Journal of Preventive Medicine and Public Health

Original Articles

Mortality Burden Due to Short-term Exposure to Fine Particulate Matter in Korea: Jongmin Oh, Youn-Hee Lim, Changwoo Han, Dong-Wook Lee, Jisun Myung, Yun-Chul Hong, Soontae Kim, Hyun-Joo Bae; J Prev Med Public Health. 2024;57(2):185-196. Published online March 29, 2024; DOI: https://doi.org/10.3961/jpmph.23.514

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Abstract Summary PDF Supplementary Material: Objectives
Excess mortality associated with long-term exposure to fine particulate matter (PM_2.5) has been documented. However, research on the disease burden following short-term exposure is scarce. We investigated the cause-specific mortality burden of short-term exposure to PM_2.5 by considering the potential non-linear concentration–response relationship in Korea.
Methods
Daily cause-specific mortality rates and PM_2.5 exposure levels from 2010 to 2019 were collected for 8 Korean cities and 9 provinces. A generalized additive mixed model was employed to estimate the non-linear relationship between PM_2.5 exposure and cause-specific mortality levels. We assumed no detrimental health effects of PM_2.5 concentrations below 15 μg/m³. Overall deaths attributable to short-term PM_2.5 exposure were estimated by summing the daily numbers of excess deaths associated with ambient PM_2.5 exposure.
Results
Of the 2 749 704 recorded deaths, 2 453 686 (89.2%) were non-accidental, 591 267 (21.5%) were cardiovascular, and 141 066 (5.1%) were respiratory in nature. A non-linear relationship was observed between all-cause mortality and exposure to PM_2.5 at lag0, whereas linear associations were evident for cause-specific mortalities. Overall, 10 814 all-cause, 7855 non-accidental, 1642 cardiovascular, and 708 respiratory deaths were attributed to short-term exposure to PM_2.5. The estimated number of all-cause excess deaths due to short-term PM_2.5 exposure in 2019 was 1039 (95% confidence interval, 604 to 1472).
Conclusions
Our findings indicate an association between short-term PM_2.5 exposure and various mortality rates (all-cause, non-accidental, cardiovascular, and respiratory) in Korea over the period from 2010 to 2019. Consequently, action plans should be developed to reduce deaths attributable to short-term exposure to PM_2.5.; Summary

Korean summary
본 연구는 2010~2019년 한국의 초미세먼지 단기 노출로 인한 사망 부담을 추정하였으며 2010~2019년간, 초미세먼지 단기노출로 인한 전체원인 사망은 10,814명, 비사고 사망은 7,855명, 심혈관 사망은 1,642명, 호흡기 사망은 708명으로 추정하였다. 본 연구 결과는 대기오염 관리, 규제, 정책 수립에 있어 도움을 줄 것으로 예상한다.

Key Message
- We estimated mortality burden attributable to short-term exposure to PM 2.5 in Korea from 2010 to 2019 - Over the 10-years study period, the estimated excess deaths due to short-term exposure to PM 2.5 totaled 10,814 for all-causes, 7,855 for non-accidental, 1,642 for cardiovascular disease, and 708 for respiratory disease. - Our findings can assist in air pollution management, regulation, and policy-making.

Regimen-related Mortality Risk in Patients Undergoing Peritoneal Dialysis Using Hypertonic Glucose Solution: A Retrospective Cohort Study: Chinakorn Sujimongkol, Cholatip Pongskul, Supannee Promthet; J Prev Med Public Health. 2018;51(4):205-212. Published online June 19, 2018; DOI: https://doi.org/10.3961/jpmph.18.066

