Journal of Preventive Medicine and Public Health

Original Articles

Seroreactivity to Q Fever Among Slaughterhouse Workers in South Korea: Hyuk Chu, Seok-Ju Yoo, Kyu-Jam Hwang, Hyun-Sul Lim, Kwan Lee, Mi-Yeoun Park; J Prev Med Public Health. 2017;50(3):195-200. Published online May 11, 2017; DOI: https://doi.org/10.3961/jpmph.17.017

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Objectives
Q fever is a zoonotic disease that occurs worldwide; however, little is known about its prevalence in South Korea. We attempted to determine the prevalence of Q fever seroreactivity among Korean slaughterhouse workers and the risk factors for seroreactivity according to the type of work.
Methods
The study was conducted among 1503 workers at a total of 73 slaughterhouses and 62 residual-product disposal plants. During the study period, sites were visited and surveys were administered to employees involved in slaughterhouse work, and serological tests were performed on blood samples by indirect immunofluorescence assays. Serological samples were grouped by job classification into those of slaughter workers, residual-product handlers, inspectors and inspection assistants, and grading testers and testing assistants. Employee risk factors were analyzed according to the type of work.
Results
Out of 1481 study subjects who provided a blood sample, 151 (10.2%) showed reactive antibodies. When these results were analyzed in accordance with the type of work, the result of slaughter workers (11.3%) was similar to the result of residual-product handlers (11.4%), and the result of inspectors and assistants (5.3%) was similar to the result of grading testers and assistants (5.4%). Among those who answered in the affirmative to the survey question, “Has there been frequent contact between cattle blood and your mouth while working?” the proportions were 13.4 and 4.6%, respectively, and this was identified as a risk factor that significantly varied between job categories among slaughterhouse workers.
Conclusions
This study found a Q fever seroreactivity rate of 10.2% for slaughterhouse workers, who are known to be a high-risk population. Contact with cattle blood around the mouth while working was the differential risk factor between job categories among slaughterhouse workers.

Summary

Citations

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Q Fever in Greece and Factors of Exposure: A Multiregional Seroprevalence Study
Magdalini K Christodoulou, Konstantinos Tsaras, Charalambos Billinis, Konstantinos I Gourgoulianis, Dimitrios Papagiannis
Cureus.2024;[Epub] CrossRef
Prevalence and risk factors associated with Q fever infection in slaughterhouse workers in Fars province, Iran
Alireza Zakeri, Maryam Montaseri, Seyed Shahram Shekarforoush
International Archives of Occupational and Environmental Health.2023; 96(4): 597. CrossRef
First report of an outbreak of “Q” fever IN an abattoir from Argentina
Natalia Marina Cardillo, Reginaldo Bastos, Araceli García, Rosendo Pérez, Ezequiel García, Susana Lloveras, Carlos Suarez
Zoonoses and Public Health.2023; 70(8): 674. CrossRef
Seroepidemiologic evidence of Q fever and associated factors among workers in veterinary service laboratory in South Korea
Dilaram Acharya, Ji-Hyuk Park, Jeong-Hoon Chun, Mi Yeon Kim, Seok-Ju Yoo, Antoine Lewin, Kwan Lee, José Reck
PLOS Neglected Tropical Diseases.2022; 16(2): e0010054. CrossRef
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Seroprevalence of Coxiella burnetii in a dairy cattle herd from the Al Ain region, United Arab Emirates
Robert Barigye, Nabeeha Abdelgaleel D. Hassan, Ibrahim M. Abdalla Alfaki, Mike B. Barongo, Mohamed Elfatih H. Mohamed, Khaja Mohteshamuddin
Tropical Animal Health and Production.2021;[Epub] CrossRef
Seroreactivity to Coxiella burnetii in an Agricultural Population and Prevalence of Coxiella burnetii Infection in Ticks of a Non-Endemic Region for Q Fever in South Korea
Jeong-Rae Yoo, Mi-Sun Kim, Sang-Taek Heo, Hyun-Joo Oh, Jung-Hwan Oh, Seo-Young Ko, Jeong-Ho Kang, Sung-Kgun Lee, Woo-Seong Jeong, Gil-Myeong Seong, Hyun-Jung Lee, Chul-Hoo Kang, Ji-Hyun Moon, Keun-Hwa Lee, Sung-Wook Song
Pathogens.2021; 10(10): 1337. CrossRef
Isolation of Coxiella burnetii in patients with nonspecific febrile illness in South Korea
Seung Hun Lee, Jae Hoon Lee, Sungdo Park, Hae Kyung Lee, Seon Do Hwang, Hye Won Jeong, Jung Yeon Heo, Yeong Seon Lee
BMC Infectious Diseases.2020;[Epub] CrossRef
Coxiella burnetiiinfection in humans: to what extent do cattle in infected areas free from small ruminants play a role?
M. Pouquet, N. Bareille, R. Guatteo, L. Moret, F. Beaudeau
Epidemiology and Infection.2020;[Epub] CrossRef
Hepatitis in slaughterhouse workers
Hassan Tariq, Muhammad Umar Kamal, Jasbir Makker, Sara Azam, Usman Ali Pirzada, Vaniza Mehak, Kishore Kumar, Harish Patel
World Journal of Hepatology.2019; 11(1): 37. CrossRef
Clinical characteristics of acute Q fever patients in South Korea and time from symptom onset to serologic diagnosis
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Serologic Survey and Risk Factors forCoxiella burnetiiInfection among Dairy Cattle Farmers in Korea
Ji-Hyuk Park, Hyuk Chu, Seok-Ju Yoo, Kyu-Jam Hwang, Hyun-Sul Lim
Journal of Korean Medical Science.2018;[Epub] CrossRef
Seroreactivity and Risk Factors Associated with Coxiella burnetii Infection among Cattle Slaughterhouse Workers in South Korea
Ji-Hyuk Park, Seon Do Hwang, Dilaram Acharya, Seung Hun Lee, Kyu Jam Hwang, Seok-Ju Yoo, Kwan Lee
International Journal of Environmental Research and Public Health.2018; 15(10): 2264. CrossRef

A Survey on the Status of Hepatitis E Virus Infection Among Slaughterhouse Workers in South Korea: Byung-Seok Kim, Hyun-Sul Lim, Kwan Lee, Young-Sun Min, Young-Sil Yoon, Hye-Sook Jeong; J Prev Med Public Health. 2015;48(1):53-61. Published online January 15, 2015; DOI: https://doi.org/10.3961/jpmph.14.048

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Abstract PDF

Objectives
The seroprevalence of hepatitis E virus (HEV) among high-risk groups overseas is high, but studies in these groups are rare in South Korea. We conducted the present study from April to November 2012 to obtain data on the seroprevalence and associated risk factors for HEV among slaughterhouse workers in South Korea.
Methods
Slaughterhouse workers from 80 workplaces nationwide were surveyed in South Korea in 2012. The subjects comprised 1848 cases: 1434 slaughter workers and 414 residual products handlers. By visiting 80 slaughterhouses, which were mixed with 75 of which also performed residual products handling, we conducted a questionnaire survey for risk factors and obtained blood samples in order to determine the seropositivity and seroprevalence of HEV. Anti-HEV IgG and IgM were measured using HEV IgG and IgM enzyme-linked immunospecific assay kits and HEV antigen was measured by reverse transcription polymerase chain reaction (RT-PCR).
Results
The seropositivity of anti-HEV IgG was 33.5% (slaughter workers 32.8% and residual products handlers 36.2%), and among the seropositive individuals the seroprevalence of anti-HEV IgM was 0.5% (slaughter workers 0.5%, residual products handlers 0.7%). The response rate of HEV-antigen as measured by RT-PCR was 0.2%. Risk factors significantly related to anti-HEV IgG seropositivity were age, sex , and working duration (slaughter workers only).
Conclusions
There were significant risk factors (sex, age, and working duration) for HEV identified in our study. All three positive cases for HEV-antigen by RT-PCR were related to pig slaughter but without statistical significance. To prevent HEV, an educational program and working guidelines may be needed for high risk groups.

