Journal of Preventive Medicine and Public Health

Original Article

Modeling Fatigue and Work Stress in Aircraft Maintenance Personnel at Sultan Hasanuddin Airport, Makassar, Indonesia: A PLS-SEM Study on Quality of Life: Lalu Muhammad Saleh, Syamsiar Siang Russeng, Mahfuddin Yusbud, Tae-Gu Kim, Nurul Mawaddah Syafitri, Fatimah Azzahrah Zainuddin, Andi Alifah Kultsum Umniyah Tenri; J Prev Med Public Health. 2026;59(3):308-317. Published online April 6, 2026; DOI: https://doi.org/10.3961/jpmph.25.726

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Abstract Summary PDF: Objectives
This study aimed to develop and test a comprehensive model analyzing direct and indirect relationships among workload, demographic factors, fatigue, work stress, and quality of life among aircraft maintenance personnel (AMP).
Methods
This cross-sectional study was conducted at the maintenance, repair, and overhaul facility at Sultan Hasanuddin Airport, Makassar. Data collection combined structured interviews, standardized questionnaires (the NASA Task Load Index, Work Fatigue Feeling Measurement Questionnaire, Depression Anxiety Stress Scale-21, and World Health Organization Quality of Life-BREF), and objective measures (a Cocoro Meter for stress and an oximeter for physical workload). The model was examined using partial least squares structural equation modeling (PLS-SEM), which is well-suited to complex models with latent variables and non-normally distributed data.
Results
In the PLS-SEM analysis, physical workload (β=0.229, p=0.018) and work experience (β=0.277, p=0.007) were significantly and directly associated with fatigue. Age significantly predicted work stress (β=0.371, p=0.001). Crucially, fatigue (β=−0.344, p=0.002) and work stress (β=−0.385, p<0.001) had significant negative direct effects on quality of life and were central mediators. No direct effects of exogenous variables on quality of life were observed. Cross-tabulation supported these findings; subgroups with higher physical demands, longer tenure, and older age reported greater fatigue, higher stress, and lower quality of life.
Conclusions
Fatigue and work stress are pivotal mediators that are significantly associated with reduced quality of life among AMP. Interventions to reduce physical workload and provide targeted support for more experienced and older workers may improve well-being and safety in the aviation maintenance industry.; Summary

Key Message
Fatigue and work stress are serious occupational health concerns that can threaten aviation safety. This study showed that greater physical workload, longer work experience, and older age were associated with higher fatigue and work stress, which in turn were significantly associated with lower quality of life among AMP. Strategic interventions, such as improved ergonomic design, structured breaks, and targeted support for more experienced and older workers, may help address these risks. By investing in the well-being of AMP, aviation organizations may strengthen both worker health and the reliability and safety of flight operations.

Brief Report

Long Working Hours and Risk of Ischemic Heart Disease Among Japanese Workers: The Jichi Medical School Cohort Study: Mayumi Saiki, Akizumi Tsutsumi, Jian Li; J Prev Med Public Health. 2026;59(2):211-218. Published online February 5, 2026; DOI: https://doi.org/10.3961/jpmph.25.577

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Abstract Summary PDF Supplementary Material: Objectives
Karoshi, or “death from overwork,” has been recognized for decades; however, epidemiological findings regarding long working hours (LWH) and ischemic heart disease (IHD) remain inconsistent. This study aimed to provide new evidence on the association between LWH and IHD, while accounting for job strain among Japanese workers, both male and female.
Methods
This study utilized data from 6670 workers participating in the Jichi Medical School Cohort Study. Baseline working hours were categorized as <5.0, 5.0 to 6.9, 7.0 to 8.9 (reference), 9.0 to 10.9, and ≥11.0 hr/day. Fatal and non-fatal incident IHD cases were determined during follow-up using International Classification of Diseases, 10th revision codes. Multivariable Cox proportional hazards models were used to examine associations, adjusting for socio-demographic factors, lifestyle behaviors, cardiometabolic characteristics, and job strain.
Results
During a mean follow-up of 12 years, 58 incident IHD cases (42 male and 16 female) were documented. Long working hours (≥11.0 hr/day) were significantly associated with an increased risk of IHD in the total sample (hazard ratio, 2.92; 95% confidence interval, 1.15 to 7.39), and the overall pattern of associations was similar in sex-stratified analyses.
Conclusions
These findings suggest that LWH independently increases the risk of IHD among Japanese workers, even after adjustment for job strain, underscoring the importance of managing working hours to reduce karoshi in both male and female workers.; Summary

Key Message
Our study provides new evidence on the association between long working hours (LWH) and ischemic heart disease (IHD), while accounting for job strain among Japanese workers, both male and female, utilizing data from the Jichi Medical School Cohort Study. Our study revealed that LWH (≥11.0 hr/day) were significantly associated with an increased risk of IHD in the total sample (hazard ratio, 2.92; 95% confidence interval, 1.15 to 7.39). These findings suggest that LWH increase the risk of IHD among Japanese workers, underscoring the importance of managing working hours to reduce karoshi in both male and female workers.

Original Articles

Psychometric Properties of the Areas of Worklife Survey in an Industrial Context in Thailand: Jate Ratanachina, Inthuon Hongsiri, Watcharakorn Chuthong, Wiroj Jiamjarasrangsi; J Prev Med Public Health. 2026;59(1):75-85. Published online October 16, 2025; DOI: https://doi.org/10.3961/jpmph.25.569

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Abstract Summary PDF Supplementary Material: Objectives
The Areas of Worklife Survey (AWS) is widely used to assess organizational factors contributing to burnout. However, evidence regarding its construct and criterion validity has been reported primarily in human service settings. This study evaluated the construct validity of the AWS measurement model and the criterion validity of the AWS–burnout relationship among industrial workers in Thailand.
Methods
In this cross-sectional study, a Thai-language electronic questionnaire was administered to 446 industrial workers between June 2024 and August 2024. Of these, 390 participants (87.4%) completed both the AWS and the Maslach Burnout Inventory–General Survey. Data were analyzed using confirmatory factor analysis within a structural equation modeling framework.
Results
A modified 6-factor (chi-square/degree of freedom [χ²/df], comparative fit index [CFI], Tucker– Lewis index [TLI], root mean square error of approximation [RMSEA], and standardized root mean square residual [SRMR]) AWS model—excluding 5 items and allowing 2 correlated error terms—demonstrated satisfactory fit (χ²(213)=436.02, p<0.001; χ²/df=2.05; CFI=0.94; TLI=0.92; RMSEA=0.053; SRMR=0.053). Convergent validity (composite reliability=0.74–0.87; average variance extracted [AVE]=0.49–0.58) and discriminant validity were acceptable for most dimensions; however, the Fairness dimension (AVE=0.36) and the Reward–Fairness correlation remained problematic. The partial mediation model demonstrated acceptable criterion validity, with all mediation paths—except reward to values—reaching statistical significance.
Conclusions
The AWS is a valid measure for assessing factors contributing to burnout among Thai industrial workers. Nevertheless, further refinement is necessary to ensure strong dimension-specific validity with minimal modification.; Summary

Key Message
• The Areas of Worklife Survey (AWS) demonstrated acceptable construct and criterion validity for assessing organizational risk factors related to burnout among Thai industrial workers after model refinement. • A modified 18-item, six-factor structure showed good model fit and meaningful associations with burnout dimensions, supporting the AWS as a useful tool beyond human service settings.

Are Non-standard Work Schedules Related to Sleep Difficulty and Health-related Quality of Life in Korea? An Examination of Gender Differences: Seowoo Park, Ji Sun Park, Moo Hyuk Lee, Young Kyung Do; J Prev Med Public Health. 2025;58(4):396-405. Published online April 15, 2025; DOI: https://doi.org/10.3961/jpmph.24.378

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Abstract Summary PDF Supplementary Material: Objectives
The rise of flexible and diverse work schedules has become increasingly common in modern society. This study aims to investigate whether non-standard work schedules are related to sleep difficulty and other aspects of health-related quality of life (HRQoL) in Korea, with special attention to gender differences.
Methods
Data from the 2019 and 2021 National Health and Nutrition Examination Survey (Phase 8) were used, with a final sample consisting of 6735 participants. Ordinal logistic regression analysis was performed on sleep difficulty and the other seven items of the Health-related Quality of Life Instrument with 8 items (HINT-8) to examine associations with work schedules. Linear regression analysis was also conducted using the HINT-8 index as a composite measure.
Results
Non-standard work schedules were associated with a higher likelihood of sleep disturbances compared to the standard daytime work schedule. In particular, the negative impact of the night work schedule on sleep was greater for women than for men. Women working under the night work schedule were 12.2 percentage points more likely to report severe sleep difficulty than women under the day work schedule (9.6%). Additionally, the working, happiness, and vitality items of the HINT-8 were negatively associated with the night work schedule, whereas the other HINT-8 items and the HINT-8 index did not exhibit similar results.
Conclusions
Non-standard work schedules are associated with increased sleep difficulty, particularly among women, and negatively affect several aspects of HRQoL, including vitality, happiness, and work performance. Given their rising prevalence and adverse impact on workers’ sleep, health, well-being, as well as workplace safety and performance, non-standard work schedules should be recognized as a significant public health concern.; Summary

Korean summary
저녁 및 밤 시간대 근무는 수면을 포함한 건강 관련 삶의 질에 부정적 영향을 끼치며, 그 영향은 여성에서 더 크게 나타난다. 비표준시간대 근무는 중요한 공중보건학적 문제이다.

Key Message
Non-standard work schedules are associated with increased sleep difficulty, particularly among women, and negatively affect several aspects of health-related quality of life, including vitality, happiness, and work performance. Given their rising prevalence and adverse impact on workers’ sleep, health, well-being, as well as workplace safety and performance, non-standard work schedules should be recognized as a significant public health concern.

Prevalence, Sources, and Correlates of Second-hand Smoke Exposure Among Non-smoking Pregnant Women in India: Farheen Ahmed, Nilesh Gawde, Sulabha Parasuraman; J Prev Med Public Health. 2025;58(2):136-145. Published online December 4, 2024; DOI: https://doi.org/10.3961/jpmph.24.278

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Abstract Summary PDF: Objectives
Second-hand tobacco smoke (SHS) is a risk factor for adverse health outcomes, particularly among pregnant women. This study aimed to address the research gap concerning the prevalence and correlates of SHS exposure at home and in public settings among non-smoking pregnant women in India.
Methods
The dataset from the Global Adult Tobacco Survey (2016-17), India, was utilised to evaluate the prevalence of SHS exposure in pregnant women both at home and in public spaces. Multivariable logistic regression analysis was employed to identify the determinants of SHS exposure among this population.
Results
The prevalence of SHS exposure at home was 36.9%, while exposure outside the home was 26.5%. Among non-smoking pregnant women, 10.0% were exposed to SHS on public transport. The risk of SHS exposure at home was significantly higher in the North (adjusted odds ratio [aOR], 5.33; 95% confidence interval [CI], 2.45 to 11.60), Central (aOR, 4.46; 95% CI, 1.98 to 10.02), and Northeast (aOR, 4.18; 95% CI, 1.78 to 9.81) regions compared to the South. Pregnant women aged 25-34 (aOR, 0.61; 95% CI, 0.39 to 0.93) and those aged 35 and above (aOR, 0.48; 95% CI, 0.27 to 0.86), as well as those with secondary (aOR, 0.50; 95% CI, 0.30 to 0.85) or higher education (aOR, 0.30; 95% CI, 0.15 to 0.58), had lower odds of SHS exposure at home. For SHS exposure outside the home, the North region (aOR, 2.53; 95% CI, 1.19 to 5.36), employment status (aOR, 1.99; 95% CI, 1.13 to 3.47), and belonging to scheduled tribes (aOR, 3.20; 95% CI, 1.25 to 8.21) were associated with higher odds.
Conclusions
The prevalence of SHS exposure among pregnant non-smoking women was notably high both at home and in external environments.; Summary

Key Message
Our secondary analysis of GATS-2 India data (2016-17) showed that the prevalence of Second-hand Tobacco smoke (SHS) exposure at home was high (36.9%) among non-smoking pregnant women in India. Among pregnant women, younger age, lower education levels, and residing in the country's North, Central, and Northeast regions were significantly associated with higher odds of SHS exposure at home. Overall, about a quarter (26.5%) of pregnant women reported SHS exposure outside their home. Tribal women, employed ones, and those residing in the North region were at higher risk of SHS exposure outside their homes during their pregnancies.