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Objectives
The main purpose of this study was to quantify the risk of mortality linked to various regimens of hypertonic peritoneal dialysis (PD) solution.
Methods
A retrospective cohort study of patients using home-based PD was carried out. The prescribed regimen of glucose-based PD solution for all patients, determined on the basis of their individual conditions, was extracted from their medical chart records. The primary outcome was death. The treatment regimens were categorized into 3 groups according to the type of PD solution used: original PD (1.5% glucose), shuffle PD (1.5 and 2.5% glucose), and serialized PD (2.5 and 4.5% glucose). Multivariate analysis (using the Weibull model) was applied to comprehensively examine survival probabilities related to the explanatory variable, while adjusting for other potential confounders.
Results
Of 300 consecutive patients, 38% died over a median follow-up time of 30 months (interquartile range: 15-46 months). Multivariate analysis showed that a treatment regimen with continued higher-strength PD solution (serialized PD) resulted in a lower survival rate than when the conventional strength solution was used (adjusted hazard ratio, 2.6; 95% confidence interval, 1.6 to 4.6, p<0.01). Five interrelated risk factors (age, length of time on PD, hemoglobin levels, albumin levels, and oliguria) were significant predictors contributing to the outcome.
Conclusions
Frequent exposure to high levels of glucose PD solution significantly contributed to a 2-fold higher rate of death, especially when hypertonic glucose was prescribed continuously.

Summary

Citations

Citations to this article as recorded by

Associations of Glucometabolic Indices with Aortic Stiffness in Patients Undergoing Peritoneal Dialysis with and without Diabetes Mellitus
Chi-Chong Tang, Jen-Pi Tsai, Yi-Hsin Chen, Szu-Chun Hung, Yu-Li Lin, Bang-Gee Hsu
International Journal of Molecular Sciences.2023; 24(23): 17094. CrossRef

Causes of Child Mortality (1 to 4 Years of Age) From 1983 to 2012 in the Republic of Korea: National Vital Data: Seung Ah Choe, Sung-Il Cho; J Prev Med Public Health. 2014;47(6):336-342. Published online November 7, 2014; DOI: https://doi.org/10.3961/jpmph.14.024

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Abstract PDF

Objectives
Child mortality remains a critical problem even in developed countries due to low fertility. To plan effective interventions, investigation into the trends and causes of child mortality is necessary. Therefore, we analyzed these trends and causes of child deaths over the last 30 years in Korea.
Methods
Causes of death data were obtained from a nationwide vital registration managed by the Korean Statistical Information Service. The mortality rate among all children aged between one and four years and the causes of deaths were reviewed. Data from 1983-2012 and 1993-2012 were analyzed separately because the proportion of unspecified causes of death during 1983-1992 varied substantially from that during 1993-2012.
Results
The child (1-4 years) mortality rates substantially decreased during the past three decades. The trend analysis revealed that all the five major causes of death (infectious, neoplastic, neurologic, congenital, and external origins) have decreased significantly. However, the sex ratio of child mortality (boys to girls) slightly increased during the last 30 years. External causes of death remain the most frequent origin of child mortality, and the proportion of mortality due to child assault has significantly increased (from 1.02 in 1983 to 1.38 in 2012).
Conclusions
In Korea, the major causes and rate of child mortality have changed and the sex ratio of child mortality has slightly increased since the early 1980s. Child mortality, especially due to preventable causes, requires public health intervention.

Summary

Citations

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Child mortality of twins and singletons among late preterm and term birth: a study of national linked birth and under-five mortality data of Korea
Young Shin Kim, Minku Kang, Young June Choe, Joohon Sung, Ji Yeon Lee, Seung-Ah Choe
European Journal of Pediatrics.2022; 181(5): 2109. CrossRef

Changes in Contribution of Causes of Death to Socioeconomic Mortality Inequalities in Korean Adults: Kyunghee Jung-Choi, Young-Ho Khang, Hong-Jun Cho; J Prev Med Public Health. 2011;44(6):249-259. Published online November 14, 2011; DOI: https://doi.org/10.3961/jpmph.2011.44.6.249

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Abstract PDF

Objectives

This study aimed to analyze long-term trends in the contribution of each cause of death to socioeconomic inequalities in all-cause mortality among Korean adults.

Methods

Data were collected from death certificates between 1990 and 2004 and from censuses in 1990, 1995, and 2000. Age-standardized death rates by gender were produced according to education as the socioeconomic position indicator, and the slope index of inequality was calculated to evaluate the contribution of each cause of death to socioeconomic inequalities in all-cause mortality.