Summary

Citations

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Thamir A. Alandijany, Shahd M. Balakhtab, Sherif A. El-Kafrawy, Ahmad M. Hassan, Arwa A. Faizo, Tian-Cheng Li, Esam I. Azhar
Journal of Epidemiology and Global Health.2025;[Epub] CrossRef
Epidemiological Aspects of Hepatitis E Virus Infections between South Korea and Japan
Myeong-Jin Lee, Won-Chang Lee, Young Hwan Kwon
The Korean Journal of Aerospace and Environmental Medicine.2022; 32(1): 27. CrossRef
Hepatitis E virus in professionally exposed: A reason for concern?
Anna Mrzljak, Ivan Balen, Ljubo Barbic, Maja Ilic, Tatjana Vilibic-Cavlek
World Journal of Hepatology.2021; 13(7): 723. CrossRef

Analysis of the Change of Health Status Among the Republic of Korea Air Force Soldiers During Military Service: Seok-Ju Yoo, Won-Ju Park, Kwan Lee, Hyun-Sul Lim, Hyun-Jin Kim, Suk-Ho Lee; J Prev Med Public Health. 2014;47(4):230-235. Published online July 31, 2014; DOI: https://doi.org/10.3961/jpmph.2014.47.4.230

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Abstract PDF

Objectives
The aim of this study was to investigate whether the health status of Republic of Korea Air Force (ROKAF) soldiers changed after one year of military service. Methods: We selected 483 ROKAF soldiers from the 11 749 recruits who participated in the 2011 physical examination. The selected soldiers underwent another physical examination in 2012 for advancement to senior airman. Data from 2011 and 2012 were merged. To collect data on lifestyle, a questionnaire was sent to all included subjects via the military intranet e-mail service. Results: The percentage of recruits with an abnormal alanine transaminase level (normal range <40 IU/L) decreased from recruitment (13.7%) to the following year (2.7%). Moreover, the percentage of obese soldiers (body mass index ≥25 kg/m2) decreased from recruitment (20.5%) to the following year (10.4%). There was a significant change in mean duration of exercise carried out each day before (0.8±1.3 hours) and after (1.0±0.7 hours) joining the ROKAF service. Conclusions: These ROKAF soldiers were generally in good health before and after joining the armed service. After one year of military service, the health status of most soldiers improved, especially with respect to body mass index and alanine transaminase level.

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Brief Report

Epidemiological Investigation of an Outbreak of Salmonellosis in Gyeongju, Korea: Seok-Ju Yoo, Hyun-Sul Lim, Kwan Lee; J Prev Med Public Health. 2014;47(3):177-181. Published online May 30, 2014; DOI: https://doi.org/10.3961/jpmph.2014.47.3.177

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Abstract PDF

Objectives

A salmonellosis outbreak occurred within a community of Gyeongju residents who ingested catered food from a wedding in June 2009. We aimed to epidemiologically investigate the probable vehicle of the infection.

Methods

We conducted a retrospective cohort study on 34 local residents who ingested the wedding food.

Results

Among the 34 residents, 31 (91.2%) reported symptoms of infection after eating the food. Among all of the wedding foods, pan-fried foods were highly associated with the diarrheal attack rate. On bacteriological examination, Salmonella species were detected in the pan-fried foods among the leftover foods and in 17 of the 31 stool specimens from the cases. There were five different types of pan-fried foods, but the onset of symptoms was independent of the ingredients used. We found that the pan-fried food was prepared at a food store in Seoul and that eggs were a common ingredient.

Conclusions

The major cause of the salmonellosis in this population was presumed to be the pan-fried food prepared with contaminated eggs. These food items might have been partially undercooked because of their irregular shape, which allowed the Salmonella species to survive and multiply before ingestion.

Summary

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Original Article

Airborne Nicotine Concentrations in the Workplaces of Tobacco Farmers: Seok-Ju Yoo, Sung-Jun Park, Byoung-Seok Kim, Kwan Lee, Hyun-Sul Lim, Jik-Su Kim, In-Shik Kim; J Prev Med Public Health. 2014;47(3):144-149. Published online May 30, 2014; DOI: https://doi.org/10.3961/jpmph.2014.47.3.144

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Abstract PDF

Objectives

Nicotine is a natural alkaloid and insecticide in tobacco leaves. Green tobacco sickness (GTS) is known as a disease of acute nicotine intoxication among tobacco farmers. Until now, GTS has been recognized globally as a disease that results from nicotine absorption through the skin. However, we assumed that GTS might also result from nicotine inhalation as well as absorption. We aimed to measure the airborne nicotine concentrations in various work environments of Korean tobacco farmers.

Methods

We measured the nicotine concentrations in the tobacco fields, private curing barns, and joint curing barns of farmers from July to October 2010. All sampling and analyses of airborne nicotine were conducted according to the National Institute for Occupational Safety and Health manual of analytic methods.

Results

The airborne nicotine concentrations (geometric mean [geometric standard deviation]) in the tobacco field were 83.4 mg/m³ (1.2) in the upper region and 93.3 mg/m³ (1.2) in the lower region. In addition, the nicotine concentration by personal sampling was 150.1 mg/m³. Similarly, the nicotine concentrations in the private curing barn, workers in curing barns, the front yard of the curing barn, and in the joint curing barn were 323.7 mg/m³ (2.0), 121.0 mg/m³ (1.5), 73.7 mg/m³ (1.7), and 610.3 mg/m³ (1.0), respectively.

Conclusions

The nicotine concentration in the workplaces of tobacco farmers was very high. Future studies should measure the environmental concentration of nicotine that is inhaled by tobacco farmers.

Summary

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English Abstract

Epidemiological Investigation for Outbreak of Food Poisoning Caused by Bacillus cereus Among the Workers at a Local Company in 2010.: Kum Bal Choi, Hyun Sul Lim, Kwan Lee, Gyoung Yim Ha, Kwang Hyun Jung, Chang Kyu Sohn; J Prev Med Public Health. 2011;44(2):65-73.; DOI: https://doi.org/10.3961/jpmph.2011.44.2.65

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Abstract PDF

OBJECTIVES
In July 2 2010, a diarrhea outbreak occurred among the workers in a company in Gyeungju city, Korea. An epidemiological investigation was performed to clarify the cause and transmission route of the outbreak. METHODS: We conducted a questionnaire survey among 193 persons, and we examined 21 rectal swabs and 6 environmental specimens. We also delegated the Daegu Bukgu public health center to examine 3 food service employees and 5 environmental specimens from the P buffet which served a buffet on June 30. The patient case was defined as a worker of L Corporation and who participated in the company meal service and who had diarrhea more than one time. We also collected the underground water filter of the company on July 23. RESULTS: The attack rate of diarrhea among the employees was 20.3%. The epidemic curve showed that a single exposure peaked on July 1. The relative risk of attendance and non-attendance by date was highest for the lunch of June 30 (35.62; 95% CI, 2.25 to 574.79). There was no specific food that was statistically regarded as the source of the outbreak. Bacillus cereus was cultured from two of the rectal swabs, two of the preserved foods and the underground water filter. We thought the exposure date was lunch of June 30 according the latency period of B. cereus. CONCLUSIONS: We concluded the route of transmission was infection of dishes, spoons and chopsticks in the lunch buffet of June 30 by the underground water. At the lunch buffet, 50 dishes, 40 spoons, and chopsticks were served as cleaned and wiped with a dishcloth. We thought the underground water contaminated the dishes, spoons, chopsticks and the dishcloth. Those contaminated materials became the cause of this outbreak.