Health Effects of Heavy Metal Exposure Among E-waste Workers and Community-dwelling Adults in Thailand: A Cross-sectional Study: Chonyitree Sangwijit, Parichat Ong-artborirak, Warangkana Naksen, Kraiwuth Kallawicha, Pallop Siewchaisakul; J Prev Med Public Health. 2025;58(2):156-166. Published online November 21, 2024; DOI: https://doi.org/10.3961/jpmph.24.415

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Abstract Summary PDF Supplementary Material: Objectives
Global concern is increasing about the health effects of electronic waste (e-waste). This study examines the health impacts of heavy metal (HM) exposure among e-waste workers (EWWs) and community-dwelling adults (CDAs) in Northeastern Thailand and identifies factors associated with adverse health outcomes.
Methods
A cross-sectional study was conducted of 164 EWWs and 164 CDAs. A survey was employed to collect data on participant characteristics, symptoms, anxiety, depression, and sleep quality. Urine samples were analyzed for lead (Pb) and cadmium (Cd) levels using atomic absorption spectrometry. Multiple logistic regression analysis was used to identify factors impacting health.
Results
Across all participants, urinary Pb and Cd levels ranged from 5.30 µg/g to 29.50 µg/g creatinine and from 0.60 µg/g to 4.00 µg/g creatinine, respectively. The most frequently reported health issues pertained to musculoskeletal disorders (MSDs) at 38.70%, central nervous system (CNS) issues at 36.60%, and skin disorders at 31.10%. Multivariable analysis indicated that the presence of MSDs was significantly associated with exposure to Pb and Cd. Poor sleep quality (PSQ) was significantly linked to CNS problems, while body mass index was significantly related to skin disorders. Factors including primary education level or below, smoking, cleaning the house more than 3 times weekly, and PSQ were significantly linked to depression. Anxiety was significantly associated with PSQ.
Conclusions
Environmental exposure to Pb and Cd can have adverse health impacts in the form of MSDs. Depression and anxiety are common conditions among CDAs. Public health officials should monitor HM exposure and mental health within the community.; Summary

Key Message
- Pb and Cd level was not significant difference between e-waste workers and community-dwelling adults. - Pb and Cd can adversely affect symptoms in the MSD and PSQ affects the CNS in e-waste workers. - E-waste workers had a higher chance of having musculoskeletal disorder, central nervous system disorder, and skin disorder problems than community-dwelling adults but a lower chance of having depression and anxiety than community-dwelling adults.

HIV-related Perceptions, Knowledge, Professional Ethics, Institutional Support, and HIV/AIDS-related Stigma in Health Services in West Sumatra, Indonesia: An Empirical Evaluation Using PLS-SEM: Vivi Triana, Nursyirwan Effendi, Brian Sri Pra Hastuti, Cimi Ilmiawati, Dodi Devianto, Afrizal Afrizal, Adang Bachtiar, Rima Semiarty, Raveinal Raveinal; J Prev Med Public Health. 2024;57(5):435-442. Published online July 15, 2024; DOI: https://doi.org/10.3961/jpmph.23.503

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Abstract Summary PDF: Objectives
The aim of this study was to investigate the significance of associations between knowledge, professional ethics, institutional support, perceptions regarding HIV/AIDS, and HIV/AIDS-related stigma among health workers in West Sumatra, Indonesia.
Methods
We conducted a cross-sectional study involving health workers at public hospitals and health centers in West Sumatra in June 2022. The Health Care Provider HIV/AIDS Stigma Scale was employed to assess the stigma associated with HIV/AIDS. To estimate and evaluate the model’s ability to explain the proposed constructs, we utilized the standardized partial least squares structural equation model (PLS-SEM).
Results
In total, 283 individuals participated in this study (average age, 39 years). The majority were female (91.2%), nearly half were nurses (49.5%), and 59.4% had been working for more than 10 years. The study revealed that HIV/AIDS-related stigma persisted among health workers. The PLS-SEM results indicated that all latent variables had variance inflation factors below 5, confirming that they could be retained in the model. Knowledge and professional ethics significantly contributed to human immunodeficiency virus (HIV)-related stigma, with an effect size (f²) of 0.15 or greater. In contrast, perceived and institutional support had a smaller impact on HIV-related stigma, with an effect size (f²) of at least 0.02. The R 2 value for health worker stigma was 0.408, suggesting that knowledge, professional ethics, institutional support, and perceived support collectively explain 40.8% of the variance in stigma.
Conclusions
Improving health workers’ understanding of HIV, fostering professional ethics, and strengthening institutional support are essential for reducing HIV-related stigma in this population.; Summary

Key Message
This study explores the relationships between HIV knowledge, professional ethics, institutional support, perceptions of HIV/AIDS, and HIV/AIDS-related stigma among healthcare workers in West Sumatra, Indonesia. Using a PLS-SEM model, the analysis reveals that HIV knowledge and professional ethics significantly reduce HIV-related stigma, while the effects of perceptions and institutional support are less pronounced. The model explains 40.8% of the variance in stigma, highlighting the critical role of improving HIV knowledge, fostering ethical conduct, and strengthening institutional support. These findings suggest that comprehensive strategies addressing these factors are essential to reducing HIV/AIDS stigma in healthcare settings.

Mental Health Among Healthcare Workers During the COVID-19 Pandemic in Vietnam: Nhan Phuc Thanh Nguyen, Ha Phan Ai Nguyen, Cao Khoa Dang, Minh Tri Phan, Huynh Ho Ngoc Quynh, Van Tuan Le, Chinh Van Dang, Tinh Huu Ho, Van Trong Phan, Thang Van Dinh, Thang Phan, Thi Anh Thu Dang; J Prev Med Public Health. 2024;57(1):37-46. Published online December 11, 2023; DOI: https://doi.org/10.3961/jpmph.23.327

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Abstract Summary PDF

Objectives
The objective of this study was to characterize mental health issues among Vietnamese healthcare workers (HCWs) and to identify related factors.
Methods
A cross-sectional study was conducted with 990 HCWs in 2021. Their mental health status was measured using the Depression, Anxiety, and Stress Scale.
Results
In total, 49.9%, 52.3%, and 29.8% of respondents were found to have depression, anxiety, and stress, respectively. The multivariable linear regression model revealed that factors associated with increased anxiety scores included depression scores (β, 0.45; 95% confidence interval [CI], 0.39 to 0.51) and stress scores (β, 0.46; 95% CI, 0.41 to 0.52). Factors associated with increased depression scores included being frontline HCWs (β, 0.57; 95% CI, 0.10 to 1.10), stress scores (β, 0.50; 95% CI, 0.45 to 0.56), and anxiety scores (β, 0.41; 95% CI, 0.36 to 0.47), while working experience was associated with reduced depression scores (β, -0.08; 95% CI, -0.16 to -0.01). Factors associated with increased stress scores included working experience (β, 0.08; 95% CI, 0.00 to 0.16), personal protective equipment interference with daily activities (β, 0.55; 95% CI, 0.07 to 1.00), depression scores (β, 0.54; 95% CI, 0.48 to 0.59), and anxiety scores (β, 0.45; 95% CI, 0.39 to 0.50), while age was associated with reduced stress scores (β, -0.12; 95% CI, -0.20 to -0.05).
Conclusions
Specific interventions are necessary to enhance and promote the mental health of HCWs so they can successfully cope with the circumstances of the pandemic.

Summary

Key Message
A cross-sectional study of 990 Vietnamese healthcare workers in Vietnam, 2021 revealed significant mental health issues: 49.9 % suffered from depression, 52.3 % from anxiety, and 29.8 % from stress. The study found a correlation between these conditions, with frontline workers being particularly vulnerable to depression. These findings highlight the critical need for targeted mental health interventions for healthcare workers, particularly those new to the field and working on the front lines, in order to better manage pandemic-related stressors.

Citations

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Pandemic preparedness in Vietnam: a review of health system resilience and areas for improvement
Bach Xuan Tran, Taufique Joarder, Vincent Junxiong Pang, Clara Marin Carballo, Hoa Thi Do, Cuong Tat Nguyen, Linh Gia Vu, Ngo Van Toan, Shenglan Tang
Journal of Global Health.2025;[Epub] CrossRef
Emotional Competence of Healthcare Workers and Its Impact on Patient Loyalty in Vietnamese Hospitals
Phuoc Thien Mai, Nah Pi Sa, Triet Dinh Luu, Nam Khoa Ly, Phi Duong Nguyen
Health Psychology Research.2024; 12(1): 1. CrossRef

Associations of Workplace Violence With Cardiovascular Disease Among United States Workers: Findings From a National Survey: Zheyu Hu, Jian Li; J Prev Med Public Health. 2023;56(4):368-376. Published online July 10, 2023; DOI: https://doi.org/10.3961/jpmph.23.032

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Abstract PDF

Objectives
Recent research indicates a potential association between workplace violence and an increased risk of cardiovascular disease (CVD) in the working-age population. However, the relevant evidence in the United States is sparse. Thus, this study was conducted to explore the possible relationship between workplace violence and CVD among United States workers.
Methods
We utilized cross-sectional data from the 2015 National Health Interview Survey, which included a representative sample of 18 380 workers, to investigate the associations between workplace violence and the prevalence of CVD using logistic regression. Workplace violence was determined based on self-reported threats, bullying, or harassment at work over the past 12 months, supplemented with additional information regarding frequency. CVD included all forms of heart disease and stroke.
Results
A total of 1334 workers reported experiences of workplace violence, and 1336 workers were diagnosed with CVD. After adjustment for covariates, participants who reported any instance of workplace violence had significantly higher odds of having CVD (odds ratio [OR], 1.76; 95% confidence interval [CI], 1.35 to 2.30) than those who reported no such violence. Furthermore, the highest odds of CVD (OR, 1.80; 95% CI, 1.23 to 2.63) were observed among those frequently exposed to workplace violence. Even occasional exposure to workplace violence was associated with 74% excess odds of CVD.
Conclusions
Our study indicates an association between workplace violence and CVD in United States workers, exhibiting a dose-response pattern.