Results

Among adults aged 25-44, accidental injuries with transport accidents, suicide, liver disease and cerebrovascular disease made relatively large contributions to socioeconomic inequalities in all-cause mortality, while, among adults aged 45-64, liver disease, cerebrovascular disease, transport accidents, liver cancer, and lung cancer did so. Ischemic heart disease, a very important contributor to socioeconomic mortality inequality in North America and Western Europe, showed a very low contribution (less than 3%) in both genders of Koreans.

Conclusions

Considering the contributions of different causes of death to absolute mortality inequalities, establishing effective strategies to reduce socioeconomic inequalities in mortality is warranted.

Summary

Citations

Citations to this article as recorded by

Educational inequalities in adult mortality: a systematic review and meta-analysis of the Asia Pacific region
Kathryn Christine Beck, Mirza Balaj, Lorena Donadello, Talal Mohammad, Hanne Dahl Vonen, Claire Degail, Kristoffer Eikemo, Anna Giouleka, Indrit Gradeci, Celine Westby, Kam Sripada, Magnus Rom Jensen, Solvor Solhaug, Emmanuela Gakidou, Terje Andreas Eikem
BMJ Open.2022; 12(8): e059042. CrossRef
Socioeconomic Disparities in Cardiovascular Health in South Korea
Chi-Young Lee, Eun-Ok Im
Journal of Cardiovascular Nursing.2021; 36(1): 8. CrossRef
Mainstreaming of Health Equity in Infectious Disease Control Policy During the COVID-19 Pandemic Era
Hongjo Choi, Seong-Yi Kim, Jung-Woo Kim, Yukyung Park, Myoung-Hee Kim
Journal of Preventive Medicine and Public Health.2021; 54(1): 1. CrossRef
Cancer Incidence by Occupation in Korea: Longitudinal Analysis of a Nationwide Cohort
Hye-Eun Lee, Masayoshi Zaitsu, Eun-A Kim, Ichiro Kawachi
Safety and Health at Work.2020; 11(1): 41. CrossRef
Mortality inequalities by occupational class among men in Japan, South Korea and eight European countries: a national register-based study, 1990–2015
Hirokazu Tanaka, Wilma J Nusselder, Matthias Bopp, Henrik Brønnum-Hansen, Ramune Kalediene, Jung Su Lee, Mall Leinsalu, Pekka Martikainen, Gwenn Menvielle, Yasuki Kobayashi, Johan P Mackenbach
Journal of Epidemiology and Community Health.2019; 73(8): 750. CrossRef
Measurement of Socioeconomic Position in Research on Cardiovascular Health Disparities in Korea: A Systematic Review
Chi-Young Lee, Yong-Hwan Lee
Journal of Preventive Medicine and Public Health.2019; 52(5): 281. CrossRef
Forty years of economic growth and plummeting mortality: the mortality experience of the poorly educated in South Korea
Jinwook Bahk, John W Lynch, Young-Ho Khang
Journal of Epidemiology and Community Health.2017; 71(3): 282. CrossRef
Increased breast cancer mortality only in the lower education group: age-period-cohort effect in breast cancer mortality by educational level in South Korea, 1983-2012
Jinwook Bahk, Sung-Mi Jang, Kyunghee Jung-Choi
International Journal for Equity in Health.2017;[Epub] CrossRef
Effects of Periodontal Disease on Cardio-Cerebrovascular Disease: A Focus on Personal Income and Social Deprivation
Min-Young Kim, Hosung Shin
Journal of Dental Hygiene Science.2017; 17(4): 375. CrossRef
Joint Symposium of Korean Cancer Association & UICC-ARO—Cross-boundary cancer studies: cancer and Universal Health Coverage (UHC) in Asia
Eun-Cheol Park, Norie Kawahara, Shinjiro Nozaki, Hasbullah Thabrany, Shunya Yoshimi, Sohee Park, Duk Hyoung Lee, Hideyuki Akaza, Jae Kyung Roh
Japanese Journal of Clinical Oncology.2017; 47(9): 889. CrossRef
Impact of Childhood Socioeconomic Position on Self‐Rated Health Trajectories of South Korean Adults
Joan P. Yoo, Min Sang Yoo
Asian Social Work and Policy Review.2016; 10(1): 142. CrossRef
Mortality rates by occupation in Korea: a nationwide, 13-year follow-up study
Hye-Eun Lee, Hyoung-Ryoul Kim, Yun Kyung Chung, Seong-Kyu Kang, Eun-A Kim
Occupational and Environmental Medicine.2016; 73(5): 329. CrossRef
Educational Inequality in Female Cancer Mortality in Korea
Mi-Hyun Kim, Kyunghee Jung-Choi, Hyoeun Kim, Yun-Mi Song
Journal of Korean Medical Science.2015; 30(1): 1. CrossRef
The population attributable fraction of low education for mortality in South Korea with improvement in educational attainment and no improvement in mortality inequalities
Dohee Lim, Kyoung Ae Kong, Hye Ah Lee, Won Kyung Lee, Su Hyun Park, Sun Jung Baik, Hyesook Park, Kyunghee Jung-Choi
BMC Public Health.2015;[Epub] CrossRef
Sex Differences Associated With Hepatitis B Virus Surface Antigen Seropositivity Unwareness in Hepatitis B Virus Surface Antigen-positive Adults: 2007‐2012 Korea National Health and Nutrition Examination Survey
Suk-Yong Jang, Sung-In Jang, Hong-Chul Bae, Jaeyong Shin, Eun-Cheol Park
Journal of Preventive Medicine and Public Health.2015; 48(2): 74. CrossRef
Decomposition of educational differences in life expectancy by age and causes of death among South Korean adults
Kyunghee Jung-Choi, Young-Ho Khang, Hong-Jun Cho, Sung-Cheol Yun
BMC Public Health.2014;[Epub] CrossRef
Trends in income-related health inequalities in self-assessed health in Korea, 1998–2011
Jong Won Min
Global Public Health.2014; 9(9): 1053. CrossRef
Cancer Control and the Communication Innovation in South Korea: Implications for Cancer Disparities
Minsoo Jung
Asian Pacific Journal of Cancer Prevention.2013; 14(6): 3411. CrossRef
Socioeconomic inequalities in health status in Korea
Kyunghee Jung-Choi, Yu-Mi Kim
Journal of the Korean Medical Association.2013; 56(3): 167. CrossRef
Difference of Area-based deprivation and Education on Cerebrovascular Mortality in Korea
Jeoung-Ha Sim, Dong-Choon Ahn, Mi-A Son
Korean Journal of Health Policy and Administration.2012; 22(2): 163. CrossRef

