Journal of Preventive Medicine and Public Health

Original Articles

Obstetric Outcomes of Jehovah’s Witness Women Under Patient Blood Management: A Single-center, Propensity Score–Matched Cohort Study in Korea: Jeong-Won Oh, Seug Yun Yoon, Jeong Jae Lee, Kyu Yeon Choi, Seong Soon Kwon; J Prev Med Public Health. 2026;59(2):143-151. Published online January 6, 2026; DOI: https://doi.org/10.3961/jpmph.25.596

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Abstract Summary PDF: Objectives
Patient blood management (PBM) is increasingly recognized as an essential strategy in obstetric care for reducing transfusion-related risks and improving maternal safety. Jehovah’s Witness (JW) women, who categorically refuse blood transfusion, represent a unique clinical population in which to evaluate the effectiveness of PBM. This study aimed to assess obstetric outcomes of JW women compared with non-JW women at a PBM-based center in Korea.
Methods
We retrospectively reviewed delivery outcomes and PBM practices among JW women (n=205) with singleton pregnancies and non-JW women (n=601) who were matched at a 1:3 ratio using propensity scores at Soonchunhyang University Seoul Hospital between 2018 and 2023. The primary outcomes included obstetric morbidities, with particular attention to complications related to postpartum hemorrhage and the interventions used for its management.
Results
JW women were more likely to receive intravenous iron administration (7.3 vs. 2.8%, p=0.008) and had higher hemoglobin (Hb) levels during the first trimester (12.6±1.1 vs. 11.8±3.4 g/dL, p=0.012) than non-JW women. Blood loss during cesarean section and the incidence of severe postpartum anemia (Hb <7 g/dL) were lower among JW women; however, these differences did not reach statistical significance. In the hemorrhage-related high-risk subgroup, JW women were managed according to PBM protocols without transfusion, and their obstetric outcomes were comparable to those observed in non-JW women.
Conclusions
This study identified no significant differences in hemorrhage-related obstetric outcomes between JW and non-JW women at a PBM-based center. The systematic application of PBM enables safe delivery in transfusion-restricted settings and may reduce reliance on blood transfusion while maintaining maternal safety.; Summary

Korean summary
수혈을 거부하는 여호와의 증인 산모에게 환자혈액관리(PBM) 프로토콜을 적용한 결과, 일반 산모와 비교하여 산후출혈 및 중증 빈혈 등 주요 산과적 합병증에서 유의한 차이는 관찰되지 않았으며, 이는 선제적인 철분 관리의 기여로 해석된다. 비록 대량 출혈 시에는 적용에 한계가 있으나, 이는 PBM이 종교적 특수 상황을 넘어 향후 혈액 수급 위기에 대응할 수 있는 보편적이고 안전한 산과적 대안이 될 수 있음을 시사한다.

Key Message
Implementation of patient blood management (PBM) in Jehovah’s Witness women who refuse transfusion resulted in obstetric outcomes comparable to those of non-JW women, with no significant differences in postpartum hemorrhage or severe anemia. These outcomes were associated with proactive anemia management, including intravenous iron therapy. Although its applicability may be limited in cases of massive hemorrhage, PBM represents a safe and potentially generalizable obstetric strategy to mitigate future blood supply constraints.

Relationship Between Pesticide Exposure Factors and Health Symptoms Among Chili Farmers in Northeast Thailand: Ratchadaporn Pengpan, Kulthida Y. Kopolrat, Sribud Srichaijaroonpong, Nutta Taneepanichskul, Patiwat Yasaka, Ratanee Kammoolkon; J Prev Med Public Health. 2024;57(1):73-82. Published online December 20, 2023; DOI: https://doi.org/10.3961/jpmph.23.353