Summary

Citations

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Work as a social determinant of health on cardiovascular and musculoskeletal diseases: A literature review
Anjanette Wells, Melissa Previtera, Michael Markey, Kelly J Brunst, Marepalli Rao, Emily A Adkins, Tongfan Wu, Julia Rodner, Amit Bhattacharya
WORK: A Journal of Prevention, Assessment & Rehabilitation.2025; 82(2): 578. CrossRef
The Role of Transformational Leadership in Prevention of Workplace Bullying and Psychosomatic Disorders in Non-university Women Teachers
Pedro R. Gil-Monte, Begoña Espejo, Irene Checa, Pedro Gil-LaOrden
International Journal of Bullying Prevention.2025;[Epub] CrossRef
El efecto de los factores psicosociales laborales sobre el estrés y bienestar de trabajadores de restaurantes y bares de México
Claudia Saldaña Orozco, Oscar Iván Gutiérrez-Carvajal, Jean David Polo-Vargas, Guadalupe Montserrat Ibarra Rentería, Leidy Alejandra Franco
Cuadernos de Administración.2024; 40(80): e2213596. CrossRef

Sleep Quality and Poor Sleep-related Factors Among Healthcare Workers During the COVID-19 Pandemic in Vietnam: Thang Phan, Ha Phan Ai Nguyen, Cao Khoa Dang, Minh Tri Phan, Vu Thanh Nguyen, Van Tuan Le, Binh Thang Tran, Chinh Van Dang, Tinh Huu Ho, Minh Tu Nguyen, Thang Van Dinh, Van Trong Phan, Binh Thai Dang, Huynh Ho Ngoc Quynh, Minh Tran Le, Nhan Phuc Thanh Nguyen; J Prev Med Public Health. 2023;56(4):319-326. Published online May 31, 2023; DOI: https://doi.org/10.3961/jpmph.22.528

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5 Crossref

Abstract PDF

Objectives
The coronavirus disease 2019 (COVID-19) pandemic has increased the workload of healthcare workers (HCWs), impacting their health. This study aimed to assess sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and identify factors associated with poor sleep among HCWs in Vietnam during the COVID-19 pandemic.
Methods
In this cross-sectional study, 1000 frontline HCWs were recruited from various healthcare facilities in Vietnam between October 2021 and November 2021. Data were collected using a 3-part self-administered questionnaire, which covered demographics, sleep quality, and factors related to poor sleep. Poor sleep quality was defined as a total PSQI score of 5 or higher.
Results
Participants’ mean age was 33.20±6.81 years (range, 20.0-61.0), and 63.0% were women. The median work experience was 8.54±6.30 years. Approximately 6.3% had chronic comorbidities, such as hypertension and diabetes mellitus. About 59.5% were directly responsible for patient care and treatment, while 7.1% worked in tracing and sampling. A total of 73.8% reported poor sleep quality. Multivariate logistic regression revealed significant associations between poor sleep quality and the presence of chronic comorbidities (odds ratio [OR], 2.34; 95% confidence interval [CI], 1.17 to 5.24), being a frontline HCW directly involved in patient care and treatment (OR, 1.59; 95% CI, 1.16 to 2.16), increased working hours (OR, 1.84; 95% CI,1.37 to 2.48), and a higher frequency of encountering critically ill and dying patients (OR, 1.42; 95% CI, 1.03 to 1.95).
Conclusions
The high prevalence of poor sleep among HCWs in Vietnam during the COVID-19 pandemic was similar to that in other countries. Working conditions should be adjusted to improve sleep quality among this population.

Summary

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The Effect of Cognitive Impairment on the Association Between Social Network Properties and Mortality Among Older Korean Adults: Eunji Kim, Kiho Sung, Chang Oh Kim, Yoosik Youm, Hyeon Chang Kim; J Prev Med Public Health. 2023;56(1):31-40. Published online November 22, 2022; DOI: https://doi.org/10.3961/jpmph.22.350

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Abstract Summary PDF Supplementary Material

Objectives
This study investigated the effect of cognitive impairment on the association between social network properties and mortality among older Korean adults.
Methods
This study used data from the Korean Social Life, Health, and Aging Project. It obtained 814 older adults’ complete network maps across an entire village in 2011-2012. Participants’ deaths until December 31, 2020 were confirmed by cause-of-death statistics. A Cox proportional hazards model was used to assess the risks of poor social network properties (low degree centrality, perceived loneliness, social non-participation, group-level segregation, and lack of support) on mortality according to cognitive impairment.
Results
In total, 675 participants (5510.4 person-years) were analyzed, excluding those with missing data and those whose deaths could not be verified. Along with cognitive impairment, all social network properties except loneliness were independently associated with mortality. When stratified by cognitive function, some variables indicating poor social relations had higher risks among older adults with cognitive impairment, with adjusted hazard ratios (HRs) of 2.12 (95% confidence interval [CI], 1.34 to 3.35) for social nonparticipation, 1.58 (95% CI, 0.94 to 2.65) for group-level segregation, and 3.44 (95% CI, 1.55 to 7.60) for lack of support. On the contrary, these effects were not observed among those with normal cognition, with adjusted HRs of 0.73 (95% CI, 0.31 to 1.71), 0.96 (95% CI, 0.42 to 2.21), and 0.95 (95% CI, 0.23 to 3.96), respectively.
Conclusions
The effect of social network properties was more critical among the elderly with cognitive impairment. Older adults with poor cognitive function are particularly encouraged to participate in social activities to reduce the risk of mortality.

Summary

Korean summary
고령인구에서의 불충분한 사회연결망 특성은 높은 사망 위험과 연관이 있었으며, 이는 인지기능이 저하된 그룹에서 그렇지 않은 군에 비해 더 높게 관찰되었다. 특히, 인지기능이 저하된 노인에서 사회활동들에 참여하지 않는 것, 한정된 소집단에만 속하는 것, 주변으로부터 도움을 받지 못하는 것은 높은 사망 위험과 연관이 있기 때문에, 이들의 사회연결망을 강화하는 것이 사망 위험을 낮추는 데 도움이 될 수 있다.

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Social participation and cognitive health in older adults: A scoping review
Eduardo Sandoval-Obando , Cristián Barros-Osorio , Gerardo Fuentes-Vilugrón , Luis Castellanos-Alvarenga , Ronnie Videla-Reyes , Miguel Salazar-Muñoz, Walter Sepulveda-Loyola
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Associations between taxi drivers’ aggressive driving behavior and sleep, cognition, and psychological factors in Korea: negative binomial regression analysis
Jong Sun Ok, Hyeongsu Kim, Soo Young An, Mi Young Kim
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Teleworking Survey in Saudi Arabia: Reliability and Validity of Arabic Version of the Questionnaire: Heba Yaagoub AlNujaidi, Mehwish Hussain, Sama’a H. AlMubarak, Asma Saud AlFayez, Demah Mansour AlSalman, Atheer Khalid AlSaif, Mona M. Al-Juwair; J Prev Med Public Health. 2022;55(6):578-585. Published online November 18, 2022; DOI: https://doi.org/10.3961/jpmph.22.242

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Abstract PDF Supplementary Material: Objectives
This study aimed to adapt the survey questionnaire designed by Moens et al. (2021) and determine the validity and reliability of the Arabic version of the survey in a sample of the Saudi population experiencing teleworking.
Methods
The questionnaire includes 2 sections. The first consists of 13 items measuring the impact of extended telework during the coronavirus disease 2019 (COVID-19) crisis. The second section includes 6 items measuring the impact of the COVID-19 crisis on self-view of telework and digital meetings. The survey instrument was translated based on the guidelines for the cultural adaptation of self-administrated measures.
Results
The reliability of the questionnaire responses was measured by Cronbach’s alpha. The construct validity was checked through exploratory factor analysis followed by confirmatory factor analysis (CFA) to further assess the factor structure. CFA revealed that the model had excellent fit (root mean square error of approximation, 0.00; comparative fit index, 1.0; Tucker-Lewis index, 1; standardized root mean squared residual, 0.0).
Conclusions
The Arabic version of the teleworking questionnaire had high reliability and good validity in assessing experiences and perceptions toward teleworking. While the validated survey examined perceptions and experiences during COVID-19, its use can be extended to capture experiences and perceptions during different crises.; Summary

Special Articles

Well-being Index Scores and Subjective Health Status of Korean Healthcare Workers: Yoonhee Shin, Bohyun Park, Nam-eun Kim, Eun Jeong Choi, Minsu Ock, Sun Ha Jee, Sue K. Park, Hyeong Sik Ahn, Hyesook Park; J Prev Med Public Health. 2022;55(3):226-233. Published online May 31, 2022; DOI: https://doi.org/10.3961/jpmph.22.114

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Abstract Summary PDF

Objectives
The aim of this study was to evaluate the subjective level of health-related quality of life of Korean healthcare workers using various quality-of-life instruments.
Methods
This study included 992 participants, who were doctors and nurses. A survey was conducted between November 28 and December 4, 2019. Data from 954 participants divided into 3 groups (physicians, residents, and nurses) were analyzed. Four measurement tools (29 questions) were used in the survey to evaluate subjective health status and well-being.
Results
In the Mayo Well-being Index, burnout during work (88.5%) and emotional difficulties caused by work (84.0%) were frequently cited by the respondents. Regarding questions on burnout and emotional difficulties, residents and nurses had the highest scores (91.0 and 89.6%, respectively). Emotional problems, such as anxiety, depression, and irritability, accounted for a high percentage (73.1%) of the total, while 82.2% of respondents reported that their work schedules interfered with their leisure and family time. There was no significant difference among the groups in subjective health status. However, 10.1% of the residents experienced very low quality of life, which was a higher proportion than that of physicians (2.7%) and nurses (5.2%).
Conclusions
The level of well-being that Korean medical workers experienced in relation to work was lower than the results of the United States healthcare workers surveyed using the same tool. This study was unique in that it conducted a subjective quality-of-life survey on Korean healthcare workers.

Summary

Korean summary
본 연구의 목적은 다양한 삶의 질 도구를 사용하여 한국 의료종사자들의 건강과 관련된 삶의 질에 대한 주관적인 수준을 평가하는 것이다. 피로와 정서적 어려움, 업무로 인한 일상생활의 방해 등 한국 의료종사자의 일부 삶의 질 점수가 낮았다. 의료 종사자의 소진 경험이 환자의 치료에 부정적인 영향을 미친다는 것을 고려할 때 의료 종사자들의 삶의 질을 향상시키는 정책이 마련되어야하며, 건강과 관련된 직업적 위험요인 연구도 추가적으로 필요하다.

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Network Analysis in Systems Epidemiology: JooYong Park, Jaesung Choi, Ji-Yeob Choi; J Prev Med Public Health. 2021;54(4):259-264. Published online July 7, 2021; DOI: https://doi.org/10.3961/jpmph.21.190

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Abstract Summary PDF

Traditional epidemiological studies have identified a number of risk factors for various diseases using regression-based methods that examine the association between an exposure and an outcome (i.e., one-to-one correspondences). One of the major limitations of this approach is the “black-box” aspect of the analysis, in the sense that this approach cannot fully explain complex relationships such as biological pathways. With high-throughput data in current epidemiology, comprehensive analyses are needed. The network approach can help to integrate multi-omics data, visualize their interactions or relationships, and make inferences in the context of biological mechanisms. This review aims to introduce network analysis for systems epidemiology, its procedures, and how to interpret its findings.

Summary

Korean summary
본 리뷰는 시스템역학연구에 활용할 수 있는 네트워크 분석의 간략한 개념과 분석 절차 그리고 결과 해석에 대하여 소개하고 있다. 기존 역학연구의 주요 한계점은 생물학적 기전과 같은 복잡한 관계를 충분히 설명하지 못한다는 것이다. 최근 역학 연구에서 대규모의 오믹스 데이터가 활용 가능하게 됨에 따라 통합적 분석의 필요성이 제기되고 있고, 네트워크 분석 기법이 이런 다중 오믹스 데이터들을 포괄적으로 분석하는데 활용 될 수 있을 것이다.

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Original Articles

The Effect of an Empowerment Program on the Health-promoting Behaviors of Iranian Women Workers: A Randomized Controlled Trial: Fatemeh Noori, Zahra Behboodimoghadam, Shima Haghani, Shahzad Pashaeypoor; J Prev Med Public Health. 2021;54(4):275-283. Published online June 24, 2021; DOI: https://doi.org/10.3961/jpmph.21.088

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Abstract PDF

Objectives
The workplace is an ideal place for encouraging health-promoting behaviors. Therefore, the aim of the present study was to determine the effect of an empowerment program on the health-promoting behaviors of women workers.
Methods
This randomized clinical trial was conducted with 80 women workers employed at a food packaging facility in 2020. The subjects were selected using convenience sampling and were classified into intervention and control groups using block randomization. An empowerment program for women workers was conducted across 6 sessions based on an empowerment model. Data collection tools included a demographic questionnaire and the Health Promoting Lifestyle Profile-II, which participants completed both before the program and 8 weeks after the last session. Data analysis was performed in SPSS version 16 using descriptive analysis and inferential statistics.
Results
There were no significant differences between the 2 groups in various health-promoting behaviors before the program. However, the intervention group’s scores for nutrition (34.92±1.09 vs. 27.87±4.23), physical activity (24.40±2.94 vs. 17.40±5.03), stress management (26.35±2.60 vs. 23.05±4.27), spiritual growth (34.02±3.00 vs. 30.22±5.40), interpersonal relationships (30.82±2.38 vs. 27.60±4.61), and health responsibility (31.60±2.71 vs. 28.22±4.59) were significantly higher than the control group’s 8 weeks after the program had ended. Moreover, there was a significant difference in the total score of health-promoting behaviors for the intervention group compared to the control group (179.00±9.22 vs. 151.42±20.25, p=0.001).
Conclusions
An empowerment program for women workers led to significant improvements in the health-promoting behaviors of the participants. Similar programs can ultimately improve women’s health in the workplace.