Proportion of Death Certificates Issued by Physicians and Associated Factors in Korea, 1990-2002.: Min Woo Jo, Young Ho Khang, Sungcheol Yun, Jin Yong Lee, Moo Song Lee, Sang Il Lee; J Prev Med Public Health. 2004;37(4):345-352. Published online November 30, 2004

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Abstract PDF: OBJECTIVES
Previous studies showed that death certification by physicians was an important predictor to improve the quality of death certificate data in South Korea. This study was conducted to examine the proportion of death certificates issued by physicians and associated factors in South Korea from 1990 to 2002. METHODS: Data from 3, 110, 883 death certificates issued between 1990 and 2002, available to the public from the National Statistical Office of Korea, were used to calculate the proportion of death certificates issued by physicians and to examine associated factors with logistic regression analysis. RESULTS: The overall proportion of death certificates issued by physicians increased from 44.6% in 1990 to 77.6% in 2002 (mean: 63.5%). However, the proportion was greatly influenced by the deceased's age. In 2002, more than 90% of the deceased aged 51 or less were certified by physicians. A higher proportion was found among deceased who had tertiary education (college or higher) living in more developed urban areas. CONCLUSION: The information regarding the cause of death for younger, well-educated deceased in urban areas of South Korea may show a higher level of accuracy. Epidemiologic research using information on causes of death may well benefit from the continually increasing proportion of death certificates issued by physicians in the future in South Korea.; Summary

Medical Service Utilization and Trends among Korean Elderly in the Last One Year of Life.: Jee Jeon Yi, Ki Soon Park, Seung Hum Yu, Jeong In Kim, Jae Yong Park, Wang Kun Yoo, Sang Wook Yi; Korean J Prev Med. 2003;36(4):325-331.