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Original Article

Work-Related Musculoskeletal Symptoms Among Dairy Farmers in Gyeonggi Province, Korea.: Ji Hyuk Park, Hyun Sul Lim, Kwan Lee; J Prev Med Public Health. 2010;43(3):205-212.; DOI: https://doi.org/10.3961/jpmph.2010.43.3.205

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Abstract PDF

OBJECTIVES
The prevalence of work-related musculoskeletal symptoms (WMS) among Korean dairy farmers has not been investigated. The purpose of this study was to assess the prevalence of WMS and to evaluate the relationship between WMS and risk factors. METHODS: Self-developed questionnaires including the questionnaire developed by the Korean Occupational Safety and Health agency (KOSHA) were used to investigate WMS among dairy farmers in Gyeonggi Province, Korea. We informed selected dairy farmers about the study and sent the questionnaires by registered mail. They visited a public health center nearby or a branch of public health center on the appointed date and skillful researchers identified or conducted the questionnaires by interview. We analyzed 598 (32.8%) of the 1824 dairy farmers. Multiple logistic regression was implemented to estimate the odds ratios of risk factors. RESULTS: The mean age of the respondents was 50.4 +/- 8.7 years and the proportion of males was 63.0%. The prevalence of WMS at any site was 33.3%. The prevalence of neck WMS was 2.2%, shoulders 10.0%, arms/elbows 5.0%, hands/wrists/fingers 4.2%, low back 11.5%, and legs/feet 11.7%. The adjusted odds ratio of low back WMS for milking 4 or more hours per day was 4.231 (95% CI = 1.124 - 15.932) and statistically significant. Low back WMS (2.827, 95% CI = 1.545 - 5.174) was significantly decreased by education. CONCLUSIONS: Low back WMS increased with milking hours and milking 4 or more hours per day was significantly associated with low back WMS. Low back WMS was significantly reduced with education. We hope that there will be increased attention about WMS in dairy farmers and the subject of future investigations.

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Aoife Osborne, Catherine Blake, Brona M. Fullen, David Meredith, James Phelan, John McNamara, Caitriona Cunningham
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English Abstracts

Seroprevalence and Risk Factors of Brucellosis among Slaughterhouse Workers in Korea.: Seok Ju Yoo, Young Sill Choi, Hyun Sul Lim, Kwan Lee, Mi Yeoun Park, Chaeshin Chu, Young A Kang; J Prev Med Public Health. 2009;42(4):237-242.; DOI: https://doi.org/10.3961/jpmph.2009.42.4.237

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Abstract PDF

OBJECTIVES
The incidence of zoonoses in Korea has increased recently. However, the study of high risk groups for zoonoses has not been conducted to date in Korea. Thus, we did this study to obtain data on brucellosis among slaughterhouse workers in Korea. METHODS: We evaluated the structure of slaughterhouses and the process of slaughtering by reviewing the relevant literature and doing field studies. We visited 73 slaughterhouses and 62 residual products handle houses across the country. In addition, we conducted a questionnaire survey of the work activities, and obtained blood samples in order to determine the seroprevalence and risk factors of brucellosis. The titers of brucellosis antibodies were measured using the standard tube agglutination test (SAT). We diagnosed subjects as seropositive for Brucellosis if the titers were more than 1:160. The data collected was evaluated using SPSS ver. 17.0. RESULTS: We included 1,503 subjects and obtained 1,482 blood samples among them: 849 workers involved in slaughtering, 351 handlers of residual products, 190 inspectors and their assistants, and 92 grading testers and their assistants. The seroprevalence of brucellosis among the slaughterhouse workers was 0.8% (95% CI=0.4-1.5). Broken down, the seroprevalence of brucellosis among the workers involved in slaughtering was 0.7% (95% CI=0.3-1.6), the handlers of residual products was 1.7% (95% CI=0.7-3.9) respectively. Risk factors for contracting brucellosis among slaughterhouse workers were being splashed with cattle blood around the mouth, cattle secretions around the body and not putting on protective apron while at work. CONCLUSIONS: An educational program is needed for high risk groups on zoonoses about the prevention of infection. Thus, effective working guidelines for workers who participate in the slaughter of animals must be developed in order to protect them from zoonoses.

Summary

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Spatial analysis to assess the relationship between human and bovine brucellosis in South Korea, 2005–2010
Jun-Sik Lim, Kyung-Duk Min, Sukhyun Ryu, Seung-Sik Hwang, Sung-Il Cho
Scientific Reports.2019;[Epub] CrossRef
Obituary: Dr. Hyun-Sul Lim’s (1952-2018) life as an epidemiologist, occupational and environmental medicine researcher, and family physician
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Epidemiology and Health.2018; 40: e2018033. CrossRef
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Mwense Leya, Won Kyong Kim, Jeong Sang Cho, Eun-Chae Yu, Young-Jee Kim, Yoonhwan Yeo, Kwang-Soo Lyoo, Myeon-Sik Yang, Sang-Seop Han, John Hwa Lee, Dongseob Tark, Jin Hur, Bumseok Kim
Journal of Veterinary Science.2018; 19(5): 643. CrossRef
Seroreactivity and Risk Factors Associated with Human Brucellosis among Cattle Slaughterhouse Workers in South Korea
Dilaram Acharya, Seon Do Hwang, Ji-Hyuk Park
International Journal of Environmental Research and Public Health.2018; 15(11): 2396. CrossRef
Seroprevalence of Brucellosis, Leptospirosis, and Q Fever among Butchers and Slaughterhouse Workers in South-Eastern Iran
Saber Esmaeili, Saied Reza Naddaf, Behzad Pourhossein, Abdolrazagh Hashemi Shahraki, Fahimeh Bagheri Amiri, Mohammad Mehdi Gouya, Ehsan Mostafavi, Jonas Waldenström
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Hachung Yoon, Oun-Kyong Moon, Soo-Han Lee, Won-Chang Lee, Moon Her, Wooseog Jeong, Suk-Chan Jung, Do-Soon Kim
Journal of Veterinary Science.2014; 15(4): 537. CrossRef
Awareness on Zoonoses among Pig Farmers in Korea
Seok-Ju Yoo, Hyun-Sul Lim, Kwan Lee
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Time series analysis of human and bovine brucellosis in South Korea from 2005 to 2010
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Preventive Veterinary Medicine.2013; 110(2): 190. CrossRef
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International Journal of Environmental Health Research.2011; 21(4): 306. CrossRef

Seroprevalence of Brucellosis among Risk Population in Gyeongsangbuk-do, 2006.: Kwan Lee, Hyun Sul Lim, Woo Won Park, Sung Hwan Kim, Do Young Lee, Mi Yeoun Park, Youngju Hur; J Prev Med Public Health. 2007;40(4):285-290.; DOI: https://doi.org/10.3961/jpmph.2007.40.4.285

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Abstract PDF

OBJECTIVES
Cases of human brucellosis in Korea have recently increased due to the increasing incidence of bovine brucellosis. The authors conducted this study to elucidate the status of brucellosis through seroepidemiologic study. METHODS: We selected our study population from a high risk group. We conducted a questionnaire survey and obtained blood samples to determine the seroprevalence of brucellosis antibodies for 10 days in February, 2005. The titers of brucellosis were measured by the combination of standard tube agglutination test (STA) and enzyme-linked immunosorbent assay (ELISA) test. RESULTS: Our study subjects comprised 1,075 cases: 971 livestock workers, 51 veterinarians, and 53 artificial inseminators. In the STA test, 27 cases (2.5%) had titers of greater than or equal to 1:20. Of 1,068 cases (7 cases were excluded due to previous brucellosis), 7 cases of brucellosis were diagnosed with titers of 1:160, giving a seroprevalence of brucellosis of 0.66%. The seroprevalence in the male group was 0.95%, and that of livestock workers, veterinarians, and artificial inseminators was 0.52%, 4.17%, and 0.00%, respectively. The Spearman's correlation coefficient between the positive rate of bovine brucellosis per capita and household and human brucellosis was 0.806 and 0.744, respectively. The concordance rate between the Korea National Institute of Health and the Gyeongsangbuk-do Institute of Health and Environment by the STA and ELISA tests was 94.7% and 100.0%, respectively. CONCLUSIONS: The study results indicated in higher seroprevalence rate among veterinarians than among livestock workers and artificial inseminators. Because veterinarians may be exposed to this high risk, effective working guidelines for veterinarians to guard against brucellosis must be developed. Moreover, more extensive epidemiologic research for laboratory workers and meat handlers is needed.