Summary

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Relationship Between Shift Intensity and Insomnia Among Hospital Nurses in Korea: A Cross-sectional Study: Yuhjin Chung, Hyunjoo Kim, Dong-Hee Koh, Ju-Hyun Park, Seohyun Yoon; J Prev Med Public Health. 2021;54(1):46-54. Published online December 22, 2020; DOI: https://doi.org/10.3961/jpmph.20.555

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Abstract Summary PDF Supplementary Material

Objectives
This study explored the relationship between shift intensity and insomnia among hospital nurses.
Methods
The participants were 386 female hospital nurses who underwent a special health examination for night workers in 2015. The Korean Insomnia Severity Index (ISI), indices of shift work intensity, and other covariates such as amount of exercise, level of alcohol consumption, employment duration, and hours worked were extracted from the health examination data. The indices for shift intensity were (1) number of 3 consecutive night shifts and (2) number of short recovery periods after a previous shift, both assessed over the prior 3 months. Multiple logistic regression analysis adjusted for the aforementioned covariates was performed to evaluate the association of shift intensity with insomnia, defined as an ISI score of ≥8.
Results
The nurses with insomnia tended to be younger (p=0.029), to have worked 3 consecutive night shifts more frequently (p<0.001), to have experienced a greater number of short recovery periods after the previous shift (p=0.021), and to have worked for more hours (p=0.006) than the nurses without insomnia. Among the other variables, no statistically significant differences between groups were observed. Experiences of 3 or more consecutive night shifts (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.29 to 4.20) and 3 or more short recovery periods (OR, 2.01; 95% CI, 1.08 to 3.73) were associated with increased odds of insomnia.
Conclusions
The results suggest that decreasing the shift intensity may reduce insomnia among hospital nurses working rotating shifts.

Summary

Korean summary
불면증상의 척도로서 ‘한국판 불면증 심각도 평가척도’를, 교대근무강도의 지표로서 지난 3개월 간의 ‘3회 연속 야간근무 횟수’와 ‘교대근무 이후 짧은 휴식기간’을 사용하여, 대학병원 야간 근무 간호사 386명의 불면증상과 교대근무강도 간의 연관성을 탐색하고자 하였다. 로지스틱 회귀분석 결과, ‘3회 연속 야간근무 횟수’와 ‘교대근무 이후 짧은 휴식기간’은 불면증상의 오즈비 증가와 관련이 있었다. 이 결과는 교대근무강도를 저하시켜야 순환 교대근무 병원 간호사들의 불면증상을 줄일 수 있음을 시사한다.

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Stress, Anxiety and Depressive Symptoms, Burnout and Insomnia Among Greek Nurses One Year After the End of the Pandemic: A Moderated Chain Mediation Model
Argyro Pachi, Christos Sikaras, Dimitrios Melas, Sofia Alikanioti, Nikolaos Soultanis, Maria Ivanidou, Ioannis Ilias, Athanasios Tselebis
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Perceived Menstrual Irregularities and Premenstrual Syndrome in Relation to Insomnia: Evidence from a Cohort of Student Nurses
Anastasiia Dimlievych, Grażyna Dębska, Joanna Grzesik-Gąsior, Anna Merklinger-Gruchala
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The interaction between mental resilience and insomnia disorder on negative emotions in nurses in Guangdong Province, China
Ningjing Zhan, Yixuan Xu, Jiangfeng Pu, Waner Wang, Zhanghao Xie, Huigen Huang
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Qualidade de vida e engajamento no trabalho em profissionais de enfermagem no início da pandemia de COVID-19
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Quality of life and work engagement among nursing staff at the start of the COVID-19 pandemic
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Healthcare Workers’ Knowledge and Attitudes Regarding the World Health Organization’s “My 5 Moments for Hand Hygiene”: Evidence From a Vietnamese Central General Hospital: Huy Van Nguyen, Hieu Trung Tran, Long Quynh Khuong, Thanh Van Nguyen, Na Thi Nhi Ho, An Thi Minh Dao, Minh Van Hoang; J Prev Med Public Health. 2020;53(4):236-244. Published online May 7, 2020; DOI: https://doi.org/10.3961/jpmph.19.319

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Abstract PDF

Objectives
Although the World Health Organization (WHO) initiative “My 5 Moments for Hand Hygiene” has been lauded as effective in preventing hospital-associated infections, little is known about healthcare workers (HCWs)’ hand hygiene behavior. In this study, we sought to assess knowledge and attitudes towards the concepts in this initiative, as well as associated factors, among Vietnamese HCWs at a general hospital.
Methods
A structured questionnaire was administered to HCWs at a central Vietnamese general hospital in 2015. Multiple logistic regression analysis was used to identify factors associated with HCWs’ knowledge and attitudes towards hand hygiene.
Results
Of 120 respondents, 65.8% and 67.5% demonstrated appropriate knowledge and a positive attitude, respectively, regarding all 5 hand hygiene moments. Logistic regression indicated better knowledge of hand hygiene in workers who were over 30 years old, who were direct HCWs (rather than managers), who had frequent access to clinical information, and who received their clinical information from training. Those who worked in infectious and tropical disease wards, who had frequent access to clinical information, and who received information from training were more likely to have a positive attitude towards hand hygiene than their counterparts.
Conclusions
Although many Vietnamese HCWs displayed moderate knowledge and positive attitudes towards the WHO hand hygiene guidelines, a key gap remained. Regular education and training programs are needed to increase knowledge and to improve attitudes and practices towards hand hygiene. Furthermore, a combination of multimodal strategies and locally-adapted interventions is needed for sustainable hand hygiene adherence.

Summary

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Associations Between Activities Outside Work and Presenteeism Among Korean Wage Workers: An Analysis Using a Nationwide Survey: Sung Won Jung, June-Hee Lee, Kyung-Jae Lee; J Prev Med Public Health. 2019;52(5):292-298. Published online August 2, 2019; DOI: https://doi.org/10.3961/jpmph.19.132

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Abstract Summary PDF

Objectives
Presenteeism is currently recognized as a significant global health issue that can potentially cause productivity losses. Hence, many studies have analyzed the relationships between workplace factors and presenteeism. However, few studies have considered non-occupational factors. This study examined the associations between presenteeism and activities outside work, including volunteering, self-development, leisure/sports, and gardening and house repair activities, in Korean wage workers.
Methods
This study analyzed the fourth Korean Working Conditions Survey, in which a total of 19 294 wage workers participated. To identify relationships between presenteeism and activities outside work, multivariate logistic regression analysis was used after adjusting for general and occupational characteristics.
Results
Self-development and leisure/sports activities significantly increased the odds ratio (OR) of presenteeism (OR, 1.166; 95% confidence interval [CI], 1.061 to 1.282 and OR, 1.276; 95% CI, 1.181 to 1.379, respectively).
Conclusions
Certain activities outside work, such as self-development or leisure/sports, were related to presenteeism among Korean wage workers. Although many previous studies have emphasized the positive effects of those activities on health, this study documented negative effects of these activities outside work on health.

Summary

Korean summary
본 연구는 제4차 근로환경조사를 통해 한국인 임금근로자들에서 다양한 ‘업무 외 활동’과 프리젠티즘과의 연관성을 알아보았다. 자기계발 및 레저/스포츠활동 등의 ‘업무 외 활동’에 참여할 경우 프리젠티즘 위험도가 상승했으며, 이를 통해 자기계발의 긍정적인 역할을 강조 하였던 기존 연구들과는 달리 ‘업무 외 활동’의 부정적인 면을 확인 할 수 있었다.

Citations

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Investigating Associations Between Physical Activity and Presenteeism – A Scoping Review
Valérie Hervieux, Caroline Biron, Justine Dima
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Review

A Scoping Review of Components of Physician-induced Demand for Designing a Conceptual Framework: Marita Mohammadshahi, Shahrooz Yazdani, Alireza Olyaeemanesh, Ali Akbari Sari, Mehdi Yaseri, Sara Emamgholipour Sefiddashti; J Prev Med Public Health. 2019;52(2):72-81. Published online December 31, 2018; DOI: https://doi.org/10.3961/jpmph.18.238

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Abstract PDF Supplementary Material

Objectives
The current study presents a new conceptual framework for physician-induced demand that comprises several influential components and their interactions.
Methods
This framework was developed on the basis of the conceptual model proposed by Labelle. To identify the components that influenced induced demand and their interactions, a scoping review was conducted (from January 1980 to January 2017). Additionally, an expert panel was formed to formulate and expand the framework.
Results
The developed framework comprises 2 main sets of components. First, the supply side includes 9 components: physicians’ incentive for pecuniary profit or meeting their target income, physicians’ current income, the physician/population ratio, service price (tariff), payment method, consultation time, type of employment of physicians, observable characteristics of the physician, and type and size of the hospital. Second, the demand side includes 3 components: patients’ observable characteristics, patients’ non-clinical characteristics, and insurance coverage.
Conclusions
A conceptual framework that can clearly describe interactions between the components that influence induced demand is a critical step in providing a scientific basis for understanding physicians’ behavior, particularly in the field of health economics.

Summary

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Original Articles

Probability of Early Retirement Among Emergency Physicians: Jaemyeong Shin, Yun Jeong Kim, Jong Kun Kim, Dong Eun Lee, Sungbae Moon, Jae Young Choe, Won Kee Lee, Hyung Min Lee, Kwang Hyun Cho; J Prev Med Public Health. 2018;51(3):154-162. Published online May 17, 2018; DOI: https://doi.org/10.3961/jpmph.18.079

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Abstract PDF Supplementary Material

Objectives
Early retirement occurs when one’s job satisfaction suffers due to employment mismatch resulting from factors such as inadequate compensation. Medical doctors report high levels of job stress and burnout relative to other professionals. These levels are highest among emergency physicians (EPs), and despite general improvements in their working conditions, early retirement continues to become more common in this population. The purpose of this study was to identify the factors influencing EPs intention to retire early and to develop a probability equation for its prediction.
Methods
A secondary analysis of data from the 2015 Korean Society of Emergency Physicians Survey was performed. The variables potentially influencing early retirement were organized into personal characteristics, extrinsic factors, and intrinsic factors. Logistic regression analysis was performed to identify risk factors and to develop a probability equation; these findings were then arranged in a nomogram.
Results
Of the 377 survey respondents included in the analysis, 48.0% intended to retire early. Risk factors for early retirement included level of satisfaction with the specialty and its outlook, slanderous reviews, emergency room safety, health status, workload intensity, age, and hospital type. Intrinsic factors (i.e., slanderous reviews and satisfaction with the specialty and its outlook) had a stronger influence on early retirement than did extrinsic factors.
Conclusions
To promote career longevity among EPs, it is vital to improve emergency room safety and workload intensity, to enhance medical professionalism through a stronger vision of emergency medicine, and to strengthen the patient-doctor relationship.

Summary

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Barriers to Health Service Utilization Among Iranian Female Sex Workers: A Qualitative Study: Mehran Asadi-Aliabadi, Jamileh Abolghasemi, Shahnaz Rimaz, Reza Majdzadeh, Fereshteh Rostami-Maskopaee, Effat Merghati-Khoei; J Prev Med Public Health. 2018;51(2):64-70. Published online February 6, 2018; DOI: https://doi.org/10.3961/jpmph.17.174

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Abstract PDF

Objectives
In most countries around the world, sex work is an illegal activity. Female sex workers (FSWs) in Iran hide their identities, and they are known to be a hard-to-reach population. Despite free access to HIV testing, fewer than half of FSWs receive HIV testing. The purpose of this study was to characterize the reasons for which FSWs do not seek testing at drop-in centers (DICs) and voluntary counseling and testing (VCT) centers in Iran. Methods: A qualitative study was conducted in 2016. The participants were 24 FSWs who received services at VCT centers and DICs for vulnerable females in the north of Iran and 9 males who were the clients of FSWs. In this study, we made use of purposive sampling and carried out a thematic analysis. Results: We found 4 major and 6 minor themes. The major themes were: fear of being infected (with HIV), stigma, indifference, and knowledge. Conclusions: Despite the significant efforts made by the government of Iran to establish and expand DICs for vulnerable females, the number of FSWs receiving services at these centers has not been very considerable. Consequently, by introducing and implementing training programs for peer groups, it may be possible to take steps toward establishing strategic programs for the control and prevention of HIV/AIDS.

