVES
The aim of this study was to evaluate the response to a hepatitis B vaccination, and investigate the HBV DNA in subjects with isolated anti-HBc. METHODS: 34 subjects with persistent isolated anti-HBc were included in the study. 32 subjects negative for HBsAg, anti-HBs and anti-HBc were included as a control group. They were all vaccinated with Hepaccine at 0, 1 and 2 months, and anti-HBs titers were measured 1 month after the 1st and 3rd vaccinations (1 and 3 months). The HBV-DNA was tested by polymerase chain reaction in subjects with isolated anti-HBc. RESULTS: After the 1st & 3rd vaccinations, the anti-HBs titers > or =10mIU/ml were 70.6 & 70.6% in isolated anti-HBc group, and 34.4 & 81.2% in the control group, respectively. There were statistically significant differences after the 1st vaccination, but none after the 3rd, between the two groups. In the isolated anti-HBc and control groups, the primary, amnestic and no responses were 0 vs. 46.9%, 55.9 vs. 6.3% and 29.4 vs. 18.8%, respectively. The HBV DNA was not detected in all subjects with isolated anti-HBc. CONCLUSION: None of the subjects with isolated anti-HBc had a false positive result (primary response) ; therefore, they should be excluded from vaccination programs in Korea. To differentiate between immunity and occult infections, a single dose of vaccine, with a follow-up anti- HBs test, is preferable for subjects with isolated anti-HBc. An amnestic response indicates late immunity, and no response a suspect occult infection.; Summary

Estimating the Burden of Diseases due to High Alcohol Consumption in Korea.: Jung Kyu Lee, Yong Ik Kim, Seok Jun Yoon, Jin Yong Lee, Heeyoung Lee, Jong Hyock Park, Youngsoo Shin; J Prev Med Public Health. 2005;38(2):175-181.

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Abstract PDF: OBJECTIVES
This study estimated the burden of disease due to high alcohol consumption using DALY, a composite indicator recently developed by the Global Burden of Disease study group. The results were analyzed by age and sex. METHODS: Firstly, high alcohol consumption-related diseases, and their relative risk (RR), were selected. Secondly, population attributable fractions (PAFs) were computed using formulae, including the relative risk (RR) and prevalence of exposure (Pe). Thirdly, the DALYs of high alcohol consumption-related diseases were estimated. Lastly, the attributable burdens of diseases due to high alcohol consumption wereconcluded as being the sum of the products that multiplied the DALYs of high alcohol consumption-related diseases by their population attributable fraction (PAF). RESULTS: The burden of high alcohol consumption in Korea was 2992.3 person years (PYs) per 100, 000 persons in men, and 1426.6 in women. For men, the high alcohol consumption-induced diseases with the five biggest burdens were liver cirrhosis, hypertensive disease, liver cancer, cerebral infarction and intracerebral hemorrhage. For women, these were cerebral infarction, intracerebral hemorrhage, hypertensive disease, liver cirrhosis and liver cancer. CONCLUSION: This study highlighted the attributable fraction of diseases due to exposure to high alcohol consumption, by quantifying the results of exposure to risk factors. Therefore, it is now possible to assess interventions for risk factors in quantifiable terms in each population. Finally, measuring the risk factor burdens was expected to contribute to priority setting and effective resource allocation in public health policy.; Summary

Research Support, Non-U.S. Gov't

Epidemiologic Investigation on Sporadic Occurrence of Shigellosis in a Subcounty of Cheongwon County in Chungbuk Province in 2003.: Yong Jae Lee, Ue Kyoung Hwang, Jong Suk Kim, Jun Young Kim, Ja Seol Koo, Bok Kwon Lee, Jong Won Kang; J Prev Med Public Health. 2005;38(2):182-188.

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Abstract PDF: OBJECTIVES
This study was undertaken to investigate the source of infection and mode of transmission of shigellosis, which occurred sporadically among residents and students in a subcounty of Cheongwon county, Chungbuk province, Korea, from June 4 to July 3 2003. METHODS: 692 subjects completed a questionnaire and provided a swab for microbiological examinations, and 7 environmental specimens were examined for bacterial organisms. PFGE (pulsed-field gel electrophoresis) and fingerprinting were performed to find the genetic relationship among the temporally associated sporadic isolates. RESULTS: A total of 29 patients had symptoms consistent with the case definition, with 13 confirmed and 16 suspected cases. The frequency of diarrhea was 6 times or more a day (80.8%), with a duration of 1 to 4 days (88.5%) in most cases. The most common symptoms accompanying the diarrhea were fever (80.9%) followed by abdominal pain (76.9%), headache (65.4%), chill (61.5%), vomiting (46.2%) and tenesmus (15.4%). The epidemic curve was characteristic of a person-to-person transmission. The PFGE and fingerprinting demonstrated identical or similar DNA patterns among the 3 Shigella sonnei isolates (A51, A53 and A61 types) found in this outbreak. CONCLUSION: A genetically identical strain of S. sonnei was estimated to be the cause of this outbreak, and the mode of transmission was most likely person-to-person.; Summary