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Objectives
The unsafe use of pesticides in agriculture represents a major hazard to human health. This study was conducted to investigate the association between pesticide exposure and health symptoms among chili farmers in northeast Thailand.
Methods
This cross-sectional analytic study included 141 chili farmers in Sakon Nakhon Province, in northeast Thailand. Data regarding health symptoms were gathered using a self-report questionnaire. A medical technician tested blood cholinesterase activity using an erythrocyte method, and an occupational medicine specialist at Ramathibodi Hospital in Bangkok, Thailand reviewed the results. Associations between personal characteristics, pesticide exposure factors, and health symptoms were analyzed using multiple logistic regression.
Results
Of the 141 chili farmers studied, 66.7% experienced pesticide poisoning, as indicated by below-normal cholinesterase levels. Fatigue was the most frequently reported symptom associated with pesticide exposure, affecting 37.6% of participants. This was followed by nausea and vomiting (31.9%), dizziness (14.9%), and dry throat (14.9%). Multivariate logistic regression analysis revealed that several factors were significantly associated with adverse symptoms: amount of work experience, volume of pesticides used, use of chemical pesticides, use of leaking containers during spraying, direct pesticide exposure while working, contact with pesticide-soaked clothing, consumption of food and drinks in the fields, and blood cholinesterase level indicating risk.
Conclusions
This study suggests potential health risks for chili farmers stemming from exposure to and contamination by pesticides used in agricultural practices. To mitigate these risks, it is essential to supply personal protective equipment and to implement educational programs aimed at improving protective behaviors among farmers.

Summary

Key Message
This study aimed to demonstrate the impact of pesticide exposure on health symptoms. In a cross-sectional study, the effects of pesticide exposure on acetylcholinesterase erythrocyte activity in blood during agricultural practices were examined as potential health risks for chili farmers. It is crucial to provide personal protective equipment and to implement educational initiatives targeted at encouraging farmers to adopt more protective behaviors to reduce these risks.

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Piyapong Chaiyasarn, Kulthida Y. Kopolrat, Patiwat Yasaka, Sribud Srichaijaroonpong, Birabongse Hardthakwong, Pathanan Suwannaboon, Chavanakorn Krueakaew, Ratanee Kammoolkon
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Jessica Gama, Bianca Cruz Neves, Antonio Pereira
Humanities and Social Sciences Communications.2025;[Epub] CrossRef
Fatigability and Long-Term Pesticide Exposure in Organic and Conventional Farmers
Talita Regina Coelho, Maurício Bedim dos Santos, Hugo M. Pereira, Ana Tereza Bittencourt Guimarães
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Barry Parasram, Avishek Choudhury, Olutosin Ademola Otekunrin
PLOS One.2025; 20(7): e0327283. CrossRef
Health Literacy and Associated Factors Influencing Pesticide Protective Behaviors Among Cassava Farmers in an Eastern Thailand Province: A Cross-Sectional Study
Chaninan Praserttai, Phannathat Tanthanapanyakorn, Nonlapan Khantikulanon, Sootthikarn Mungkhunthod, Kunlaphatcha Maoon
Pacific Rim International Journal of Nursing Research.2025; 29(4): 892. CrossRef
Pesticide exposure and health risk assessment in Durian farmers from Southern of Thailand
Pattama Senthong, Sivasit Wittayasilp
International Archives of Occupational and Environmental Health.2025; 98(9-10): 821. CrossRef
Pesticide poisoning as an occupational and environmentally determined disease: modern approaches to diagnosis in accordance with the recommendations of the international labour organization (part I)
A.V. Basanets, M.G. Prodanchuk, N.V. Kurdil, Т.О. Yastrub
Ukrainian Journal of Modern Problems of Toxicology.2025; 99(2): 28. CrossRef
Emerging diseases: trend research and omics-based analysis reveals mechanisms of endophytes modulate Chilli plant resilience
Wiwiek Harsonowati, Evy Latifah, Arinal Haq Izzawati Nurrahma, Jati Purwani, Rashid Iqbal, Javid Ahmad Parray, Ashish D. Patel
Symbiosis.2024; 93(3): 241. CrossRef
An Analysis of Occupational Hazards Based on the Physical Ergonomics Dimension to Improve the Occupational Health of Agricultural Workers: The Case in Mayo Valley, Mexico
Víctor Manuel Ramos-García, Josué Aarón López-Leyva, Ana Paola Balderrama-Carmona, Iván Ochoa-Vázquez, Juan José García-Ochoa, Manuel de Jesús Espinoza-Espino
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Determinants of Adherence to Diabetes Screening in Iranian Adults With a Positive Family History of Diabetes: Narges Malih, Mohammad-Reza Sohrabi, Alireza Abadi, Shahnam Arshi; J Prev Med Public Health. 2021;54(3):190-198. Published online April 7, 2021; DOI: https://doi.org/10.3961/jpmph.20.496