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Abstract PDF: OBJECTIVES
To analyze medical service utilization and trends among the elderly in the last year of life. METHOD: The subjects of this study were people that had died at the age sixty-five and above between January 1st and June 30th 2000 The names of the deceased and their dates of death were collected from the data of the funeral-expenses-receivers of the National Health Insurance Corporation (NHIC). This data was merged with that of the individual medical expenses of the NHIC. RESULTS: In the first half of 2000, 84.2% of the funeral-expenses-receivers (53, 063) utilized medical services during the year prior to their death; 51.0% (27, 042) were female and 49.0% (26, 021) male. In the last twelve months of life, the medical fees, the number of days receiving medical services and the number of days receiving medicine were 3, 107, 935 Won, 47.88 and 153.21, respectively, for each person. As the age of the groups increased, the level of medical service utilization decreased; the change was more obvious in female group. The level of medical service utilization during the twelve months prior to death drastically increased around the time of death. CONCLUSIONS: This study, from an analysis of the level of medical service utilization prior to death, shows a concentrated volume of medical services during a certain time period prior to death.; Summary

Accuracy of the Registered Cause of Death in a County and its Related Factors.: Eun Kyung Chung, Hee Young Shin, Jun Ho Shin, Hae Sung Nam, So Yeon Ryu, Jeong Soo Im, Jung Ae Rhee; Korean J Prev Med. 2002;35(2):153-159.

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Abstract PDF: OBJECTIVES
To evaluate the accuracy of the registered cause of death in a county and its related factors. METHODS: The data used in this study was based on 504 cases, in a county of Chonnam province, registered between January and December 1998. Study subjects consisted of 388 of the 504 cases, and their causes of death were established by an interview survey of the next of kin or neighbor and medical record surveys. We compared the registered cause of death with the confirmed cause of death, determined by surveys and medical records, and evaluated the factors associated with the accuracy of the registered cause of death. RESULTS: 62.6% of the deaths were concordant with 19 Chapters classification of cause of death. external causes of mortality, endocrine, nutritional and metabolic diseases, neoplasms and diseases of the circulatory system showed the good agreement between the registered cause of death and the confirmed cause of death. The factors relating to the accuracy of the registered cause of death were the doctors' diagnosis for the cause of death (adjusted Odds Ratio: 2.67, 95% Confidence Interval: 1.21-5.89) and the grade of the public officials in charge of the death registry (adjusted Odds Ratio: 0.30, 95% CI= 0.12-0.78). CONCLUSIONS: The accuracy of the registered cause of death was not high. It could be improved by using the doctors' diagnosis for death and improving the job specification for public officials who deal with death registration.; Summary

Burden of Disease in Korea: Years of Life Lost due to Premature Deaths.: Hyejung Chang, Jae Il Myoung, Youngsoo Shin; Korean J Prev Med. 2001;34(4):354-362.

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Abstract PDF: OBJECTIVES
The aim of this study was to estimate the burden of disease through an analysis of Years of Life Lost due to premature deaths, one component of the Disability-Adjusted Life Years (DALY). In addition, the cause of death statistics were adjusted to improve validity, and the results were compared with those of the Global Burden of Disease (GBD). METHODS: In closely following the approach taken in the original GBD study, most of the explicit assumptions and the value judgments were not changed. However, the statistics for some problematic concerns such as deaths of infants or those due to senility, were adjusted. Deaths, standard expected years of life lost (SEYLL), and potential years of life lost (PYLL) were computed using vital registration data compiled by the National Statistical Office. RESULTS: The burden for males is 1.8 and 2.3 times higher than that for females, according to SEYLL and PYLL, respectively. The proportions of deaths due to Group I, II, and III causes are 5.4%, 80.4%, and 14.3%, respectively, for PYLL, but in a major shift from Group II to III they are 6.3%, 66.2%, and 27.5%, respectively, for SEYLL. The proportion of Group III causes in Korea, 27.5%, is extremely high when compared to 10.1% for the world, 7.6% for developed countries, and 10.7% for developing countries. CONCLUSIONS: Estimation results showed that the total burden due to premature deaths is smaller than that for the entire world but larger than that for developed countries. The disease structure of Korea has changed to resemble that of developed countries. Also, an overly large portion of the total burden in Korea stems from injuries arising from car accidents.; Summary