Summary

Citations

Citations to this article as recorded by

Awareness on Zoonoses among Pig Farmers in Korea
Seok-Ju Yoo, Hyun-Sul Lim, Kwan Lee
Journal of agricultural medicine and community health.2014; 39(4): 222. CrossRef
Evaluation and Selection of Multilocus Variable-Number Tandem-Repeat Analysis Primers for Genotyping Brucella abortus Biovar 1 Isolated from Human Patients
Subok Lee, Kyu-Jam Hwang, Mi-Yeoun Park, Seon-Do Hwang, Hee-Youl Chai, Hyuk Chu, Sang-Hee Park
Osong Public Health and Research Perspectives.2013; 4(5): 265. CrossRef
Application of the Microagglutination Test for Serologic Diagnosis of Human Brucellosis
Sang-Hee Park, Yoo-Hoon Lee, Hyuk Chu, Seon-Do Hwang, Kyu-Jam Hwang, Hee-Yeol Choi, Mi-Yeoun Park
Osong Public Health and Research Perspectives.2012; 3(1): 19. CrossRef
Awareness of Major Zoonoses among Dairy Farmers in Gyeonggi Province
Kum-Bal Choi, Hyun-Sul Lim, Kwan Lee, Young-Sun Min
Journal of agricultural medicine and community health.2010; 35(4): 339. CrossRef
Seroprevalence and Risk Factors of Brucellosis among Slaughterhouse Workers in Korea
Seok-Ju Yoo, Young-Sill Choi, Hyun-Sul Lim, Kwan Lee, Mi Yeoun Park, Chaeshin Chu, Young-A Kang
Journal of Preventive Medicine and Public Health.2009; 42(4): 237. CrossRef
The Relationship between Cerebrovascular Mortality and Community Health Indicators in Gangwon-do
Jeoung-Ha Sim, Mi-A Son
Journal of agricultural medicine and community health.2009; 34(1): 1. CrossRef
Awareness of Zoonoses among Cattle Slaughterhouse Workers in Korea
Hyun-Sul Lim, Seok-Ju Yoo, Kwan Lee
Journal of agricultural medicine and community health.2009; 34(1): 101. CrossRef
A review of published reports regarding zoonotic pathogen infection in veterinarians
Whitney S. Baker, Gregory C. Gray
Journal of the American Veterinary Medical Association.2009; 234(10): 1271. CrossRef

Original Articles

Prevalence and Risk Factors of Green Tobacco Sickness among Korean Tobacco Harvesters.: Hyun Sul Lim, Kwan Lee, Si Hyun Nam; J Prev Med Public Health. 2004;37(1):37-43.

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Abstract PDF: OBJECTIVE
This study was carried out to understand the prevalence and risk factors of green tobacco sickness (GTS) among Korean tobacco harvesters. METHODS: The authors conducted a questionnaire among the tobacco harvesters (1, 064 persons from 555 out of 723 tobacco harvesting households) in Cheongsong-gun for 4 days from May 7 to 10, 2002. RESULTS: The study subjects were 550 males and 514 females. The recognition and experience of GTS up until 2001 were 96.4% and 61.9%, respectively. The prevalence of GTS in 2001 was 42.5%, and was significantly higher in females than in males (59.0% vs. 26.6%, p< 0.01). The incidence density of GTS according to the number of workdays in 2001 was 12.3 spells/100 person' days. The GTS symptoms reported by the tobacco harvesters in 2001 were dizziness in 441 cases (97.6%), nausea in 414 (91.6%), headache in 349 (77.2%) and vomiting in 343 (75.9%). The use of gloves, hat and wristlets, sweating at work and the number of working hours significantly increased the prevalence of GTS (p< 0.05). Multiple logistic regression analysis was used to determine the factors significantly associated with GTS. Odds ratios for smoking, working over 10 hours and sweating at work were 0.26 (95% CI: 0.19-0.35), 1.64 (95% CI: 1.26-2.14) and 1.60 (95% CI: 1.14-2.25), respectively. Of those who reported GTS in 2001, 311 cases (68.8%) underwent treatment from their local medical facilities. CONCLUSION: In Korea, there are many tobaccoharvesting households, and most may be stricken with GTS. More extensive epidemiological studies, including heincidence and associated risk factors, are expected and a surveillance system including measurements of cotinine in urine should be conducted.; Summary

Survey on the Symptoms Related to Hair Dyeing among University Freshmen.: Kwan Lee, Hyun Sul Lim; Korean J Prev Med. 2003;36(3):223-229.

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Abstract PDF: OBJECTIVES
This study was carried out to investigate the prevalence and symptoms related to hair dyeing among university freshmen. METHODS: The authors conducted a questionnaire survey among 1, 499 university freshmen from Mar 11 to 15, 2002. RESULTS: The study group contained 710 females and 789 males. Up until 2002, 62.7% of the subjects had experienced hair dyeing, and this was significantly higher in females (66.2%, p< 0.05). The period of first experience of hair dyeing was in high school for 361 cases (38.4%), after high school for 345 cases (36.7%) and before high school for 234 cases (24.9%). The major reasons of hair dyeing were 'to improve their appearance' in 466 cases (49.6%), and 'to follow the hair dyeing fashion' in 169 cases (18.0%). The prevalence of hair dyeing in 2002 was 47.8%, and again was significantly higher in females (53.7%, p< 0.05). The major symptoms related to hair dyeing were 'cleaved and nonelastic hair' in 498 cases (69.6%), and 'thin and easily breakable hair' in 353 cases (49.3%). Of those, 361 cases (50.4%) appealed to three or more symptoms related to hair dyeing. Through multiple logistic regression, factors significantly associated with symptoms related to hair dyeing were found to be female (OR=2.14, 95% CI; 1.61-2.83), use of hair dryer (OR=1.36, 95% CI; 1.004-1.854), a frequency of hair dyeing of three or more (OR=1.48, 95% CI; 1.04-2.09), and a duration of processing hair dyeing of over 60 minutes (OR=2.18, 95% CI; 1.50-3.18). CONCLUSIONS: The prevalence and experience of hair dyeing were generally high among university freshmen. Therefore, more extensive epidemiological studies on the symptoms related to hair dyeing should be conducted.; Summary

Epidemiologic Investigation on an Outbreak of Cholera in Gyeongsangbuk-do, Korea, 2001.: Jun Ho Lee, Hyun Sul Lim, Kwan Lee, Jun Chul Kim, Sang Won Lee, Un Yeong Go, Byung Kuk Yang, Jong Koo Lee, Moon Sik Kim; Korean J Prev Med. 2002;35(4):295-304.