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Abstract PDF Supplementary Material

Objectives
Insufficient evidence exists regarding factors that affect screening adherence among people with a family history of diabetes, who comprise roughly half of all patients with diabetes. Therefore, we aimed to identify the determinants of diabetes screening adherence in adults with a family history of diabetes who had not yet been diagnosed with diabetes.
Methods
This cross-sectional study was conducted at selected urban primary healthcare facilities in Tehran, Iran. The study population was clinically non-diabetic adults above 20 years of age with a family history of diabetes in at least 1 first-degree relative. All eligible people identified on randomly-selected days of the month were invited to join the study.
Results
Among 408 participants, 128 (31.4%) had received a fasting blood glucose check during the last year. Using binary logistic regression, the independent predictors of screening adherence were knowledge of adverse effects of diabetes such as sexual disorders (odds ratio [OR], 3.05) and renal failure (OR, 2.73), the impact of family members’ advice on receiving diabetes screening (OR, 2.03), recommendation from a healthcare provider to have a fasting blood glucose check (OR, 2.61), and intention to have a fasting blood glucose check within the next 6 months (OR, 2.85). Other variables that predicted screening adherence were age (OR, 1.05), job (being a housekeeper; OR, 3.39), and having a college degree (OR, 3.55).
Conclusions
Knowledge of the adverse effects of diabetes, physicians’ and healthcare providers’ advice about the benefits of early disease detection, and family members’ advice were independent predictors of screening adherence.

Summary

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The association between sociodemographic characteristics, clinical indicators and body mass index in a population at risk of type 2 diabetes: A cross-sectional study in two Colombian cities
Yenifer Diaz Montes, Tania Acosta Vergara, Rafael Tuesca Molina, Gillian Martinez Guerrero, Luis A. Anillo Arrieta, Pablo Aschner, Jorge Acosta-Reyes, Victor Florez-Garcia, Edgar Navarro Lechuga, Noël C. Barengo
Primary Care Diabetes.2024; 18(4): 458. CrossRef
Socio-personal factors affecting adherence to treatment in patients with type 2 diabetes: A systematic review and meta-analysis
Nahid Shahabi, Yadolah Fakhri, Teamur Aghamolaei, Zahra Hosseini, Atefeh Homayuni
Primary Care Diabetes.2023; 17(3): 205. CrossRef
Clinical traits and systemic risks of familial diabetes mellitus according to age of onset and quantity: an analysis of data from the community-based KoGES cohort study
Ju-Yeun Lee, Kyungsik Kim, Sangjun Lee, Woo Ju An, Sue K. Park
Epidemiology and Health.2023; 45: e2023029. CrossRef
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Hatice İkiışık, Sibel Sakarya
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Association between a family history of diabetes and carotid artery atherosclerosis in Korean adults
Sun Young Shim, Ga Bin Lee, Jee-Seon Shim, Sun Jae Jung, Hyeon Chang Kim
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Blood Pressure and the Risk of Death From Non-cardiovascular Diseases: A Population-based Cohort Study of Korean Adults: Jeoungbin Choi, Jieun Jang, Yoonsuk An, Sue K. Park; J Prev Med Public Health. 2018;51(6):298-309. Published online November 14, 2018; DOI: https://doi.org/10.3961/jpmph.18.212

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Abstract Summary PDF Supplementary Material