English Abstracts

Epidemiologic Investigation on an Outbreak of Shigellosis in Seongju-gun, Korea, 2003.: Young Sun Min, Hyun Sul Lim, Kwan Lee, Sang Hyuk Lim, Bog Soon Lee; J Prev Med Public Health. 2005;38(2):189-196.

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Abstract PDF: OBJECTIVES
An outbreak of shigellosis occurred among students and staff of S primary and middle school, Seongju-gun, in 2003. This investigation was carried out to institute an effective counterplan, and study the infection source and transmission of the shigellosis. METHODS: The authors conducted a questionnaire survey among 235 students and staff from S preschool, primary and middle school relating to the ingestion of school lunch and the manifestation of symptoms. Also, the author investigated the drinking water, feeding facility and reconstructed cooking process of the food presumed to be the cause of the shigellosis. The diarrhea cases were defined as confirmed cases and those cases who had had diarrhea more than one time, accompanied with symptoms such as fever, vomiting and tenesmus. RESULTS: From rectal swabs 20 people, between June 28 and July 4, 2003, were confirmed with shigellosis. The diarrhea attack rate was 40.0%. Those who had ingested tomatoes and cubed radish kimchi had significantly higher diarrhea attack rates (p< 0.05), with the relative risk of tomatoes being 2.69 (95% CI: 0.98-7.42). The major cause of shigellosis was presumed to be from contaminated tomatoes due to cooking with rubber gloves containing holes. CONCLUSION: The cooks in charge of school lunches must make doubly sure to not only attend to their sanitation, but also to manage the table wear and items used in providing school lunches. The health care authority should introduce higher-leveled criteria for health care among cooks, so that they cannot cook when the have a case of any infectious disease.; Summary

Effects of the Severe Asian Dust Events on Daily Mortality during the Spring of 2002, in Seoul, Korea.: Seung Sik Hwang, Soo Hun Cho, Ho Jang Kwon; J Prev Med Public Health. 2005;38(2):197-202.

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Abstract PDF: OBJECTIVES
During the spring of 2002, an unprecedented 2 Asian dust events were experienced in Seoul. On those days, the PM10 was surprisingly increased, with daily PM10 averages exceeding 600 and 700 microgram/m3 on March 21 and April 8, respectively. Accordingly, public concern relating to the possible adverse health effects of these dust events has increased, as the dust arrives in Korea after having flown over heavily industrialized eastern China. We investigated the effects of these Asian dust events on the mortality during the spring of 2002, in Seoul, Korea. METHODS: The total number of deaths per day during the spring of 2002 in Seoul was extracted form the mortality records of the National Statistical Office. We constructed 14 Asian dust days (March 17-March 23, April 7-April 13) and 42 control days during the 56 day study period (March 3-April 27) with respect to the days of the week. The daily average numbers of deaths between the Asian dust and control days were analyzed, with adjustment for meteorological variables and pollutants. RESULTS: The daily PM10 average during the Asian dust weeks was 295.2 microgram/m3, which was significantly higher than during the control days (P< 0.001). The daily average number of deaths from all causes during the Asian dust days was 109.9; 65.6 for those aged 65 years and older, 6.7 from respiratory causes (J00-J99) and 25.6 from cardiovascular causes (I00-I99). The estimated percentage increases in the rate of deaths were 2.5% (95% CI=-5.0- 10.6) from all causes; 2.2% (95% CI=-7.4-12.8) for those aged 65 years and older, and 36.5% (95% CI=0.7-85.0) from respiratory causes, but with a 6.1% (95% CI=-19.7- 9.7) decrease in deaths from cardiovascular causes. CONCLUSION: The Asian dust events were found to be weakly associated with the risk of death from all causes. However, the association between dust events and deaths from respiratory causes was stronger. This suggests that persons with advanced respiratory diseases may be susceptible to Asian dust events.; Summary

What will be the Proper Criteria for Impaired Fasting Glucose for Korean Men?: Based on Medical Screening Data from a General Hospital.: Seungho Ryu, Yoo Soo Chang, Dong Il Kim, Byung Seong Suh, Woon Sool Kim; J Prev Med Public Health. 2005;38(2):203-207.