Estimation of Attributable Burden due to Premature Death from Smoking in Korea.: Seok Jun Yoon, Beom Man Ha, Jong Won Kang, Hye Chung Chang; Korean J Prev Med. 2001;34(3):191-199.

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Abstract PDF: OBJECTIVE
In this study, we focused on estimating the burden of premature death in Korea caused by smoking using the YLL (years of life lost due to premature death) measurement. METHODS: First, we determined parameters: such as age-specific standard life expectancy, age on death, sex, and cause of death by analyzing the national death certificate data and life table collected during 1997. These were provided by the National Statistical Office. Secondly, we estimated the age group- specific years of life lost due to premature death by employing the standard expected years of life lost (SEYLL) measurement. Thirdly, the burden of premature death caused by smoking was estimated using the YLLs measurement which was developed by the global burden of disease study group. Fourthly, We calculated the risk related to smoking using the population attributable risk. RESULTS: The following results were obtained in this study:1) Premature death that is attributable to smoking in males could be prevented in 60.9% (513,582 person-year) by non-smoking.2) The burden of premature death by smoking for female was prevented to 17.7% (513,582 person-year) by non-smoking. CONCLUSION: We found that the YLL method employed in this study was appropriate in quantifying the burden of premature death. This provides a rational basis for planning a national health policy regarding premature deaths caused by smoking and other related risk factors.; Summary

Measuring the Burden of Major Cancers due to Premature Death in Korea.: Seok Jun Yoon, Yong Ik Kim, Chang Yup Kim, Hyejung Chang; Korean J Prev Med. 2000;33(2):231-238.

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Abstract PDF: OBJECTIVE
To estimate the burden of diseases in Korea especially caused by major cancers using the YLL(years of life lost due to premature death) measurement. METHODS: First, we determined the parameters: such as age-specific standard life expectancy, age on death, sex, cause of death by analyzing the national death certificate data and life table collected during 1996 provided by the National Statistical Office. Secondly, we estimated the age group-specific YLL by employing standard expected years of life lost(SEYLL). Thirdly, final burden of disease due to premature death was estimated by using YLLs measurement which developed by global burden of disease study group. RESULTS: The burden of premature death by cancer for male was attributed mainly to liver cancer(514.5 person-year), stomach cancer(436.4 person-year), and lung cancer(367.7 person-year). Each of these cancers was responsible for the loss of over 100 person-year based on our YLL measurement. The burden of premature death by cancer for female was attributed mainly to liver cancer(135.1 person-year), stomach cancer(252.1 person-year), and lung cancer(121.8 person-year). Each of these cancers was responsible for the loss of over 100 person year based on our YLL measurement. CONCLUSION: We found the YLL method employed in this study was appropriate to quantify the burden of premature death. Thereby, it would provide a rational bases to plan a national health policy regarding premature death caused by cancer.; Summary

What Factors Affect Mortality over the Age of 40?.: Jong Ku Park, Sang Baek Koh, Chun Bae Kim, Myung Guen Kang, Kee Ho Park, Seung Jun Wang, Sei Jin Chang, Soon Ae Sin; Korean J Prev Med. 1999;32(3):383-394.