Objectives
The objective of this study was to assess the relationship between systolic and diastolic blood pressure (SBP, DBP) and the risk of death from specific causes other than cardiovascular diseases.
Methods
We calculated the risk of specific death by SBP and DBP categories for 506 508 health examinees in 2002-2003 using hazard ratios (HRs) and 95% confidence intervals (CIs) in a Cox proportional hazards model.
Results
Compared to normal levels (SBP <120 or DBP <90 mmHg), stage I systolic and diastolic hypertension (SBP 140-159, DBP 85- 89 mmHg, respectively) were associated with an increased risk of death from diabetes mellitus, alcoholic liver disease, and renal failure (HR, 1.83; 95% CI, 1.51 to 2.22; HR, 1.24; 95% CI, 1.06 to 1.46; HR, 2.30; 95% CI, 1.64 to 3.21; HR, 1.67; 95% CI, 1.27 to 2.20; HR, 1.99; 95% CI, 1.41 to 2.81; HR, 1.31; 95% CI, 0.99 to 1.73, respectively), but a decreased risk of death from intestinal pneumonia (HR, 0.64; 95% CI, 0.42 to 0.98; HR, 0.59; 95% CI, 0.39 to 0.91). Only stage II systolic hypertension (SBP ≥160 mmHg) was associated with an increased risk of death from pneumonia, liver cirrhosis, and intestinal ischemia (HR, 1.54; 95% CI, 1.19 to 1.98; HR, 1.46; 95% CI, 1.00 to 2.15; HR, 3.77; 95% CI, 1.24 to 11.40, respectively), and stage I and II diastolic hypertension (SBP 140-159 and ≥160 mmHg) were associated with an increased risk of death from intestinal ischemia (HR, 3.07; 95% CI, 1.27 to 7.38; HR, 4.39; 95% CI, 1.62 to 11.88, respectively).
Conclusions
An increase in blood pressure levels may alter the risk of death from certain causes other than cardiovascular diseases, a well-known outcome of hypertension, although the mechanism of these associations is not well documented.

Summary

Korean summary
2002년 및 2003년 한국 국민건강보험공단 건강검진 수검자 코호트(NHIS-HEALS) 중 506,508명을 대상으로 2013년 말일까지의 통계청 사망자료 기반 심뇌혈관질환을 제외한 기타 사망원인으로의 사망위험을 콕스회귀모형으로 분석한 결과에서 1단계 수축기 고혈압 군과 1단계 이완기 고혈압 군에서 당뇨, 알코올성 간질환, 콩팥부전 사망의 위험도가 통계적으로 유의하게 증가함을 보인 반면, 간질성 폐렴의 사망위험은 유의하게 감소함을 보였다. 2단계 수축기 고혈압 군에서는 폐렴, 간경화 및 허혈성 장질환의 사망위험이 증가하는 것을 보였다. 혈압의 증가가 기존에 알려진 심뇌혈관 질환 이외의 사망위험도에도 연관된 것으로 보이며, 고혈압의 질병부담 연구 및 보건정책 수립시 이 같은 점에 대한 고려가 필요하다.

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Binary cutpoint and the combined effect of systolic and diastolic blood pressure on cardiovascular disease mortality: A community-based cohort study
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Hypertension, the renin–angiotensin system, and the risk of lower respiratory tract infections and lung injury: implications for COVID-19
Reinhold Kreutz, Engi Abd El-Hady Algharably, Michel Azizi, Piotr Dobrowolski, Tomasz Guzik, Andrzej Januszewicz, Alexandre Persu, Aleksander Prejbisz, Thomas Günther Riemer, Ji-Guang Wang, Michel Burnier
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Russian Journal of Cardiology.2020; 25(6): 3823. CrossRef

Low Systolic Blood Pressure and Mortality From All Causes and Vascular Diseases Among Older Middle-aged Men: Korean Veterans Health Study: Sang-Wook Yi, Heechoul Ohrr; J Prev Med Public Health. 2015;48(2):105-110. Published online March 11, 2015; DOI: https://doi.org/10.3961/jpmph.15.003

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Abstract PDF

Objectives
Recently, low systolic blood pressure (SBP) was found to be associated with an increased risk of death from vascular diseases in a rural elderly population in Korea. However, evidence on the association between low SBP and vascular diseases is scarce. The aim of this study was to prospectively examine the association between low SBP and mortality from all causes and vascular diseases in older middle-aged Korean men.
Methods
From 2004 to 2010, 94 085 Korean Vietnam War veterans were followed-up for deaths. The adjusted hazard ratios (aHR) were calculated using the Cox proportional hazard model. A stratified analysis was conducted by age at enrollment. SBP was self-reported by a postal survey in 2004.
Results
Among the participants aged 60 and older, the lowest SBP (<90 mmHg) category had an elevated aHR for mortality from all causes (aHR, 1.9; 95% confidence interval [CI], 1.2 to 3.1) and vascular diseases (International Classification of Disease, 10th revision, I00-I99; aHR, 3.2; 95% CI, 1.2 to 8.4) compared to those with an SBP of 100 to 119 mmHg. Those with an SBP below 80 mmHg (aHR, 4.5; 95% CI, 1.1 to 18.8) and those with an SBP of 80 to 89 mmHg (aHR, 3.1; 95% CI, 0.9 to 10.2) also had an increased risk of vascular mortality, compared to those with an SBP of 90 to 119 mmHg. This association was sustained when excluding the first two years of follow-up or preexisting vascular diseases. In men younger than 60 years, the association of low SBP was weaker than that in those aged 60 years or older.
Conclusions
Our findings suggest that low SBP (<90 mmHg) may increase vascular mortality in Korean men aged 60 years or older.