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Abstract PDF: OBJECTIVES
This study was carried out to investigate the cause, magnitude and transmission route of the cholera outbreak in 2001. METHODS: The study population were those persons who ingested foods at the restaurant, were confirmed as cholera patients, had symptoms of diarrhea and served as workers at the restaurant. A questionnaire survey and microbiological examinations on the microbes isolated from rectal swabs were conducted. Of the cases, 316 food histories were surveyed by an analysis of the restaurant menu. RESUJLTS: There were 139 confirmed cases of cholera reported in Korea in 2001. Of these, 104 were related to the restaurant. By region, Gyeongsangbuk-do had the highest incidence with 91 cases. Of these 91 cases, 74 had ingested foods at the restaurant, 2 were employees and 3 were secondary infection cases within the families. The results of the odds ratio analysis of the 316 persons having ingested foods at the restaurant were as follows: sandwiches 5.07 (95% CI, 1.85-14.59), soybean curd 2.45 (95% CI, 1.09-5.56), noodles 2.34 (95% CI, 1.24-4.42), steamed squid 2.01 (95% CI, 1.17-3.47) and vinegared rice 1.82 (95% CI, 1.08-3.09). It was certain the restaurant in question was the cause of the 2001 outbreak. CONCLUSIONS: We suspected that more than one restaurant employee contaminated foods served at the restaurant. In addition, eating raw fishes purchased at the Pohang Fisheries infected the employees of the restaurant. There is a possibility that these raw fishes were themselves contaminated by cholera bacilli in the sea.; Summary

Physical Fitness, Leisure Time Physical Activity, and Serum Lipid Levels in Middle-Aged Male Workers .: Jang Rak Kim, Bock Dong Nam, Ju Ho Kim, Song Kwan Lee, Joong Kap Moon, Jang Ho Lee, Dae Yong Hong; Korean J Prev Med. 1996;29(2):173-186.

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Abstract PDF: This is a cross-sectional study to evaluate the relationships between physical fitness, leisure time physical activity, and serum lipid levels in middle-aged male workers. Physical fitness was measured by a step test score, and leisure time physical activity was self-reported on a questionnaire. Serum total cholesterol was negatively related to physical fitness(r=-0.27), and positively to obesity index(r=0.27). But leisure time physical activity was related to total cholesterol negatively(r.-0.20) only in subjects whose total cholesterol levels were above 170mg/dl. High density lipoprotein(HDL) cholesterol was positively related to physical faintness(r=0.15), negatively to obesity index(r=-0.22), and positively to weekly alcohol consumption(r=0.14). Total cholesterol/HDL cholesterol ratio was related to physical fitness(r=-0.23), obesity index(r=0.32), total cigarette index (r=0.13), weekly alcohol consumption(r=-0.13), and vegetable preference(r=0.13) physical fitness was also related to leisure time physical activity(r=0.19) and obesity index(r=-0.18). In multiple linear regression models, physical fitness(beta= -0.23) and obesity index(beta=0.18) were significantly associated with total cholesterol, obesity index(beta=-0.25) with HDL cholesterol, and obesity index(beta=0.30), physical fitness(beta= -0.16) and vegetable preference (beta=0.14) with total cholesterol HDL cholesterol ratio. In conclusion, as physical fitness has a stronger relationship with serum lipid levels than leisure time physical activity, and the association between physical fitness and leisure time physical activity is modest, physical fitness should be added as an important variable in addition to activity in future epidemiologic studies.; Summary

Leukocyte count and hypertension in the health screening data in some rural and urban residents.: Choong Won Lee, Nung Ki Yoon, Sung Kwan Lee; Korean J Prev Med. 1991;24(3):363-372.

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Abstract PDF: We used the health screening data of some rural and urban residents to examine the cross-sectional association between leukocyte count and hypertension. The 206 male and 203 female rural residents were selected by multi-stage cluster sampling method in Kyungsan-Kun area of Kyungbuk province in 1985 and 600 urban residents were selected by the same sampling method as the rural residents in Daegu city of the same province in 1986 compatible with age-sex distribution of Daegu city of 1985 census, but of whom 384 actually responded. The rest of 600 were replaced by age and sex with those who were members of the medical insurance plan visiting the health management department of the university hospital to get the biannual preventive medical checkups. Excluded in the analysis were those having hypertensive history, diseases and extreme outlying values of the screening tests, leaving 373 rural and 571 urban residents. Leukocyte count was measured with ELT-8 Laser shadow method and the unit cells/mm3. Blood pressures were determined with an aneroid sphygmomanometer with pre-standardized method and hypertensives were defined as those showing systolic blood pressure more than 140 mmHg and / or diastolic blood pressure more than 90 mmHg. Total residents pooled (N=944) showed a significant difference between hypertensives and normotensives (6965.93+/-1997.01 vs 6490.61+/-1941.32, P=0.00) and in rural residents was noted the similar significant difference (P=0.03). None of significant differences were noted in any stratum stratified by residency and sex. Compared to the lowest quintile of WBC, 2/5 quintile showed odds ratio 0.99 (95% CI 0.90-2.21), 4/5 quintile 1.76 (95% CI 1.14-2.72), and highest quintile 1.80 (1.15-2.82) in the total residents. Likelihood ratio test for linear trend for in indicated a significant trend (x2 trend=5.53, df=1, P<0.05). There were no other significant odds ratios compared to the lowest quintile of WBC in strata stratified by residency and sex. The odds ratios in total residents which had showed significant odds ratios became nonsignificant and of reduced magnitude after controlling age, frequency of smoking and drinking with multiple logistic regression. In each stratum, it changed magnitudes of odds ratios slightly and unstably. None of the trend tests showed any significant trend. These results suggest that the Friedman et al's finding of association between leukocyte count and hypertension may be due to an statistical type I error result in from the data dredging in an exploratory study, in which more than 800 variables were screened as possible predictors of hypertension.; Summary

The Relationship of Psychosocial Factors to Blood Pressure.: Choong Won Lee, Sung Kwan Lee; Korean J Prev Med. 1988;21(1):99-112.

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Abstract PDF: Questionnaires and blood pressure measurements were administered to 279 medical school undergraduates in 1987 to investigate the relationship between psychosocial factors and blood pressure as well as reliability and validity of the Framingham Type A Behavior Scale(FTA). The reliability coefficients of SCL-90-R and FTA measured by Spearman-Brown haves split test were 0.57-0.91, The factors of FTA extracted by principal component analysis were hard-driving competitiveness factor and impatience factor(2-factor solution). The total score of FTA was positively correlated with relative weight and place raised but the correlations were insignificant, and had significantly positive but weak correlations with depression, anxiety hostility, paranoid, and psychoticism subscales of SCL-90-R. In the univariate analysis of blood pressures, relative weight and family history were significant in systolic pressure in males and economic status was significant in blood pressures in both sexes. For diastolic pressure, relative weight and frequency of alcohol intake were significant in males and relative weight was in females. After controlling relative weight, the frequency of alcohol intake for diastolic pressure and economic status for systolic pressure were significant in males. The important variables selected by stepwise regression analysis were relative weight and economic status for systolic pressure of males and relative weight and the frequency of alcohol to the model, changing coefficient of determination 0.206 to 0.217. In females, economic status and relative weight were selected for systolic pressure and for diastolic pressure body mass index alone, but the model of blood pressure for females was considered to be unstable due to small sample size(56). FTA was unrelated to the blood pressures in both sexes.; Summary

A Study on the Cause of Death of School Teachers in Korea.: Sung Kwan Lee; Korean J Prev Med. 1987;20(1):10-39.