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Abstract PDF: OBJECTIVES
This study was conducted to identify the factors influencing the mortality of Koreans over the age of 40 by a nested case-control study. METHODS: The cohort consisted of the beneficiaries of Korea Medical Insurance Corporation for Government Employees & Private School Teachers and Staff(KMIC) who received health examinations of KMIC in 1992 and 1993 retrospectively. At that time, they were more than 40 years old. The cases were 19,258 cohort members who had died until December 31, 1997. The controls were 19,258 cohort members who were alive until December 31, 1997. Controls were matched with age and sex distribution of the cases. The data used in this study were the funeral expenses requesting files, and the files of health examinations and health questionnaires gathered in 1992 and 1993. To assess the putative risk factors of death, student t-test, chi-square test, multiple logistic regression analysis were used. RESULTS: In multiple logistic regression analysis, independent risk factors of death were as follows; systolic blood pressure, diastolic blood pressure, blood glucose, AST, urine glucose, urine protein, alcohol drinking(frequency), cigarette smoking and perceived health status, intake of restoratives and blood transfusion showed positive associations with death; coffee consumption showed negative associations with death; and body mass index and serum total cholesterol showed J-shaped association with death. CONCLUSIONS: Regarding the direction of association, the result of analysis on the data restricted to '96-'97 was same as that of '93-'97. But in some variables such as obesity, serum cholesterol, the odds ratios of death in the data of '96-'97 were higer than those of '93-'94, which suggested that the data of '93-'94 was bearing effect-cause relationship. We concluded that it suggested further researches using long-term follow-up data to be needed in this area.; Summary

Self-Rating Perceived Health: The Influence on Health Care Utilization and Death Risk.: Sun Seog Kweon, Sang Yong Kim, Jeong Soo Im, Seok Joon Sohn, Jin Su Choi; Korean J Prev Med. 1999;32(3):355-360.

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Abstract PDF: OBJECTIVES
This 3-year longitudinal study was conducted to evaluate the influence of self-rating health perception on health care utilization and all cause-death risk. METHODS: The hypothesis was tested using a community-based samples, among which subjects 3,414 were interviewed in 1995. Self-rating health perception was assessed by single-item question. Three components of health care utilization amount(number of visits, number of medications, yearly health care expenses) per year were measured using medical insurance data during 3-year follow-up period among subjects in district health care insurance. There were 123 deaths from all causes among 3,085 subjects interviewed. RESULTS: The results showed that those who had poor health perception revealed more increases in the amount of health care utilization than good health perception group (p<0.05). After adjusting for age and sex, the poor health perception group had higher death risk over 3 years than good health perception group(hazard ratio=1.88). but, after adjusting health care utility, supplementary, was not significant. CONCLUSION: These results suggest that self-rating health percep-tion was associated with difference in health care utilization and all cause-death risk.; Summary

Air Pollution and Daily Mortality in Seoul.: Ho Jang Kwon, Soo Hun Cho; Korean J Prev Med. 1999;32(2):191-199.

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Abstract PDF: OBJECTIVES
To examine the relationship between air pollution exposure and mortality in Seoul for the years of 1991-1995. METHODS: Daily counts of death were analyzed by general additive Poisson model, with adjustment for effects of secular trend, seasonal factor, day of the week, heat wave, temperature, and humidity. Pollution variables were ozone, nitrogen dioxide, total suspended particles(TSP), and sulfur dioxide. RESULTS: Daily death counts were associated with ozone(1 day before), nitrogen dioxide(1 day before), TSP(2 days before), sulfur dioxide(2 days before). The association with ozone was most statistically significant and independent of other air pollutants. Increase of 100 ppb in ozone was associated with 6%(95% CI= 2%-10%) increase in the daily number of death. This effect was greater in persons aged 65 and older. The relative risks of death from respiratory disease and cardiovascular disease were greater than for all-cause mortality in each pollutant. After ozone level exceeds 25 ppb, the dose-response relationship between mortality and ozone was almost linear. However, the effect of TSP, sulfur dioxide, and nitrogen dioxide on mortality might be confounded with each other. CONCLUSION: Daily variations in air pollution within the range currently occurring in Seoul might have an adverse effect on daily mortality.; Summary

An Epidemiologic Study on Death Caused by Cancer in Pusan.: Hwi Dong Kim, Hye Won Koo, Moon Suk Kwak, Jong Ryul Kim, Byung Chul Son, Deog Hwan Moon, Jong Tae Lee, Kyu Il Lee, Sang Hwa Ohm, Kui Oak Jung, Jin Ho Chun, Chae Un Lee; Korean J Prev Med. 1996;29(4):765-784.