Summary

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Relationship between systolic blood pressure and all-cause mortality: a prospective study in a cohort of Chinese adults
Chunsheng Li, Youren Chen, Qiongbing Zheng, Weiqiang Wu, Zhichao Chen, Lu Song, Shasha An, Zhifang Li, Shuohua Chen, S. L. Wu
BMC Public Health.2018;[Epub] CrossRef
Baseline and longitudinal change in blood pressure and mortality in a Chinese cohort
Jian-Bing Wang, Qiu-Chi Huang, Shu-Chang Hu, Pei-Wen Zheng, Peng Shen, Die Li, Huai-Chu Lu, Xiang Gao, Hong-Bo Lin, Kun Chen
Journal of Epidemiology and Community Health.2018; 72(12): 1083. CrossRef
Low Systolic Blood Pressure and Vascular Mortality Among More Than 1 Million Korean Adults
Sang-Wook Yi, Yejin Mok, Heechoul Ohrr, Jee-Jeon Yi, Young Duk Yun, Jihwan Park, Sun Ha Jee
Circulation.2016; 133(24): 2381. CrossRef

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

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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 Abstracts

A Factor of Fasting Blood Glucose and Dietary Patterns in Korean Adults Using Data From the 2007, 2008 and 2009 Korea National Health and Nutrition Examination Survey.: Kyung Won Paek, Ki Hong Chun, Soo Jin Lee; J Prev Med Public Health. 2011;44(2):93-100.; DOI: https://doi.org/10.3961/jpmph.2011.44.2.93

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OBJECTIVES
This study was performed to identify the socioeconomic factors, health behavior factors and dietary patterns that have an influence on the fasting blood glucose in adults. METHODS: This study used data collected from the 2007, 2008, 2009 Korea National Health and Nutrition Examination Survey. The final sample included 4163 subjects who were 30-59 years old and who had completed the necessary health examinations, the health behaviors survey and nutrition survey. RESULTS: Eleven dietary patterns emerged from the factor analysis with different factor loading. After controlling for potential confounders, multiple regression analysis of the dietary patterns showed that 'fruits', 'alcohols', and 'starchy foods' affected the fasting blood. Lower consumption of 'fruits' and higher consumption of 'alcohols' and 'starch foods' were significantly associated only with an increased risk of high blood glucose. CONCLUSIONS: In the light of the results of this study, it appears pretty likely that the risk of developing high blood glucose can be reduced by changing a person's dietary patterns.

Summary

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The Prevalence of High Myopia in 19 Year-Old Men in Busan, Ulsan and Gyeongsangnam-Do.: Sang Joon Lee, Sang Hwa Urm, Byeng Chul Yu, Hae Sook Sohn, Young Seoub Hong, Maeng Seok Noh, Yong Hwan Lee; J Prev Med Public Health. 2011;44(1):56-64.; DOI: https://doi.org/10.3961/jpmph.2011.44.1.56