Summary

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Peer Smoking and Smoking-related Beliefs Among College Students in Bangladesh: Akiko Kamimura, Zobayer Ahmmad, Mu Pye, Bethany Gull; J Prev Med Public Health. 2018;51(1):51-58. Published online January 22, 2018; DOI: https://doi.org/10.3961/jpmph.17.146

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Abstract PDF

Objectives
Smoking is a significant public health issue in Bangladesh. The purpose of this study was to examine peer smoking and smoking-related beliefs among college students in Bangladesh.
Methods
College students at two universities in Dhaka, Bangladesh participated in a self-administered survey in May and June 2017.
Results
First, being a current or former smoker is associated with lower levels of beliefs among respondents that they would not smoke even with smoker friends or nervousness, and lower levels of intentions that they would not smoke, while current smokers and former smokers have different smoking-related beliefs. Second, having smoker friends is associated with lower levels of intentions that they would not smoke. Third, higher levels of normative beliefs that it is important not to smoke are associated with higher levels of beliefs that they would not smoke even with smoker friends or nervousness, higher levels of intentions that they would not smoke, and higher levels of avoidance of smoking.
Conclusions
Smoking-related beliefs and perceived norms in individuals’ social networks are important components in promoting tobacco cessation in Bangladesh. But it is challenging to prevent or intervene in smoking because of the high rates of smoking in this country and the high prevalence of smokers in individuals’ social networks. Future studies should examine the most effective interventions to combat smoking in high-smoking social networks, such as using mobile apps or social media, and evaluate the effectiveness of such interventions.

Summary

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Reconstruction of Radiation Dose Received by Diagnostic Radiologic Technologists in Korea: Yeongchull Choi, Jaeyoung Kim, Jung Jeung Lee, Jae Kwan Jun, Won Jin Lee; J Prev Med Public Health. 2016;49(5):288-300. Published online August 23, 2016; DOI: https://doi.org/10.3961/jpmph.16.064

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Abstract PDF Supplementary Material

Objectives
Diagnostic medical radiation workers in Korea have been officially monitored for their occupational radiation doses since 1996. The purpose of this study was to design models for reconstructing unknown individual radiation doses to which diagnostic radiation technologists were exposed before 1996.
Methods
Radiation dose reconstruction models were developed by using cross-sectional survey data and the personal badge doses of 8167 radiologic technologists. The models included calendar year and age as predictors, and the participants were grouped into six categories according to their sex and facility type. The annual doses between 1971 and 1995 for those who were employed before 1996 were estimated using these models.
Results
The calendar year and age were inversely related to the estimated radiation doses in the models of all six groups. The annual median estimated doses decreased from 9.45 mSv in 1971 to 1.26 mSv in 1995, and the associated dose variation also decreased with time. The estimated median badge doses from 1996 (1.22 mSv) to 2011 (0.30 mSv) were similar to the measured doses (1.68 mSv to 0.21 mSv) for the same years. Similar results were observed for all six groups.
Conclusions
The reconstruction models developed in this study may be useful for estimating historical occupational radiation doses received by medical radiologic technologists in Korea.

Summary

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Public Participation in the Process of Local Public Health Policy, Using Policy Network Analysis: Yukyung Park, Chang-yup Kim, Myoung Soon You, Kun Sei Lee, Eunyoung Park; J Prev Med Public Health. 2014;47(6):298-308. Published online November 11, 2014; DOI: https://doi.org/10.3961/jpmph.14.029

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Abstract PDF: Objectives
To assess the current public participation in-local health policy and its implications through the analysis of policy networks in health center programs.
Methods
We examined the decision-making process in sub-health center installations and the implementation process in metabolic syndrome management program cases in two districts (‘gu’s) of Seoul. Participants of the policy network were selected by the snowballing method and completed self-administered questionnaires. Actors, the interactions among actors, and the characteristics of the network were analyzed by Netminer.
Results
The results showed that the public is not yet actively participating in the local public health policy processes of decision-making and implementation. In the decision-making process, most of the network actors were in the public sector, while the private sector was a minor actor and participated in only a limited number of issues after the major decisions were made. In the implementation process, the program was led by the health center, while other actors participated passively.
Conclusions
Public participation in Korean public health policy is not yet well activated. Preliminary discussions with various stakeholders, including civil society, are needed before making important local public health policy decisions. In addition, efforts to include local institutions and residents in the implementation process with the public officials are necessary to improve the situation.; Summary

Epidemiological Investigation of an Outbreak of Hepatitis A at a Residential Facility for the Disabled, 2011: Hyun-Sul Lim, Kumbal Choi, Saerom Lee; J Prev Med Public Health. 2013;46(2):62-73. Published online March 28, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.2.62

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Abstract PDF

Objectives

An outbreak of hepatitis A occurred at a residential facility for the disabled in July 10, 2011. This investigation was carried out to develop a response plan, and to find the infection source of the disease.

Methods

A field epidemiologist investigated the symptoms, vaccination histories, living environments, and probable infection sources with 51 residents and 31 teachers and staff members. In July 25, 81 subjects were tested for the hepatitis A virus antibody, and specimens of the initial 3 cases and the last case were genetically tested.

Results

Three cases occurred July 10 to 14, twelve cases August 3 to 9, and the last case on August 29. Among the teachers and staff, no one was IgM positive (on July 25). The base sequences of the initial 3 and of the last case were identical. The vehicle of the outbreak was believed to be a single person. The initial 3 patients were exposed at the same time and they might have disseminated the infection among the patients who developed symptoms in early August, and the last patient might have, in turn, been infected by the early August cases.

Conclusions

The initial source of infection is not clear, but volunteers could freely come into contact with residents, and an infected volunteer might have been the common infection source of the initial patients. Volunteers' washing their hands only after their activity might be the cause of this outbreak. Although there may be other possible causes, it would be reasonable to ask volunteers to wash their hands both before and after their activities.

Summary

Citations

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From Outbreak to Action: The Need for Policy Change Based on Epidemiological Investigation of Hepatitis A in a Special Care Setting in Central Kerala
Sangeetha Merrin Varghese, C. S. Nandini, Amar Fettle, Abey Sushan, Libu Gnanaseelan Kanakamma, A. L. Sheeja, Betsy A. Jose, P. B. Boban, Prince Alexander
Archives of Medicine and Health Sciences.2025; 13(1): 23. CrossRef
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Noele P. Nelson, Mark K. Weng, Megan G. Hofmeister, Kelly L. Moore, Mona Doshani, Saleem Kamili, Alaya Koneru, Penina Haber, Liesl Hagan, José R. Romero, Sarah Schillie, Aaron M. Harris
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The Relationship Between the Social Network of Community-living Elders and Their Health-related Quality of Life in Korean Province: Jun Tae Lim, Jong-Heon Park, Jin-Seok Lee, Juhwan Oh, Yoon Kim; J Prev Med Public Health. 2013;46(1):28-38. Published online January 31, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.1.28

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Abstract PDF

Objectives

This study aimed to collect information that will help enhance the social networks and improve the quality of life among elderly people by observing the relationship between their social network and health-related quality of life (HRQoL) and by analyzing social network factors affecting HRQoL.

Methods

This study was based on the 2008 Community Health Survey in Yeoncheon County. Three hundred elders were included in the study population. We compared the revised Lubben Social Network Scale (LSNS-R) score and Euro quality of life-5 dimensions health status index by demographic characteristics and chronic disease prevalence. We analyzed the data using multiple regression and tobit regression by setting the HRQoL as the dependent variable and social network and other characteristics as the independent variables. We analyzed social network factors by using factor analysis.

Results

The LSNS-R score differed significantly according to age and existence of a spouse. According to the results from the hierarchical multiple regression analysis, the LSNS-R explained 0.10 of the variance and LSNS-R friends factor explained 0.10 of the variance. The tobit regression indicated that the contribution of the LSNS-R family size factor to the regression coefficient of the independent variable that affected the HRQoL was B_T=2.96, that of the LSNS-R family frequency factor was B_T=3.60, and that of LSNS-R friends factor was B_T=5.41.

Conclusions

Social networks among elderly people had a significant effect on HRQoL and their networks of friends had a relatively higher effect than those of family members.

Summary

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Special Article

Mental Exercises for Cognitive Function: Clinical Evidence: Ryuta Kawashima; J Prev Med Public Health. 2013;46(Suppl 1):S22-S27. Published online January 30, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.S.S22

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Abstract PDF

The purpose of this study was to examine the beneficial effects of a new cognitive intervention program designed for the care and prevention of dementia, namely Learning Therapy. The training program used systematized basic problems in arithmetic and Japanese language as training tasks. In study 1, 16 individuals in the experimental group and 16 in the control group were recruited from a nursing home. In both groups, all individuals were clinically diagnosed with senile dementia of the Alzheimer type. In study 2, we performed a single-blind, randomized controlled trial in our cognitive intervention program of 124 community-dwelling seniors. In both studies, the daily training program using reading and arithmetic tasks was carried out approximately 5 days a week, for 15 to 20 minutes a day in the intervention groups. Neuropsychological measures were determined simultaneously in the groups both prior to and after six months of the intervention. The results of our investigations indicate that our cognitive intervention using reading and arithmetic problems demonstrated a transfer effect and they provide convincing evidence that cognitive training maintains and improves the cognitive functions of dementia patients and healthy seniors.

Summary

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Original Articles

Social Network Effects on Post-Traumatic Stress Disorder (PTSD) in Female North Korean Immigrants: Byungkyu Lee, Yoosik Youm; J Prev Med Public Health. 2011;44(5):191-200. Published online September 28, 2010; DOI: https://doi.org/10.3961/jpmph.2011.44.5.191

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Abstract PDF

Objectives

The goal of this paper is to examine the social network effects on post-traumatic sdress disorder (PTSD) in female North Korean immigrants who entered South Korea in 2007. Specifically, it attempts to verify if the density and composition of networks make a difference after controlling for the network size.

Methods

A multivariate logistic regression is used to probe the effects of social networks using the North Korean Immigrant Panel data set. Because the data set had only completed its initial survey when this paper was written, the analysis was cross-sectional.

Results

The size of the support networks was systematically related to PTSD. Female North Korean immigrants with more supporting ties were less likely to develop PTSD, even after controlling for other risk factors (odds-ratio for one more tie was 0.8). However, once we control for the size of the network, neither the density nor the composition of the networks remains statistically significant.

Conclusions

The prevalence of the PTSD among female North Korean immigrants is alarmingly high, and regardless of the characteristics of supporting network members, the size of the supporting networks provides substantial protection. This implies that a simple strategy that focuses on increasing the number of supporting ties will be effective among North Korean immigrants who entered South Korea in recent years.