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Abstract PDF: OBJECTIVES
Recently, the American Diabetes Association (ADA) redefined the criteria of prediabetes, which has lowered the diagnostic level of fasting plasma glucose (FPG) from 110 to 125 mg/dl, down to levels between 100 to 125mg/dl. The purpose of this study was to determine the predictive cutoff level of FPG as a risk for the development of diabetes mellitus in Korean men. METHODS: A retrospective cohort study was conducted on 11, 423 (64.5%) out of 17, 696 males < or =30 years of age, and who met the FPG of < or =125 mg/dl and hemoglobin A1c of < or = 6.4% criteria, without a history of diabetes, and who were enrolled at the screening center of a certain university hospital between January and December 1999. The subjects were followed from January 1999 to December 2002 (mean follow-up duration; 2.3 (+/-0.7) years). They were classified as normal (FPG < 100mg/dl), high glucose (FPG > or =100mg/dl and < 110mg/dl) and impaired fasting glucose (FPG > or =110mg/dl and < or =125mg/dl) on the basis of their fasting plasma glucose level measured in 1999. We compared the incidence of diabetes between the 3 groups by performing Cox proportional hazards model and used receiver operating characteristic analyses of the FPG level, in order to estimate the optimal cut-off values as predictors of incident diabetes. RESULTS: At the baseline, most of the study subjects were in age in their 30s to 40s (mean age, 41.8 (+/-7.1) year). The incidence of diabetes mellitus in this study was 1.19 per 1, 000 person-years (95% CI=0.68-1.79), which was much lower than the results of a community-based study that was 5.01 per 1, 000 person-years. The relative risks of incident diabetes in the high glucose and impaired fasting glucose groups, compared with the normal glucose group, were 10.3 (95% CI=2.58-41.2) and 95.2 (95% CI= 29.3-309.1), respectively. After adjustment for age, body mass index, and log triglyceride, a FPG greater than 100mg/dl remained significant predictors of incident diabetes. Using the receiver operating characteristic (ROC) curve, the optimal cutoff level of FPG as a predictor of incident diabetes was 97.5 mg/dl, with a sensitivity and a specificity of 81.0% and 86.0%, respectively. CONCLUSION: These results suggest that lowering the criteria of impaired fasting glucose is needed in Korean male adults. Future studies on community-based populations, including women, will be required to determine the optimal cutoff level of FPG as a predictor of incident diabetes.; Summary

Factors Affecting Re-smoking in Male Workers.: Jin Hoon Yang, Hee Sook Ha, Sin Kam, Ji Seun Lim, Yune Sik Kang, Duk Hee Lee, Byung Yeol Chun; J Prev Med Public Health. 2005;38(2):208-214.

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Abstract PDF: OBJECTIVES
This study was performed to examine the factors affecting re-smoking in male workers. METHODS: A self-administrated questionnaire survey was conducted during April 2003 to examine the smoking state of 1, 154 employees of a company that launched a smoking cessation campaign in1998. Five hundred and eighty seven persons, who had stopped smoking for at least one week, were selected as the final study subjects. This study collected data on smoking cessation success or failure for 6 months, and looked at the factors having an effect on resmoking within this period. This study employed the Health Belief Model as its theoretical basis. RESULTS: The re-smoking rate of the 587 study subjects who had stopped smoking for at least one week was 44.8% within the 6 month period. In a simple analysis, the resmoking rates were higher in workers with a low age, on day and night shifts, blue collar, of a low rank, where this was their second attempt at smoking cessation and for those with a shorter job duration (p< 0.05). Of the cues to action variables in the Heath Belief Model, re-smoking was significantly related with the perceived susceptibility factor, economic advantages of smoking cessation among the perceived benefits factor, the degree of cessation trial's barrier of the perceived barriers factor, smoking symptom experience, recognition of the degree of harmfulness of environmental tobacco smoke and the existence of chronic disease due to smoking (p< 0.05). In the multiple logistic regression analysis for re-smoking, the significant variables were age, perceived susceptibility for disease, economic advantages due to smoking cessation, the perceived barrier for smoking cessation, recognition on the degree of harmfulness of environmental tobacco smoke, the existence of chronic disease due to smoking and the number of attempts at smoking cessation (p< 0.05). CONCLUSION: From the result of this study, for an effective smoking ban policy within the work place, health education that improves the knowledge of the adverse health effects of smoking and the harmfulness of environmental tobacco smoke will be required, as well as counter plans to reduce the barriers for smoking cessation.; Summary

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