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Abstract PDF

OBJECTIVES
The purpose of this study was to estimate the prevalence and correlated factors of high myopia in 19 year-old men in Southeast Korea. METHODS: This retrospective study was based on the medical checkup data of conscription during 2005. The study subjects were 19 years old men in Busan, Ulsan and Gyeongsangnam-do. The health checkup data of the conscripts consisted of noncycloplegic autorefraction test, the biometric data and social factors. To analyze the social and biometric effects, we classified the biometric factors into 4 or 5 groups and the social factors into 3 groups. High myopia was defined as a spherical equivalent of under -6.0 diopter. Data analysis was performed using the chi square test for trends and multiple logistic regression analysis. The SAS(version 9.1) program was used for all the analyses. RESULTS: The prevalence of high myopia was 12.39% (6256 / 50 508). The factors correlated with high myopia were the residence area (OR, 2.07; 95% CI, 1.77 to 2.4 for small city; OR, 2.01; 95% CI, 1.72 to 2.34 for metropolis; the reference group was rural area), academic achievement (OR, 1.43; 95% CI, 1.34 to 1.53 for students of 4-and 6-year-course university; the reference group was high school graduates & under) and blood pressure (OR, 1.54; 95% CI, 1.10 to 2.16 for hypertension; OR, 1.09; 95% CI, 1.02 to 1.17 for prehypertension; OR, 1.10; 95% CI, 1.01 to 1.20 for hypotension; the reference group was normal blood pressure). CONCLUSIONS: More than one tenth of the young men were high myopia as one of the risk factor for visual loss. Further studies on high myopia and its complications are needed to improve eye health in Southeast Korea.

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

Blood Mercury Concentration and Related Factors in an Urban Coastal Area in Korea.: Eun Mi Jo, Byoung Gwon Kim, Yu Mi Kim, Seung Do Yu, Chang Hun You, Joon Youn Kim, Young Seoub Hong; J Prev Med Public Health. 2010;43(5):377-386.; DOI: https://doi.org/10.3961/jpmph.2010.43.5.377

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OBJECTIVES
This study was carried out for the purpose of evaluating the blood mercury concentration of the residents of Busan, Korea, as well as the relationship between the mercury concentration and the pattern of fish consumption along with other epidemiological factors. METHODS: Two hundred ninety-three subjects (147 men and 146 women), who were aged 40 years or more, were recruited into this study between June and October 2009. The mean age of the subjects was 54.3 years (with a range of 40-70 years). Mercury concentrations in blood samples were measured using a gold-amalgam collection method. RESULTS: The geometric mean concentration of mercury in the total subjects was 8.63 microgram/L [range: 1.48~45.71 microgram/L]. The blood mercury concentration of the men (9.55 microgram/L) was significantly higher than that of the women (7.76 microgram/L). The blood mercury concentration of those who eat fish more than 4 times per week was higher than others, and was statistically significant (male p = 0.0019, female p = 0.0002). According to the multiple analysis, the blood mercury concentration was significantly affected by the consumed fish but other epidemiological factors were not related. CONCLUSIONS: It was found that the subjects who have consumed a large amount of fish may have high blood mercury concentration. It appears that fish consumption can influence blood mercury concentration. Therefore, guidelines for fish consumption that will decrease blood mercury concentration might be necessary in Korea.

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Association of Blood Mercury Level with the Risk of Depression According to Fish Intake Level in the General Korean Population: Findings from the Korean National Health and Nutrition Examination Survey (KNHANES) 2008–2013
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Mercury Exposure Factors among Residents in the Highly Mercury Exposed Area, Seoksan-ri, Korea
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Mary C Sheehan, Thomas A Burke, Ana Navas-Acien, Patrick N Breysse, John McGready, Mary A Fox
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Bone mineral density and blood metals in premenopausal women
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English Abstract

The Association of Central Obesity with Type 2 Diabetes among Koreans according to the Serum Gamma-Glutamyltransferase Level: Korean Genome and Epidemiology Study.: Ji Yeon Shin, Jun Hyun Hwang, Jin Young Jeong, Sung Hi Kim, Jai Dong Moon, Sang Chul Roh, Young Wook Kim, Yangho Kim, Jong Han Leem, Young Su Ju, Young Seoub Hong, Eun Hee Ha, Yong Hwan Lee, Duk Hee Lee, Dong Hyun Kim; J Prev Med Public Health. 2009;42(6):386-391.; DOI: https://doi.org/10.3961/jpmph.2009.42.6.386