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Abstract PDF: Mortality rate and causes of death are regarded as an index of strength as well as level of development of a country. However, there is no accurate data for the causes of death in Korea due to lack of systematic vital data collection system. The objective of this study was to define the causes of death of the school teachers, its changing pattern, cause-specific mortality rate, and geographic variation. The study population included all of the teachers in primary school, middle and high schools, and college who joined in Korean Teachers' Union between 1968 and 1985 that provided a total of 1,972,069 person-years to observe (1,384,911 man-years, 587,158 woman-years). There were 3,678 deaths in this period (3,377 males, 301 females). The most common cause of death was neoplasm which was followed by the diseases of circulatory system. The proportion of death of neoplasm was 1.5 times higher than that of the general population. Causes of death were classified into 5 major group (neoplasm, diseases of circulatory system, accidents and poisoning, diseases of liver, and all others). The mortality rates of diseases of circulatory system and all others for general population were 4 to 5 times higher than those for the teachers. However, mortality rates of neoplasm and diseases of liver were only about 2 times higher than those for teachers. Mortality rate of liver cancer for teachers was higher than gastric cancer mortality rate which is the reverse in general population. The crude death rate was 2.12 per 1,000 person-years for male and 1.00 for female which is one-third of the crude death rate of general population. Crude death rate of study population was higher in rural area than in urban area. However, mortality rate of neoplasm for male was higher in urban area than in rural area while mortality rates of all other causes were higher in rural area. For female, mortality rates of neoplasm and diseases of circulatory system were higher in urban area and the rates for all other causes were higher in rural area. Crude death rate was lowest in Gyeongin area and highest in Yeongnam area. The mortality of neoplasm for male accounted the highest proportion of all death in Gyeongin, Chungcheong and Yeoungnam areas while the mortality of neoplasm and mortality of circulatory system accounted the same proportion in Jeonra area. For female, the mortality of disease of circulatory system accounted the highest proportion in Gyeongin and Yeoungnam and Jeonra areas. Proportion of death due to accidents and poisoning was high in Chungcheong area and death due to all other causes was high in Yeoungnam area. The most common cause of death for male by city and province was neoplasm in Seoul, Pusan, Daegu, Gyeonggi, Chungnam, Chungbuk, Gyeongnam and Gyeongbuk. Diseases of circulatory system was the leading cause of death in the rest of city and provinces. The leading cause of death for female was diseases of circulatory system in Seoul, Incheon, Chungbuk, Chungnam, and Gyeongbuk, neoplasm in Pusan, and accident and poisons in all other cities and provinces. The mortality rates of male were above 2 per 1,000 person-years in Jeju, Gyeongbuk, Gyeongnam, Daegu, and Chungbuk, and it was below 1.5/1,000 in Seoul, Incheon and Gyeonggi. The mortality rate of female was above 1.2/1,000 person-years in Gyeongnam and Incheon while it was below 0.5/1,000 in Daegu, Geonggi Chungbuk and Jeju. The leading cause for male by school of employment was neoplasm in all levels of school with a remarkably higher rate in the professors of college. Leading cause of death for female was disease of circulatory system in primary schools, high schools and college but neoplasm in middle schools. There was no death due to liver diseases in middle and high school teachers and college professors and no death due to all other category in igh school teachers and college professors, in females. High school teachers and the highest mortality rate and college professors showed the lowest mortality rate. Temporal trend of mortality was examined in three periods; period I (1968-1974), period II (1975-1979), and period III (1980-1985). The leading cause of death for male was diseases of circulatory system in period I and II but neoplasm in period III. Such trend of decreasing diseases of circulatory system and increasing neoplasm was observed in female. Overall mortality rate was decreased over the 3 periods. The mortality rates of diseases of circulatory system, liver disease and all others were decreased in male but the mortality rates of neoplasm and accident and poisons was increased. Female showed a similar trend to male but the mortality rate of liver diseases was increased. Mortality rates of diseases of circulatory system, neoplasm and liver diseases increased with age of teachers up to 50 years of age but decreased in 60 years of age. Mean age at death due to each cause was higher in male than female by 4-10 years. However, the mean age at death of the teachers was 2-5 years lower than that of the general population in all causes of death and the sex difference in the mean age at death was smaller (2-3 years) in general population. In sex ratio of mortality, male was higher than female in almost all diseases except suicide and maintained a high ratio. The general population showed universally high ratio in male like teachers, and more or less did regular patterns in mortality with ratio smaller.; Summary

The Effects of Maternal HBs antigenemia on the Neonatal Health.: Jung Han Park, Sung Do Yoon, Chang Youn Kim, Sung Kwan Lee; Korean J Prev Med. 1984;17(1):47-56.

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Abstract PDF: To study the risk factors associated with maternal HBsAg carrier and the effects of maternal HBs antigenemia on the neonatal health, sera of 729 pergnant women admitted to the Keimyung University Hospital for delivery during the period of February 1-May 30, 1982 were tested for HBsAg by RPHA method and for anti-HBs by PHA method. Among them 43 women (5.9%) had HBsAg and 246 women (33.7%) had anti-HBs giving an infection rate of 39.6%. The interview data for 43 HBsAg positive mothers and randomly selected 210 HBsAg negative mothers showed a statistically significant association between acupuncture history and HBsAg positive rate (p<0.005) which suggest that acupuncture might have contributed significantly to the propagation of viral hepatitis in Korea. The living standard of HBsAg positive mothers was generally lower than that of HBsAg negative mothers which supports the hypothesis that environmental factors are associated with viral hepatitis B infection. None of the 43 neonates born to HBsAg positive mothers had HBsAg in their cord blood. Three months after birth, 35 out of 43 infants were retested and only one infant became HBsAg positive. At six months of age, 32 out of 35 infants were retested and none of them were HBsAg positive except the same infant who was positive at three months. Among 20 control infants of HBsAg negative mothers, all of them were HBsAg negative at three and six months follow-up. These findings are not consistent with the supposition that perinatal infection is a main route of viral hepatitis B transmission in south-east Asia including Korea. HBsAg positive mothers had significantly higher rate of premature delivery (27.9%) than HBsAg negative mothers (11.7%) (p<0.05). Also, the low birthweight incidence rate was higher among HBsAg positive mothers (23.3%) than negative mothers (14.1%) but this was not statistically significant (p=0.16). The premature rupture of membrane was more frequent among HBsAg positive mothers (25.5%) than negative mothers (11.1%) (p<0.05). There were no significant differences in the stillbirth rate and incidence of congenital anomalies between HBsAg positive and negative groups. It was not clarified in this study due to small sample size whether higher incidence of premature delivery and premature rupture of membranes among HBsAg positive mothers was due to HBs antigenemia per se or their lower living standard than HBsAg negative mothers.; Summary

A Study on the Effects of BCG Vaccination against Tuberculosis.: Pock Soo Kang, Sung Kwan Lee; Korean J Prev Med. 1982;15(1):33-46.

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Abstract PDF: In Korea BCG vaccination has been employed as the main control measure for tuberculosis since 1962. Recently, the protective efficacy of BCG against tuberculosis has been controversial worldwide. A case-control study was conducted to evaluate the efficacy of BCG in Korea which has a high prevalence of tuberculosis (2.5%). The study subjects were children under the age of 14 years who were hospitalized and diagnosed as tuberculosis in three general hospitals in Taegu City during last 6 years (1975~1980). Among 416 hospitalized tuberculous patients, 314 cases were confirmed as to the presence or absence of the BCG scar. A control group was selected from the same hospital patients of the same period as the cases. The control group was other than tuberculous patients whose distribution of age, sex and residence were the same as the cases. The results obtained are as follows: For all forms of tuberculosis, the relative risk and the protective efficacy of BCG were 3.5 and 71.8%. The efficacy was higher among female than among male (78.6% vs. 65.8%). The efficacy was higher among the one year and above than among less than 1 year of age. For tuberculous meningitis, the relative risk and the protective efficacy of BCG were 3.9 and 74.3%. The efficacy was statistically significantly higher among female than among male (p<0.05). The relative risk and the protective efficacyt of BCG for uberculous meningitis combined with miliary tuberculosis and combined with pulmonary tuberculosis represented 6.9, 85.6%, and 7.4, 86.5%, respectively. On the other hand, the relative risk and the protective efficacy of BCG for miliary tuberculosis were 2.1 and 51.6%, and for pulmonary tuberculosis, 2.3 and 54.7%, respectively. From these results, it appears that BCG vaccination is an efficient preventive measure in Korea where tubercuuosis is prevalent. Thus the routine BCG vaccination should be continued.; Summary

A Study on Smoking among Korean Rural Residents.: Pock Soo Kang, Sung Kwan Lee; Korean J Prev Med. 1980;13(1):77-86.