Summary

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“Give and take is the key”: Reciprocity leads to psychological well-being of North Korean refugees in South Korea
Soim Park, Jennifer A. Wenzel, Jin-Won Kim, Pamela J. Surkan
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Association between social networks and symptoms of post-traumatic stress during the pandemic: Cohort study in South Korea
Ji Su Yang, Yu Jin Lee, Hyeon Chang Kim, Chul-Hyun Cho, Alexander C. Tsai, Sun Jae Jung
Comprehensive Psychiatry.2023; 127: 152432. CrossRef
Lonely in the Dark: Trauma Memory and Sex‐Specific Dysregulation of Amygdala Reactivity to Fear Signals
Mitjan Morr, Jeanine Noell, Daphne Sassin, Jule Daniels, Alexandra Philipsen, Benjamin Becker, Birgit Stoffel‐Wagner, René Hurlemann, Dirk Scheele
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Elizabeth A. Olson, Tate A. Overbey, Caroline G. Ostrand, Diego A. Pizzagalli, Scott L. Rauch, Isabelle M. Rosso
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Subin Park, Minji Lee, Jin Jeon
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Frequency and Related Factors of Masked Hypertension at a Worksite in Korea: Sang-Kyu Kim, Jun-Ho Bae, Dung-Young Nah, Dong-Wook Lee, Tae-Yoon Hwang, Kyeong-Soo Lee; J Prev Med Public Health. 2011;44(3):131-139. Published online May 17, 2010; DOI: https://doi.org/10.3961/jpmph.2011.44.3.131

13,810 View
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Abstract PDF

Objectives

Masked hypertension is associated with metabolic risks and increased risk of cardiovascular disease. The purpose of this study was to identify the frequency of and risk factors of masked hypertension in Korean workers.

Methods

The study was conducted among 121 employees at a hotel in Gyeongju, Korea, from December 2008 to February 2009. We measured blood pressure (BP) both in the clinic and using 24-hour ambulatory BP monitors for all subjects. Hypertension was defined independently by both methods, and subjects were classified into four groups: true normotension, masked hypertension, white coat hypertension, and sustained hypertension.

Results

The frequency of masked hypertension in our study group was 25.6%. Compared with true normotension, the factors related to masked hypertension were male gender (odds ratio [OR], 10.7; 95% confidence interval [CI], 1.41 to 81.09), aging one year (OR, 0.88; 95% CI, 0.78 to 0.99), clinic BP 120-129/80-84 mmHg (OR, 8.42; 95% CI, 1.51 to 46.82), clinic BP 130-139 / 85-89 mmHg (OR, 12.14; 95% CI, 1.80 to 81.85), smoking (OR, 5.51; 95% CI, 1.15 to 26.54), and increase of total cholesterol 1 mg / dL (OR, 1.05; 95% CI, 1.02 to 1.08). In males only, these factors were clinic BP 120-129 / 80-84 mmHg (OR, 15.07; 95% CI, 1.55 to 146.19), clinic BP 130-139 / 85-89 mmHg (OR, 17.16; 95% CI, 1.56 to 189.45), smoking (OR, 11.61; 95% CI, 1.52 to 88.62), and increase of total cholesterol 1 mg/dL (OR, 1.05; 95% CI, 1.01 to 1.09).

Conclusions

The frequency of masked hypertension was high in our study sample. Detection and management of masked hypertension, a known strong predictor of cardiovascular risk, could improve prognosis for at-risk populations.

Summary

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English Abstract

Reliability of Self-Reported Information by Farmers on Pesticide Use.: Yo Han Lee, Eun Shil Cha, Eun Kyeong Moon, Kyoung Ae Kong, Sang Baek Koh, Yun Keun Lee, Won Jin Lee; J Prev Med Public Health. 2010;43(6):535-542.; DOI: https://doi.org/10.3961/jpmph.2010.43.6.535

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Abstract PDF

OBJECTIVES
Exposure assessment is a major challenge faced by studies that evaluate the association between pesticide exposure and adverse health outcomes. The objective of this study was to investigate the reliability of information that farmers self-report regarding their pesticide use. METHODS: Twenty five items based upon existing questionnaires were designed to focus on pesticide exposure. In 2009 a self-administrated survey was conducted on two occasions four weeks apart among 205 farmers residing in Gyeonggi and Gangwon provinces. For a reliability measure, we calculated the percentage agreement, the kappa statistics and the intraclass correlation coefficient (ICC) between the two reports according to the characteristics of the subjects. RESULTS: Agreement for ever-never use of any pesticide was 96.4% (kappa 0.61). For both 'years used' and 'age at the first use' of overall pesticides, high agreement was obtained (ICC: 0.88 and, 0.78, respectively), whereas those of 'days used' and 'hours used' were relatively low (ICC: 0.42 and, 0.66, respectively). The kappa value for the use of personal protective equipment ranged from 0.46 to 0.59, and hygiene activities came out at 0.19 to 0.37. The agreement for individual pesticide use ranged widely and there was relatively low agreement due to the low response rates. The reliability scores did not significantly vary according to gender, age, the education level, the types of crop or the years of farming. CONCLUSIONS: Our results support that carefully designed, self-reported information on ever-never pesticide use among farmers is reliable. However, the reliability of data on individual pesticide exposure may be unstable due to low response rates and needs to be refined.

Summary

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William Mueller, Aggrey Atuhaire, Ruth Mubeezi, Iris van den Brenk, Hans Kromhout, Ioannis Basinas, Kate Jones, Andrew Povey, Martie van Tongeren, Anne-Helen Harding, Karen S. Galea, Samuel Fuhrimann
International Journal of Hygiene and Environmental Health.2022; 240: 113911. CrossRef
Recall of exposure in UK farmers and pesticide applicators: trends with follow-up time
William Mueller, Kate Jones, Hani Mohamed, Neil Bennett, Anne-Helen Harding, Gillian Frost, Andrew Povey, Ioannis Basinas, Hans Kromhout, Martie van Tongeren, Samuel Fuhrimann, Karen S Galea
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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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Meta-Analysis

Radiation Exposure and Cancer Mortality Among Nuclear Power Plant Workers: a Meta-analysis.: Eun Sook Park, Kieun Moon, Han Na Kim, Won Jin Lee, Young Woo Jin; J Prev Med Public Health. 2010;43(2):185-192.; DOI: https://doi.org/10.3961/jpmph.2010.43.2.185

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Abstract PDF

OBJECTIVES
We conducted a meta-analysis to investigate the relationship between low external doses of ionizing radiation exposure and the risk of cancer mortality among nuclear power plant workers. METHODS: We searched MEDLINE using key words related to low dose and cancer risk. The selected articles were restricted to those written in English from 1990 to January 2009. We excluded those studies with no fit to the selection criteria and we included the cited references in published articles to minimize publication bias. Through this process, a total of 11 epidemiologic studies were finally included. RESULTS: We found significant decreased deaths from all cancers (SMR = 0.75, 95% CI = 0.62 - 0.90), all cancers excluding leukemia, solid cancer, mouth and pharynx, esophagus, stomach, rectum, liver and gallbladder, pancreas, lung, prostate, lymphopoietic and hematopoitic cancer. The findings of this meta-analysis were similar with those of the 15 Country Collaborative Study conducted by the International Agency for Research on Cancer. A publication bias was found only for liver and gallbladder cancer (p = 0.015). Heterogeneity was observed for all cancers, all cancers excluding leukemia, solid cancer, esophagus, colon and lung cancer. CONCLUSIONS: Our findings of low mortality for stomach, rectum, liver and gallbladder cancers may explained by the health worker effect. Yet further studies are needed to clarify the low SMR of cancers, for which there is no useful screening tool, in nuclear power plant workers.

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

Assessment of Village Health Worker Training Program in Tuguegarao, Philippine.: Jung Min Kim, Kwang Wook Koh, Chul Ho Oak, Woo Hyuk Jung, Sung Hyun Kim, Dae Hee Park; J Prev Med Public Health. 2009;42(6):377-385.; DOI: https://doi.org/10.3961/jpmph.2009.42.6.377

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Abstract PDF

OBJECTIVES
This study was performed to evaluate the effectiveness of 'village health worker training program' which aimed to build community participatory health promotion capacity of community leaders in villages of low developed country and to develop methods for further development of the program. METHODS: The intervention group were 134 community leaders from 25 barangays (village). Control group were 149 form 4 barangays. Intervention group participated 3-day training program. Questionnaire was developed based on 'Health Promotion Capacity Checklist' which assessed capacity in 4 feathers; 'knowledge', 'skill', 'commitment', and 'resource'. Each feather was assessed in 4 point rating scale. Capacity scores between intervention group and control group were examined to identify changes between the pre- and post-intervention periods. A qualitative evaluation of the program was conducted to assess the appropriateness of the program. The program was conducted in Tuguegarao city, Philippine in January, 2009. RESULTS: The result showed significant increases in the total health promotion capacity and each feather of health promotion capacities between pre and post assessment of intervention group. But there was no significant change in that of control group. Participants marked high level of satisfaction for preparedness, selection of main subjects and education method. Qualitative evaluation revealed that training program facilitated community participatory health promotion capacity of participants. CONCLUSIONS: This study suggested that the Village health worker training program is effective for building health promotion capacity of community leaders and it can be a main method for helping low developed countries with further development.

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English Abstracts

Lifestyle and Metabolic Syndrome among Male Workers in an Electronics Research and Development Company.: Jun Pyo Myong, Hyoung Ryoul Kim, Yong Kyu Kim, Jung Wan Koo, Chung Yill Park; J Prev Med Public Health. 2009;42(5):331-336.; DOI: https://doi.org/10.3961/jpmph.2009.42.5.331

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Abstract PDF

OBJECTIVES
The objectives of this study were to determine the relationship between lifestyle-implementation and metabolic syndrome in an electronics research and development company, and to provide a foundation for health providers of health management programs for setting priorities. METHODS: From July 1 to July 16, 2008 we carried out a descriptive cross-sectional survey. Consecutive workers of one R & D company in Seoul, Korea (N=2,079) were enrolled in study. A checklist for lifestyle (from the National Health Insurance Corporation) consisted of questions regarding diet, drinking, smoking and exercise. After the survey, researchers obtained data from health profiles for metabolic syndrome(waist-circumference, triglycerides, HDL cholesterol, blood pressure and fasting blood sugar level). Lifestyle was recorded as good or not good. Statistical analysis of metabolic syndrome and the lifestyle of subjects was done using multiple logistic regression analysis. RESULTS: The prevalence of metabolic syndrome in our study gropu was 13.3% (N=277). After adjustment for age, the adjusted odds ratios (odds ratio, 95% confidence intervals) for metabolic syndrome increased in proportion to the number of bad habits: two (1.72, 1.23-2.44), three (2.47, 1.73-3.56), and four (3.63, 2.03-6.34). Relative to subjects eating both vegetables and meat', the OR for 'meat' eaters was 1.66 (1.18-2.31). Compared with 'non-smokers and ever-smoker', the OR for 'current-smoker' was 1.62 (1.25-2.10). Compared with 'Healthy drinker', the OR for 'unhealthy drinker' was 1.38 (1.05-1.83). CONCLUSIONS: Poor lifestyle was associated with an increased likelihood of metabolic syndrome. These findings suggest that lifestyle-based occupational health interventions for young employees should include a specific diet, smoking cessation, and healthy-drinking programs.

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Prince Osei Akumiah, Kwabena Opoku-Addai, Adwoa Safowaa, Akosua Serwaa Akumiah
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Hosihn Ryu, Dal Lae Chin
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Dae-Sik Ko, Bu-Yeon Park, Gyeong-Hyu Seok
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Jong Uk Won, Oi Saeng Hong, Won Ju Hwang
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Employment and Married Women's Health in Korea; Beneficial or Harmful?.: Il Ho Kim, Heeran Chun; J Prev Med Public Health. 2009;42(5):323-330.; DOI: https://doi.org/10.3961/jpmph.2009.42.5.323

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OBJECTIVES
The aim of this study was to investigate whether working married women in different occupational classes affected diverse health outcomes. METHODS: We used data for married women aged 25-59 (N=2,273) from the 2005 National Health and Nutritional Examination Survey. Outcome measures included physical/mental and subjective/objective indicators (self-rated poor health, chronic diseases, depression, and suicidal ideation from reported results; metabolic syndrome and dyslipidemia from health examination results). Age-standardized prevalence and logistic regression were employed to assess health status according to three types of working groups (housewives, married women in manual jobs, married women in non-manual jobs). Sociodemographic factors (age, numbers of children under 7, education, household income) and health behaviors (health examination, sleep, rest, exercise, smoking, drinking) and a psychological factor (stress) were considered as covariates. RESULTS: Non-manual married female workers in Korea showed better health status in all five health outcomes than housewives. The positive health effect for the non-manual group persisted in absolute (age-adjusted prevalence) and relative (odds ratio) measures, but multivariate analyses showed an insignificant association of the non-manual group with dyslipidemia. Manual female workers showed significantly higher age-adjusted prevalence of almost all health outcomes than housewives except chronic disease, but the associations disappeared after further adjustment for covariates regarding sleep, rest, and stress. CONCLUSIONS: Our results suggest that examining the health impact of work on married women requires the consideration of occupational class.