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OBJECTIVES
This cross-sectional study was performed to examine if the serum gamma-glutamyltransferase (GGT) level that is within its normal range is associated with the risk of type 2 diabetes and if the association between the waist hip ratio (WHR) and type 2 diabetes is different depending on the serum GGT levels. METHODS: The study subjects were 23,436 persons aged 40 years or older and who participated in regular health check-ups at 11 hospitals (males: 5,821, females: 17,615). The gender-specific quintiles of the serum GGT and WHR were used to examine the associations with type 2 diabetes. RESULTS: The serum GGT levels within their normal range were positively associated with type 2 diabetes only in women. The adjusted odds ratios (ORs) were 1.0, 1.0, 1.4, 2.1, and 2.5 according to the quintiles of the serum GGT (p(trend)<0.01). The WHR was more strongly associated with the prevalence of diabetes among the women with a high-normal serum GGT level as compared with those with a low-normal serum GGT level (p for interaction=0.02). For example, the adjusted ORs for women with a low normal serum GGT level were 1.0, 1.2, 1.5, 2.2, and 2.4 according to the quintiles of the WHR, while those figures were 1.0, 2.4, 3.6, 5.0, and 8.3 among the women with a high normal serum GGT level. However, in men, the serum GGT was very weakly associated with type 2 diabetes and the association between the WHR and type 2 diabetes was not different depending on the serum GGT level. CONCLUSIONS: Serum GGT within its normal range was positively associated with type 2 diabetes, and central obesity was more strongly associated with the prevalence of type 2 diabetes when the serum GGT level was high-normal. However, these associations were observed only in women, which is different from the previous findings. The stronger relation between central obesity and type 2 diabetes among women with a high-normal serum GGT level can be useful for selecting a group that is at high risk for type 2 diabetes irregardless of whatever the underlying mechanism is.

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Uric Acid and GGT Have Causal Relations with Abdominal Obesity: A Real-Life Research in Turkish Population with 1214 Diabetics
Deniz Avci, Ali Çetinkaya
Journal of Biosciences and Medicines.2019; 07(02): 1. CrossRef
Serum gamma-glutamyl transferase and risk of type 2 diabetes in the general Korean population: a Mendelian randomization study
Youn Sue Lee, Yoonsu Cho, Stephen Burgess, George Davey Smith, Caroline L. Relton, So-Youn Shin, Min-Jeong Shin
Human Molecular Genetics.2016; 25(17): 3877. CrossRef
Different associations between obesity and impaired fasting glucose depending on serum gamma-glutamyltransferase levels within normal range: a cross-sectional study
Nam Soo Hong, Jeong-Gook Kim, Yu-Mi Lee, Hyun-Woo Kim, Sin Kam, Keon-Yeop Kim, Ki-Su Kim, Duk-Hee Lee
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Research Support, Non-U.S. Gov't

The Association Between Circulating Inflammatory Markers and Metabolic Syndrome in Korean Rural Adults.: So Yeon Ryu, Ki Soon Kim, Jong Park, Myeng Guen Kang, Mi Ah Han; J Prev Med Public Health. 2008;41(6):413-418.; DOI: https://doi.org/10.3961/jpmph.2008.41.6.413

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OBJECTIVES
This study was performed to investigate the associations between the metabolic syndrome (MetS) and inflammatory markers. METHODS: This cross-sectional analysis was performed using data from 1578 Koreans aged 40-69 years residing in a rural area. We investigated associations between MetS and circulating high sensitivity C-reactive protein (hs-CRP), white blood cells (WBC) and adiponectin. MetS was defined using the criteria proposed by the National Cholesterol Education Program Adult Treatment Panel III (ATP-III). RESULTS: Increased WBC counts and hs-CRP levels and decreased adiponectin levels were observed in subjects with MetS. WBC, hs-CRP and adiponectin levels linearly deteriorated with an increase in the number of MetS components (all ptrend <0.005). Finally, adjusted odds ratios (ORs) for the risk of MetS by increase/decrease in 3 inflammatory markers were calculated by multivariate logistic regression analyses. In terms of changes in inflammation markers, in men, the adjusted ORs (95% confidence interval) were 1.15 (1.01-1.31) for WBC, 1.64 (1.02-2.64) for hs-CRP, and 0.19 (0.08-0.45) for adiponectin, whereas corresponding adjusted ORs (95% CIs) in women were 1.27 (1.15-1.40), 0.98 (0.67-1.42), 0.09 (0.04-0.18), respectively. CONCLUSIONS: Serum adiponectin levels and WBC counts were found to be strongly associated with MetS in both sexes. However, hs-CRP lost its significance after adjusting for BMI and other inflammatory markers in women. This study shows that inflammatory response is associated with MetS in the Korean population. Further prospective studies are necessary to confirm the contribution made by inflammatory markers to the development of MetS.