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Abstract PDF: The present study was conducted to investigate smoking status and the relationship of smoking to hypertension and disease 1,504 subjects who were 30-year-old age in Kyungsan Gunm Jyungpook province, during the period of 12 months from March 1978 to February 1979. The results obtained are summarized as follows : of 1,504 subjects, 52.2 percent smoked. The percentage of males smoking showed 84.8 and the percentage of females was 30.7. There were no statistically significant differences between the rate smoking and educational levels. Protestants demonstrated lower rates of smoking compared with other groups. Regarding the age started to smoke, 66.4 percent of male smokers and 16.9 percent of female smokers commenced smoking before the age of 19. In the regard to the average number of cigarettes smoked daily, 45.8 percent of male smokers consumed some 20 cigarettes and 24.1 percent of female smokers consumed some 10 cigarettes. 3.2 percent of male smokers smoked 40 or more cigarettes a day. Alcohol consumption was closely associated with smoking . 90.7 percent of male alcohol drinkers and 60.1 percent of female drinkers smoked. Cigarette smokers have higher rates of ailments than nonsmokers as a whole. The complaints of cough with sputum and shortness of breath revealed higher rates among smokers than among nonsmokers. Frequency of illnesses showed higher for smokers than for nonsmokers. Smokers were more likely than nonsmokers to suffer from chronic obstructive lung diseases such as chronic bronchitis, asthma, and emphysema. Abnormal systolic blood pressure(>160mmHg) and diastolic(>100) revealed significantly higher among smokers than among nonsmokers.; Summary

Survey on Fertility Rate and Family Planning in Sub-urban Area, Taegu.: Sung Kwan Lee, Kwan Yun Kim, Hae Kun Chung, Jung Wan Kim; Korean J Prev Med. 1975;8(1):53-69.

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Abstract PDF: It is very desirable to clarify the situation of fertility, family planning and attitude toward family size of the women residing in the sub-urban slum area because of underprivilege of socio-economiccondition of the residents and negligible health services (especially MCH and family planning) to the people in the area. The study area was selected a slum and primary fixation place of the people immigrated from rural area: Taegu, Dong Ku, Shin Chun Dong, 2 Ka and Taegu, Suh Ku, Ri San Dong, 1 Ka The survey was conducted by family planning workers at Health Center from December 1974 to February 1975. The results were obtained as follows: Thirty-eight percent of residents immigrated from rural area and most of there consist of nuclear family. Average monthly income per family was 38,000 won and 74 percent of them haven't their own houses. Number of pregnancy and live births per womon were 3.8 and 3.0 respectively. The rates of spontaneous and induced abortion to total married women were 9.5% and 36% respectively. Regarding delivery conditions, 86% of deliveries were performed at home and 70% of them were cared by non-professional person or without helpers. Ideal number of children account for 1.58 for sons, 1.08 for. daughters 2.655 for both, but the rate of 2 children regardless sex difference was only 3.4%. The factors influencing to family size were age and educational level of women and economic status of the hosehold. Regarding family planning, the rate of experience of contraception in the past was 48 percent while the rate of present contraception was 24%. Most frequent pregnancy order at the first contraception was 4th and most frequent age group of the women was 35-39 years in the past while the most frequent pregnancy order and the age of women were 3rd and 30-34 years at the first contraception in the present. Average fertility rate per year to total eligible women for 5 years 20.8% indicating somewhat higher than those of oter places. Age specific marital fertility rate showed higher in younger age groups than those of other places, and total fertility rate accounts for 1548.4 showing similar to rural total fertility rate in 1970 and higher than those of other urban areas.; Summary

A Study Concerning Health Needs in Rural Korea.: Sung Kwan Lee, Doo Hie Kim, Jong Hak Jung, Keuk Soo Chung, Sang Bin Park, Chung Hun Choi, Sun Ho Hong, Jin Hoon Rah; Korean J Prev Med. 1974;7(1):29-94.

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Abstract PDF: Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. the findings presented in this report are useful measures of the major health problems an even more important, as a guide to planning for improves medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural area. -to assess the rural population's needs in terms of health and medial care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group , the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample: Sample size was one fourth of total population: 1,438. The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination. Examination sessions usually were held in the morning every Tuesday, Wednesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior hgh school in Taegu city so the time was not convenient for them to receive examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Public health problems. Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years of older was 201 needed more health care and 65 of them had disabilities (table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health. Average number of pregnancies of eligible women was 4 times. There was almost no pre-and post-natal care. Pregnancy wastage. Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery Condition. More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimate about 35 per 10,000 live births. Child health. Consultation rate for child health was almost non existent. In general, vaccination rate of children was low; vaccination rates for children but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16). Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eight of estimate number of tuberculosis in the area. Number of discharged cases in the pat accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge on the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental Problems: More than 50% of the total population have lest one or more dental problems. (Table 19) B. Medical care Problems. Incidence rate: 1. In one month. Incidence rate of medical care problems during one month was 19.6% percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-n the order. The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years of over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old th rate of health problems increases gradually with aging. Eighty-three percent of health problems that occurred during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at those because of illness during one month were 1.7days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year. The incidence rate of medical care problems during a year was 7.8%, among them health problems which required rest at those was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occurred most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10) ,diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3)-in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were 16 days per interviewee and 4 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequency were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as follows:(previous page). Utilization of medical care (treatment) by various medical for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82% while the rate of those who have health problems which did not required rest was 61percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitated used were as follows: Hospital and clinics: 32-35%. Herb clinics: 9-10%. Drugstore: 53-58%. Hospitalization. Rate of hospitalization was 1.7% and the estimate number of hospitalization among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,1109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27).Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation. 2. MCH except medical care problems. 3. Family planning except surgical intervention. 4. Tuberculosis control except diagnosis and prescription. 5. Dental care except operational intervention. 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. b. Medical care problems. 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost. Considering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is need government to solve health and medical care problems for rural people.; Summary

A Study on Maternity Aids Utilization in the Maternal and Child Health and Family Planning.: Min Hae Yeh, Sung Kwan Lee; Korean J Prev Med. 1972;5(1):57-95.