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Original Article

Workplace Smoking Ban Policy and Smoking Behavior.: Beomsoo Kim; J Prev Med Public Health. 2009;42(5):293-297.; DOI: https://doi.org/10.3961/jpmph.2009.42.5.293

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Abstract PDF

OBJECTIVES
To evaluate the impact of the workplace smoking ban in South Korea, where the male smoking rate is high (57%), on smoking behavior and secondhand smoke exposure. METHODS: A workplace smoking ban legislation implemented in April 2003 requires offices, meeting rooms, and lobbies located in larger than 3,000 square meter buildings (or 2,000 square meter multipurpose buildings) should be smoke free. A representative cross-sectional survey, the third wave (2005) of health supplements in the National Health Nutrition Survey of South Korea, was used to measure the impact of the 2003 workplace smoking ban implementation on smoking behavior. It contained 3,122 observations of adults 20 to 65 years old (excluding self-employed and non-working populations). A multivariate statistical model was used. The self-reported workplace smoking ban policy (full workplace ban, partial workplace ban, and no workplace ban) was used as the key measure. RESULTS: A full workplace smoking ban reduced the current smoking rate by 6.4 percentage points among all workers and also decreased the average daily consumption among smokers by 3.7 cigarettes relative to no smoking ban. Secondhand smoke showed a dramatic decrease of 86 percent (= -1.74/2.03)from the sample mean for full workplace ban. However, public anti-smoking campaign did not show any significant impact on smoking behavior. CONCLUSIONS: The full workplace ban policy is effective in South Korea. Male group showed bigger impact of smoking ban policy than female group. The public antismoking campaign did not show any effectiveness.

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English Abstracts

Measuring Workload of Home Visit Care Activities Using Relative Values.: Seong Ok Han, Eun Cheol Park, Dae Ryong Kang, Im Ok Kang; J Prev Med Public Health. 2008;41(5):331-338.; DOI: https://doi.org/10.3961/jpmph.2008.41.5.331

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Abstract PDF: OBJECTIVES
The purpose of this study was to measure the workload of home visit care activities and their relative values. This study examined also factors that affect the workload of home visit care activities. METHODS: The participants of this study were 126 homehelpers of 50 home visit care agencies at the 2nd Longterm Care Insurance Demonstration Project. The workload of home visit care activities was divided into total work and four dimensions ; physical efforts, mental efforts, stress and time. Home visit care activities consisted of four categories with 24 items. We used magnitude estimation method to measure their relative values of the four dimensions. The participants answered the relative values of each activities based on the reference service. We used the activity for supporting their elderly's evacuation as the reference service. RESULTS: Most of the respondents were over 40 years old female. They consumed most their time supporting elderly's going out. They consumed their highest physical, mental efforts, and stress for activities of coping with emergency situation. The Pearson correlation coefficients showed significant relationships between workload and each dimensions. This study showed that all four dimensions are statistically significant predictors of workload of home visit care activities. Also, we found that the home-helper's career affects the workload of home visit care activities. CONCLUSIONS: The workload of home visit care activities could be explained by physical efforts, mental efforts, stress and time.; Summary

Analysis of Policies in Activating the Infectious Disease Specialist Network (IDSN) for Bioterrorism Events.: Yang Soo Kim; J Prev Med Public Health. 2008;41(4):214-218.; DOI: https://doi.org/10.3961/jpmph.2008.41.4.214

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Abstract PDF

Bioterrorism events have worldwide impacts, not only in terms of security and public health policy, but also in other related sectors. Many countries, including Korea, have set up new administrative and operational structures and adapted their preparedness and response plans in order to deal with new kinds of threats. Korea has dual surveillance systems for the early detection of bioterrorism. The first is syndromic surveillance that typically monitors non-specific clinical information that may indicate possible bioterrorismassociated diseases before specific diagnoses are made. The other is infectious disease specialist network that diagnoses and responds to specific illnesses caused by intentional release of biologic agents. Infectious disease physicians, clinical microbiologists, and infection control professionals play critical and complementary roles in these networks. Infectious disease specialists should develop practical and realistic response plans for their institutions in partnership with local and state health departments, in preparation for a real or suspected bioterrorism attack.

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Byung-Chul Chun, Kyeong-Uoon Kim, Jee-Hee Kim, Jin-Woo Kim, Sang-Gyun Roh
Journal of the Korea Academia-Industrial cooperation Society.2012; 13(2): 710. CrossRef
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Original Articles

Efficient DRG Fraud Candidate Detection Method Using Data Mining Techniques.: Duho Hong, Jung Kyu Lee, Min Woo Jo, Kidong Park, Sang Il Lee, Moo Song Lee, Chang Yup Kim, Yong Ik Kim; Korean J Prev Med. 2003;36(2):147-152.

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Abstract PDF: OBJECTIVES
To develop a Diagnosis-Related Group (DRG) fraud candidate detection method, using data mining techniques, and to examine the efficiency of the developed method. METHODS: The study included 79, 790 DRGs and their related claims of 8 disease groups (Lens procedures, with or without, vitrectomy, tonsillectomy and/or adenoidectomy only, appendectomy, Cesarean section, vaginal delivery, anal and/or perianal procedures, inguinal and/or femoral hernia procedures, uterine and/or adnexa procedures for nonmalignancy), which were examined manually during a 32 months period. To construct an optimal prediction model, 38 variables were applied, and the correction rate and lift value of 3 models (decision tree, logistic regression, neural network) compared. The analyses were performed separately by disease group. RESULTS: The correction rates of the developed method, using data mining techniques, were 15.4 to 81.9%, according to disease groups, with an overall correction rate of 60.7%. The lift values were 1.9 to 7.3 according to disease groups, with an overall lift value of 4.1. CONCLUSIONS: The above findings suggested that the applying of data mining techniques is necessary to improve the efficiency of DRG fraud candidate detection.; Summary

The Impact of New Work Organizational System on Job Strain, and Psychosocial Distress.: Sang Baek Koh, Sei Jin Chang, Byeong Hwan Sun, Dong Muk Kang, Mia Son, Jong Ku Park, Bong Suk Cha; Korean J Prev Med. 2003;36(1):71-76.

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Abstract PDF: OBJECTIVES
New organizational work systems, and their impact on the mental health of employees, are considered to beone of the most important topics in the area of industrial health. This study was conducted to compare job characteristics (job demand and decision latitude) levels, and psychosocial distress of workers in acompany introducing to new organizational work systems, to those of workers managed by traditional work systems. METHODS: A study sample of 627 shipbuilding workers (446the new work organizational system and 181the traditional system) were recruited for this study. A structured-questionnaire was used to assess general characteristics, job characteristics (work demand, decision latitude), and psychosocial distress. RESULTS: The decision latitude was not significantly higher in the new work system compared to the traditional system. However, the job demand was significantly higher in the new work system than in the traditional system. The psychosocial distress was higher within the new work system than the traditional system, but no significant relationships were found. The proportion of increased strain was significantly greater with the new system than the traditional system. CONCLUSION: These results suggest that increases in the decision latitude did not sufficiently compensate for higher job strain or increased work intensity. If the increase in the decision latitude was temporary, with the typical job demand remaining high, such work can be still be considered to have a job strain. Future research should consider psychosocial distress and fatigue as important problems caused by new work organizational systems, and should be performed to assess their impact through out industry.; Summary

Cohort Study for the Effect of Chronic Noise Exposure on Blood Pressure among Male Workers.: Ji Ho Lee, Tae Joon Cha, Jang Rak Kim, Weechang Kang, Seung Rim Yaang, Choong Ryeol Lee, Cheol In Yoo; Korean J Prev Med. 2002;35(3):205-213.

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Abstract PDF: OBJECTIVE
Whether exposure to chronic noise induces an increase in blood pressure, or the development of hypertension, has not been established. A cohort study was performed to identify the effects of chronic noise exposure on blood pressure. METHODS: 530 males working at a metal manufacturing factory in Busan, Korea were enrolled for the study. They were monitored for 9 consecutive years, from 1991 to 1999, with an annual health check-up. The subjects were divided into 4 groups, which were determines by noise level categories(NLC) according to noise intensity ; NLC-I: office workers, exposed to noise a level below 60dB(A); NLC-II: field technical supporters or supervisors, frequently exposed to workplace noise, wearing no hearing protection device; NLC-III: workers, exposed to workplace noise below 85 dB(A), wearing ear plugs or muffs; NLC-IV: workers, exposed to workplace noise over 85 dB(A), wearing both ear plugs and muffs. RESULTS: After controlling possible confoundens, such as baseline age, smoking, alcohol intake, exercise, family history of hypertension, systolic(SBP) or diastolic blood pressure(DBP) and changes in BMI (body mass index), the pooled mean for the systolic blood pressures, over the duration of the study period, were 3.8mmHg, 2.0mmHg and 1.7mmHg higher in NLC-IV, NLC-III NLC-II groups, respectively, than in the NLC-I group. There were no significant differences in the diastolic blood pressures between the groups. CONCLUSION: This study suggests that chronic noise exposure increases systolic blood pressure independently, among male workers.; Summary

Maternal Working Conditions on Adverse Pregnancy Outcomes: A Prospective Cohort Study.: Jung Jin Cho, Ji Yong Kim, Jin Joo Chung, Kyung Sim Ko; Korean J Prev Med. 2002;35(3):197-204.

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Abstract PDF: OBJECTIVES
To evaluate the association between working conditions and adverse pregnancy outcomes in Korea. METHODS: We obtained data on health history, lifestyle, housework and working conditions, such as shift work, hours standing, working time, job demand, lifting at work and at home, between August and September 2000, from self-reported questionnaires. A group of 344, occupationally active, pregnant women from 51 industries were studied. Of the women studied, 328 women were further interviewed by telephone between November 2000 and September 2001. Result : Compared with daytime work, shift work increased the risk for preterm birth (an adjusted risk ratio of 2.74, 95% CI=1.02-2.62) and low birth weight (an adjusted risk ratio of 2.74, 95% CI=1.02-2.62). A significantly increased risk was found for prolonged standing, with an adjusted risk ratio of preterm births of 6.80 (95% CI=2.01-23.0). There were no significant differences in the incidence of spontaneous abortion between the occupational working conditions, with the exception of a previous history of spontaneous abortion. CONCLUSION: These findings suggest that maternal working conditions, such as shift work and prolonged standing, contribute significantly to preterm birth and low birth weight.; Summary

Job Stress and Its Related Factors in South Korean Doctors.: Yune Sik Kang, Sin Kam, Sang Won Lee, Byung Yeol Chun, Min Hae Yeh; Korean J Prev Med. 2001;34(2):141-148.

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Abstract PDF: OBJECTIVE
To investigate the sources, extent and related factors in South Korean doctors. METHODS: The study subjects were 934 doctors in Taegu, Kyungpook Province, Korea(540 independent practitioners, 105 employed at hospitals and 289 residents in training). Information concerning job stress was obtained using a 9-item questionnaire. Information regarding related factors such as demographic characteristics(age, sex, marital status), perceptions on the socioeconomic status of doctors and working conditions(work time, on-call days per week) was also obtained by self-administered questionnaire during April and May, 2000. RESULTS: Major sources of job stress included clnical responsibility/judgement factor, patient factor and work loading factor. The job stress score of residents was the highest among three groups. The score was lower in older doctors. The score was low among those who thought doctors socioeconomic status was not good. The longer the work time, the higher the job stress score was. Multiple regression analysis was conducted to control for the mutual influence of independent variables. In regression analysis, the score of residents was higher than practitioners. Work time and socioeconomic status perception had negative effects on job stress score. CONCLUSION: The average job stress score of the doctors was high. Age, work type, working conditions and perceptions of socioeconomic status were found to besignificantly related to job stress score. Although the job stress of doctors is somewhat inevitable due to the nature of the doctor's job, control of work time, development of coping tools and other intervention methods are needed to reduce job stress of doctors. Further studies are required to understand the characteristics of job stress and reduce the job stress of doctors.; Summary

Understanding the Occurrence of Lung Cancer in Foundry Workers through Health Insurance Data .: Yeon Soon Ahn, Jae Seok Song, Seong Kyu Kang, Ho Keun Chung; Korean J Prev Med. 2000;33(3):299-305.