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Abstract PDF: This study surveyed and measured the level and structure of cancer deaths and their trends over time for offering the fundamental data of the cancer prevention and control in Pusan city in the future. Authors conducted the study of descriptive epidemiology using materials derived from the computerized data of total 3,722 certified cancer deaths in Pusan city from January 1 to December 31, 1993 registered on the National Statistical Office, the Republic of Korea. The obtained results were as follows: 1. According to the total registered cases of deaths(16,331 cases) in Pusan city during 1993, cancer(3,722 cases) and cerebrovascular disease(2,718 cases) were the first and second cause of deaths as 23.1% and 16.9%, respectively. These pattern showed the change between cancer(14.7%) and cerebrovascular disease(18.5%) in order of frequency in comparison to 1982. Also, the total number of cancer deaths was increased in comparison to 1982. The rate of death certification by physicians was 87.1% of all registered deaths, which was increased to 6.8% in comparison to 1982(80.3%). 2. Crude death rate and cancer specific death rate was 4.06 per 1,000 populations and 93.8 per 100,000 populations(male:117.8, female:70.0), respectively. The former was similar to that of 1982, but the latter was increased to 1.6 times as that of 1982. 3. Age-adjusted cancer specific death rate by standardization with whole country population was 111.9(male:141.5, female:106.7) per 100,000 populations, higher than not age-adjusted cancer specific death rate(93.8), and the sex difference was statistically significant with male predominance(p<0.05). 4. Cancer specific death rate by age was generally increased with age and most of cancer deaths(male:91.8%, female:88.5%) occurred since 40 years old. 5. The major cancer(cancer specific death rate per 100,000 populations) in male was liver(30.6) followed by stomach(25.6), lung(21.9), and GB and EHBD(5.7), in female stomach(15.7), liver(9.9), lung(7.3), and uterus(6.9). The relative frequency of the leading three cancer among total cancer deaths marked 66.3% in male and 47.1% in female, and decreased in comparison to 1982(male:72.2%, female:54.5%). 6. The total ratio of male to female cancer specific death rate showed 1.68 to 1 with male predominance. And the ratio was above 2.0 in larynx, oral cavity & pharynx, esophagus, liver, lung, bladder cancer and the ratio was 1.0~1.9 in stomach, pancreas, gall bladder and EHBD, brain, rectum and anus cancer, leukemia, but the ratio was reversed in thyroid and colon cancer. In conclusion, cancer was the first cause of deaths. The proportion of lung cancer was increased, that of stomach & uterine cancer was decreased relatively, and liver cancer was constantly higher proportion. In the future, it is necessary to conduct the further investigations on the cancer risk factors considering areal specificity.; Summary

A Study of the Cause-of-Death reported on Official Death Registry in a Rural Area.: Hae Sung Nam, Kyeong Soo Park, Byeong Hwan Sun, Jun Ho Shin, Seok Joon Sohn, Jin Su Choi, Byong Woo Kim; Korean J Prev Med. 1996;29(2):227-238.

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Abstract PDF: This study was conducted to evaluate the accuracy of the official death registry in rural area. The base data used for the study was 379 deaths registered during the period of 1993 and 1994 in 4 rural townships of Chonnam Province. The interview survey for cause-of-death was performed on the next of kin and/or neighbor. Additional medical informations were collected from hospitals and medical insurance associations for the purpose of verification. The underlying cause-of-death of 278 cases presumed by the survey was compared to the cause on official death registry. There was a prominent disagreement of cause-of-death between the survey data and the registry data(agreement rate: 38.9~44.6%%, according to disease classification method). These results may be caused by extremely low rates of physicians' certification, which were mostly confined to the poisoning and injury. Symptoms, signs, and ill defined conditions on death registry could be classified into circulatory disease(32.3%), neoplasm(21.2%), digestive disease(7.l%), injury and poisoning(7.l%) and so on. These results suggest that careful attention and verification be required on utilization of death registry data in rural area.; Summary

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