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Abstract PDF: this study was conducted to assess the effectiveness of service by maternity aids concerning maternal and child health in improving simultaneously infant mortality, contraception and vital registration among expectant mothers in rural Korea, where there is less opportunity for maternal and child health care. It is unrealistic to expect to solve this problem in rural Korea through professional persons considering the situation of medical facilities and the sicioeconomic condition of residents. So, we intended to adopt a system of services by maternity aids who were educated formally among indigenous women. After the women were trained in maternal and child heath, contraception, and registration for a short period, they were assigned as a maternity aids to each village to help with various activities concerning maternal and child health, for example, registration of pregnant women, home visiting to check for complications, supplying of delivery kits, attendance at delivery, persuasion of contraception, and invitation for registration and so on. Mean- while, four researchers called on the maternity aids to collect materials concerning vital events, maternal child health, contraception and registration, and to give further instruction and supervision a s the program proceeded. A. Changes of women's attitude by services of maternity aid. Now, we examined to what extent such a service system to expectant mothers affected a change in attitude of women residing in the study area as compared to women of the control area. 1) In the birth and death places, there were no changes between last and present infants, in study or control area. 2) In regard to attendants at delivery, there were no changes except for a small percentage of attendant (8%) by maternity aid in study area. But, I expect that more maternity aids could be used as attendants at delivery if they would be trained further and if there was more explanation to the residents about such a service. 3) Considering the rate of utilization of sterilized delivery kit, I an sure that more than 90 percent would be used if the delivery kit were supplied in the proper time. There were significant differences in rates between the study and the control areas. 4) Taking into consideration the utilization rate of the clinic for prenatal care and well baby care, if such facilities were installed, it would probably be well utilized. 5) In the contraception, the rate of approval was as high as 89 percent in study area as compared to 82 percent in the control area. 6) Considering the rate of pre-and past-partum acceptance on contraception were as much as 70 percent or more, if motivation to use contraception was given to them adequately, the government could reach the goals for family planning as planned. 7) In the vital registration, the rate of birth registration in the study area was some what improved compared to that of the control area, while the rate of death registration was not changed at all. Taking into account the fact that the rate of confirmation of vital events by maternity aids was remarkably high, if the registration system changed to a "notification" system instead of formal registration system, it would be improved significantly compared to present system. B. Effect of the project. Thus, with changes in the residents' attitude, was there a reduction in the infant death rate? 1) It is very difficult problem to compare the mortality of infants between last and present infants, because many women don't wont to answer accurately about their dead children especially the infants that died within a few days after birth. In this study the data of present death comes from the maternity aides who followed up every pregnancy they had recorded to see what had happened. They seem to have very reliable information on what happened in first few weeks with follow up visitits to check out later changes. From these calculation, when we compared the rate of infant death between last and present infant, there was remarkable reduction of death rate for present infant compare to that of last children, namely, the former was 30, while the latter 42. The figure is the lowest rate that I have ever heard. As the quality of data we could assess by comparing the causes of death. In the current death rate by communicable disease was much lower compare to the last child especially, tetanus cases and pneumonia. 2) Next, how many respondents used contraception after birth because of frequent contact with the maternity aid. In the registered cases, the respondents showed a tendency to practice contraception at an earlier age and with a small number of children. In a comparison of the rate of contraception between the study and the control area, the rate int he former was significantly higher than that of the latter. What is more, the proportion favoring smaller numbers of children and younger women rose in the study area as compared to the control area. 3) Regarding vital registration, though the rate of registration was gradually improved by efforts of maternity aid, it would be better to change the registration system. 4) In the crude birth rate, the rate in the study area was 22.2 while in the control area was 26.5. Natural increase rate showed 15.4 in the study area, while control area was 19.1. 5) In assessment of the efficiency of the maternity aids judging by the cost-effect viewpoint, the workers in the Medium area seemed to be more efficiency than those of other areas.; Summary

A Comparison of Side for Termination, and Continuation Rate for Various Kinds of Oral Contraceptive Pill.: Sung Kwan Lee, Doo Hie Kim, Min Hae Yeh, Soon Ho Hong; Korean J Prev Med. 1970;3(1):51-96.

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Abstract PDF: No abstract available.; Summary

A Study in Acceptance of Oral Contraceptives among Women in a Rural Area.: Sung Kwan Lee, Dae Woo Han, Min Hae Ye, Doo Hie Kim; Korean J Prev Med. 1969;2(1):23-60.

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Abstract PDF: No abstract available.; Summary

English Abstracts

Effects of Bisphenol A on the Placental Function and Reproduction in Rats.: Chae Kwan Lee, Seog Hyun Kim, Deog Hwan Moon, Jeong Ho Kim, Byung Chul Son, Dae Hwan Kim, Chang Hee Lee, Hwi Dong Kim, Jung Won Kim, Jong Eun Kim, Chae Un Lee; J Prev Med Public Health. 2005;38(3):330-336.

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Abstract PDF: OBJECTIVE
The aim of this study was to investigate the effects of bisphenol A (BPA), an estrogen-like environmental endocrine disrupter, on the placental function and reproduction in rats. The mRNA levels of the placental prolactin-growth hormone (PRL-GH) gene family, placental trophoblast cell frequency and reproductive data were analyzed. METHODS: The pregnancies of F344 Fisher rats (160 g +/- 20 g) were detected by the presence of the copulatory plug or sperm in the vaginal smear, which marked Day 0 of pregnancy. Pregnant rats were divided into three groups. The control group was intraperitoneally injected with a sesame oil vehicle. The two remaining groups were injected with 50 or 500 mg/kg B.W/day of BPA, resuspended in sesame oil, on either days 7 to 11 or 16 to 20 of pregnancy, with the rats sacrificed on either day 11 or 20, respectively. The mRNA levels of PRL-GH and Pit-1a and b isotype genes were analyzed by Northern blot hybridization and reverse transcription-polymerase chain reaction. The hormone concentrations were analyzed by radioimmunoassay, and the frequency of the placental trophoblast cells observed by a histochemical study. Reproductive data, such as the placental weight and litter size, were surveyed on day 20. The fetal weight was surveyed for 4 weeks after birth. A statistical analysis was carried out using the SAS program (version 8.1). RESULTS: The mRNA levels of the PRL-GH gene family, such as placental lactogen I, Iv and II, prolactin like protein A, C and Cv, and decidual prolactin-related protein were significantly reduced due to BPA exposure. The mRNA levels of the Pit-1a and b isotype genes, which induce the expression of the PRL-GH gene family in the rat placenta, were also reduced due to BPA exposure. The PL-Iv and PL-II concentrations were reduced in the BPA exposed group. During the middle to last stage of pregnancy (Days 11-20), a high dose of BPA exposure reduced the frequency of spongiotrophoblast cells, which are responsible for the secretion of the PRL-GH hormones. Reproductive data, such as the placental and fetal weights and the litter size, were reduced, but that of the pregnancy period was extended in the BPA exposed compared to the control group. CONCLUSIONS: BPA disrupts the placental functions in rats, which leads to reproductive disorders.; Summary

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

Original Article

Effects of Chromium (VI) Exposure on the Placental Function and Reproduction in Rats.: Heun Lee, Jin Ho Chun, Deog Hwan Moon, Chae Un Lee, Sung Goo Kang, Byung Chul Son, Dae Hwan Kim, Chang Hee Lee, Jung Won Kim, Chae Kwan Lee; J Prev Med Public Health. 2004;37(2):157-165.

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Abstract PDF: OBJECTIONS: This study aimed to investigate the toxic effects of chromium (VI) on the placental function and reproduction in rats. For the study, the placental prolactin-growth hormone (PRL-GH) gene expression, placental trophoblast cell differentiation and reproductive data were analyzed. METHODS: The pregnancies of F344 Fisher rats were checked by the presence of a copulatory plug or sperm in the vaginal smear, which was defined as day 0 of the pregnancy. Pregnant rats were divided into the three groups. The control group was given tap water (chromium level < 0.001 ppm) and the remaining groups were given 250 or 750 ppm of chromium (VI) [as potassium dichromate], from day 7 to 19 of the pregnancy. Rats were sacrificed at days 11 and 20 of pregnancy. The mRNA levels of PRL-GH and Pit-1a and b isotype genes were analyzed by Northern blot hybridization and reverse transcriptionpolymerase chain reaction (RT-PCR). The hormonal concentration was analyzed by radioimmunoassay, and the differentiation of placental trophoblast cells were observed by histochemical studies. Reproductive data, such as placental and fetal weights, pregnancy period, and litter size, were surveyed at day 20 of pregnancy and after birth. A statistical analysis was carried out using the SAS program (version 8.1). RESULTS: The mRNA levels of the prolactin-growth hormone (PRL-GH) family of genes were dose dependently reduced by chromium exposure. The mRNA levels of Pit-1a and b isotype genes that induce the expression of the PRL-GH family of genes were also reduced by chromium exposure. The PRL-GH hormonal concentration in the rat placenta, fetus and maternal blood were decreased by chromium exposure. In the middle stage of pregnancy (day 11), a high dose of chromium suppressed the differentiation of spongiotrophoblast cells that secret the PRLGH hormones. In the last stage of pregnancy (day 20), a high dose of chromium induced apoptosis of placental cells. Reproductive data, such as placental and fetal weights, litter size, were reduced, but the pregnancy period was extended in the group exposed to chromium compared with the controls. CONCLUSION: Chromium (VI) disrupts the ordered functions of the placenta, which leads to reproductive disorders in rats.; Summary

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