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Abstract PDF: CONCLUSIONS: To investigate the difference in the occurrence of lung cancer between foundry workers and non-foundry workers by comparing the number of workers diagnosed with lung cancer through health insurance data. METHODS: The study population was comprised of 28,884 workers who had undergone at least one general or special medical examination between January 1995 and December 1997 at the occupational health center. All of the subjects had health insurance during this period. We combined the medical examination data with the health insurance data to compare the number of foundry workers diagnosed with lung cancer and the number of non-foundry workers diagnosed with lung cancer. RESULTS: Seven workers were diagnosed with lung cancer among the 1,591 foundry workers, compared to twelve workers among the 27,293 non-foundry workers (odds ratio: 10.04, 95% confidence interval: 3.95-25.55). The seven foundry workers diagnosed with lung cancer were all exposed to dust, and six out these seven workers were engaged in finishing or shake-out processes. CONCLUSIONS: Although the information for this study was obtained from health insurance data, which has limitations such as accuracy and completeness, the number of foundry workers diagnosed with lung cancer was significantly higher than that of non-foundry workers. Therefore, a well-designed cohort study should be followed to confirm the higher lung cancer rates in foundry workers.; Summary

Relationship between Occupational Electromagnetic Field Exposure and Leukemia: A Meta-Analysis.: Yong Sung Cho, Yoon Shin Kim, Hae Hiang Song, Seung Cheol Hong; Korean J Prev Med. 2000;33(1):125-133.

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Abstract PDF: OBJECTIVES
This study uses meta-analysis methodology to examine the statistical consistency and importance of random variation among results of epidemiologic studies of occupational electromagnetic field exposure and leukemia. METHODS: Studies for this meta-analysis were identified from previous reviews and by asking researcher active in this field for recommendations. Overall, 27 studies of occupational electromagnetic field exposures and leukemia were reviewed. A variety of meta-analysis statistical methods have been used to assess combined effects, to identify heterogeneity, and to provide a single summary risk estimate based on a set of simiar epidemiologic studies. In this study, classification of exposure metircs on occupational epidemiologic studies are reported for (1) job classification (20 individual studies); (2) leukemia subtypes (13 individual studies); and (3) country (27 individual studies). RESULTS: Results of this study, an inverse-variance weighted pooling of all the data leads to a small but significant elevation in risk of 11% (OR=1.11, 95% CI : 1.06~1.16) among 27 occupational epidemiologic studies. Publication bias was assessed by the 'fail-safe n' that may be not influence for all combined results exception a few categories, ie, "power station operators" and "electric utility workers" by job classification on occupational study. And all combined odds ratio results were similar for fixed-effects models and random-effects models, with slightly higher risk estimates for the random-effects model in situations where there was significant heterogeneity, ie, Q-statistic significant (p<.05). CONCLUSIONS: We found a small elevation in risk of leukemia, but the ubiquitous nature of exposure to electromagnetic fields from workplace makes even a weak association a public health issue of substantial power to influence the present overall conclusion about relationship between electromagnetic fields exposure and leukemia.; Summary

The effect of smoking and drinking habit on the health status of lead workers.: Choong Koo Lee, Yong Bae Kim, Gap Soo Lee, Kyu Yoon Hwang, Hwa Sung Kim, Sung Soo Lee, Kyu Dong Ahn, Byung Kook Lee; Korean J Prev Med. 1998;31(4):708-718.

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Abstract PDF: To investigate the effect of smoking and drinking habit on the health status in lead using industries, 2,785 male workers in lead using industries (7 storage battery industries, 7 secondary smelting and related industries, and 4 primary metal and other manufacturing industries) were selected for this study. This study was carried out as a part of periodic health examination. Selected study variables were zinc protoporphyrin in whole blood (ZPP), SGOT and SGPT for laboratory test. Questionnaire for lead related symptoms and smoking and drinking habit was provided to all the workers and filled up by themselves and reconfirmed by physician. The results obtained were as follows; 1. The overall smoking and drinking rate of study population were 69.8% and 73.6%, respectively. While the smoking and drinking rate of storage battery workers were 68.8% and 72.3%, those of secondary smelting industries and other industries were 66.0% and 66.4% and 74.6 and 80.3% respectively. 2. While the mean values of blood ZPP of lead exposed workers were significantly higher than other group, those of SGOT of storage battery workers were significant higher than other worker. But there were no differences of mean values of other variables. 3. Smoking habit did not affect on the mean value of blood ZPP of workers in special health examination group, but there were significant differences of blood ZPP and SGOT between drinker and non-drinker. 4. Symptom prevalence of lead exposure were higher in drinking and smoking group than non-drinking and non-smoking group. 5. In multiple regression analysis of the total lead related symptoms, blood ZPP, SGOT, and SGPT as dependent variable, respectively, and age, work duration, blood ZPP, pack year and amount of alcohol drinking as independent variables, work duration, pack year, amount of alcohol drinking, age contributed to total symptoms; and age, work duration, pack year contributed to blood ZPP; and age, amount of alcohol drinking, work duration contributed to SGOT; and pack year contributed to SGPT.; Summary

Chromosome Aberrations and Sister Chromatid Exchanges of Hospital Workers Exposed to Radiation.: Ae Ri Cha, Mi Sun Kim, In Kyung Hwang, Su Ill Lee, Byung Mann Cho, Don Kyoun Kim; Korean J Prev Med. 1998;31(4):616-627.

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Abstract PDF: In order to evaluate the cytogenetic hazard among hospital workers potentially exposed to low dose of radiation, the analysis of chromosome aberrations(CA) and sister chromatid exchanges(SCE) in lymphocytes were performed in 79 hospital workers and 79 non-exposed workers. The mean frequency of chromosomal exchange and deletion(respectively, 0.20X10-2/cell and 0.39X10(-2)/cell) in the exposed group were significantly higher than those(0.07X10(-2)/cell and 0.23X10-2/cell) in control group. The frequency of sister chromatid exchanges was 5.04/cell in the control vs. 6.57/cell in the exposed group. There were also significant differences in the mean frequencies of CA and SCE adjusted for age, sex, smoking, drinking between two groups. There were no evidence of significant increase of CA and SCE according to the department or duration of employment. But the frequency of cells having chromosome aberration was significantly higher in the exposed group than in the control group related to duration of employment. There was no dose-effect relationship between the cumulative doses and the frequency of CA and SCE. But in the case of last 1 yr cumulative dose, there were evidence of significant dose-dependant increase of chromosome type CA and percentage of cells with aberration. The result suggest that there is cytogenetic hazard in risk group like hospital workers handling low dose radiation. And the analysis CA and SCE are useful biological indicators for the exposure of low dose level of radiation.; Summary

The relationship between the utilization of health center and exposed amount to solvent by using cumulative exposure index.: Ju Won Park, Soon Young Lee, Jae Yeon Jang, Kyung Jong Lee, Ho Grun Jeong; Korean J Prev Med. 1998;31(3):404-413.

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Abstract PDF: This study was conducted in order to clarify the factors affecting the number of utilization to health center for the shipyard workers who have been work in exposed environment to solvent. At first the tendencies of the number of utilization to health center in accordance with cumulative exposure(CE), lifetime weighted average exposure(LWAE), one's place of duty, work contents, states of using safety apparatus, the degree of the knowledge on handling solvents, exposure year. 1) The increase in the cumulative exposure(CE) was significantly higher in the number of utilization to health center. The group with longer exposure year showed significantly higher number of utilization to health center(p<0.01). Considering the work contents such as power blasting, spray, mixing and touch-up, the group of touch-up showed higher number of utilization to health center and this difference was statistically significant(p<0.001). Those who were not using the safety apparatus, showed higher number of utilization to health center, which was statistically significant(p<0.05). The degree of the knowledge on handling the solvent had no relation with using health center. 2) The results conducted from this study by multiple regression analysis in clarifying the factors affecting the number of utilization to health center, CE, exposure year and using safety apparatus was significant factor in utilization of health center.; Summary

Effect of Therapeutic Exercises on Shoulder Dysfunction in VDT-related female Office Workers.: Soon Seok Choi, Kui Won Jeong, Sang Hwa Urm, Soo Jin Jeong, Jong Tae Lee, Jin Ho Chun, Chae Un Lee, Ki Taek Pae; Korean J Prev Med. 1998;31(2):228-239.

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Abstract PDF: Visual display terminal(VDT) is popular in majority of office in modern countries. Musculoskeletal pain due to repetitive work with VDT is a serious industrial accident at present. In recent studies, shoulder pain in VDT users is the most common problem in Korea. The purpose of this study was to evaluate and compare the effect of exercises on shoulder dysfunction in VDT-related female office workers. Of the l19 patients with shoulder dysfunction, 32 patients entered into the study. 16 patients(Group I) were not prescribed exercises, other 16 patients (Group II) performed throughout the specific shoulder exercises such as pendular exercises(forward, backward and circumduction) and sidelying external rotation exercises with weights. After 3 months of exercises, the two groups were compared in term of the pain rating scale, disability questionnaire score and range of motion score. The results were summarized as follows ; l. The pain rating scale in Group I before and after 3 months were not differenced significantly(p value=0.784) and in Group II, the scale before and after exercises were differenced significantly(p value=0.0005). 2. The disability, questionnaire scores in Group I before and after 3 months were not differenced significantly(p value=0.437) and in Group II, the scores before and after exercises were differenced significantly(p value=0.0002). 3. The ROM scores of the affected shoulder in Group I before and after 3 months were not differenced significantly(p value=0.876) and in Group II, the scores before and after exercises were differenced significantly(p value=0.0017). In conclusion, that the specific shoulder exercises on shoulder dysfunction in VDT-related female office workers are encouraged.; Summary

A Study on the Medical Insurance Utilization of Workers Suffering from Low Back Pain in an Area.: Chul Gab Lee, Hyun Ok Ahn, So Yeon Ryu, Jong Park, Ki Soon Kim, Yang Ok Kim; Korean J Prev Med. 1997;30(4):764-778.

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Abstract PDF: To find the medical insurance utilization of workers when suffering from low back pain, an analysis was made toward the data of medical insurance benefits matched with the general characteristics of 10,183 workers, who were registered continuously from 1993 to 1995 at a medical insurance cooperation for industrial workers. The results were as follows; 1. The period prevalence of the medical insurance utilization for low back pain for 3 years from 1993 to 1995 was calculated as 17.1% for male workers and 19.4% for female workers. Most common cause of utilization was other dorsopathies including the herniation of lumbar discs. 2. The utilization rate increased significantly as the present age and the age joining the company got older(p<0.001). As the duration of employment got longer, the utilization rate of the male showed the tendency to increase and that of the female increased significantly(p<0.05). Among male workers employed at cement and concrete manufacturing companies showed higher utilization rate and among female laborers showed significantly higher utilization rate than clerical workers(p<0.01). 3. Annual utilization rate for low back pain didn't show any difference, but the portion of other dorsopathies among cause of utilization showed the tendency to increase from 1993 to 1995. 4. The mean number of claims for outpatient medical care for low back pain differed significantly by age, working duration, type of industries, income level(p<0.05), and the mean of total visiting days for care of low back pain differed siginificantly by working duration. In conclusion, considering the fact that the medical insurance utilization for low back pain increased annually and other dorsopathies including the herniation of dorsopathies were increasing, an effective preventive or management program for low back pain toward worker employed at industries were required.; Summary

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