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Yuchul Jeong, Beom Jun Lee, Wonjai Hur, Minjoon Lee, Se-Hyeon Han
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Marjan Mahdavi-Roshan, Nargeskhatoon Shoaibinobarian, Morvarid Noormohammadi, Aboozar Fakhr Mousavi, Amir Savar Rakhsh, Arsalan Salari, Zeinab Ghorbani
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English Abstracts

The Effect of Smoking Status upon Occurrence of Impaired Fasting Glucose or Type 2 Diabetes in Korean Men.: Chang Hae Park, Hyuk Ga, Jong Han Leem, Seung Min Kwak, Hwan Cheol Kim, Ji Ho Choi; J Prev Med Public Health. 2008;41(4):249-254.; DOI: https://doi.org/10.3961/jpmph.2008.41.4.249

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OBJECTIVES
To investigate whether smoking and the smoking status are predictors of the incident impaired fasting glucose (IFG) or type 2 diabetes in Korean men. METHODS: A cohort of 1,717 Korean men without IFG or diabetes, who underwent annual periodic health examinations for 4 years (2002-2006), were retrospectively investigated. IFG and diabetes were defined as a serum fasting glucose concentration of 100-125 mg/dL and more than 126 mg/dL, respectively. Cox's proportional hazards model was used to evaluate the association between smoking and development of IFG or type 2 diabetes. RESULTS: A total of 558 cases (32.5%) of incident IFG and 50 cases (2.9%) of diabetes occurred. After controlling for the potential predictors of diabetes, the relative risk for IFG, compared with the never smokers, was 1.02 (95% CI=0.88 to 1.19) for the ever-smokers, 0.96 (95% CI=0.79-1.16) for those who smoked 1-9 cigarettes/d, 1.15 (95% CI=1.01 to 1.30) for those who smoked 10-19 cigarettes/d, and 1.31 (95% CI=1.10 to 1.57) for those who smoked 20 or more cigarettes/d (the P value for the current smokers was only p<0.002). The respective multivariate adjusted relative risks for type 2 diabetes, compared with the neversmokers, were 1.07 (95% CI=0.64 to 1.92), 1.47 (95% CI=0.71 to 3.04), 1.84 (95% CI=0.92-3.04), and 1.87 (95% CI=1.13-3.67), respectively (the P value for the current smokers was only p=0.004). CONCLUSIONS: The smoking status and the number of cigarettes smoked daily are associated with an increased risk for developing IFG or type 2 diabetes in Korean men.

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Health effects associated with smoking: a Burden of Proof study
Xiaochen Dai, Gabriela F. Gil, Marissa B. Reitsma, Noah S. Ahmad, Jason A. Anderson, Catherine Bisignano, Sinclair Carr, Rachel Feldman, Simon I. Hay, Jiawei He, Vincent Iannucci, Hilary R. Lawlor, Matthew J. Malloy, Laurie B. Marczak, Susan A. McLaughlin
Nature Medicine.2022; 28(10): 2045. CrossRef
Systematic review with meta-analysis of the epidemiological evidence relating smoking to type 2 diabetes
Peter N Lee, Katharine J Coombs
World Journal of Meta-Analysis.2020; 8(2): 119. CrossRef
The 2016 global and national burden of diabetes mellitus attributable to PM 2·5 air pollution
Benjamin Bowe, Yan Xie, Tingting Li, Yan Yan, Hong Xian, Ziyad Al-Aly
The Lancet Planetary Health.2018; 2(7): e301. CrossRef
The impact of smoking on the development of diabetes and its complications
Mariola Śliwińska-Mossoń, Halina Milnerowicz
Diabetes and Vascular Disease Research.2017; 14(4): 265. CrossRef
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Eun-Jin Lim, Mi Jeong Kim, Ji-Sook Han
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Associated Factors of Impaired Fasting Glucose in Some Korean Rural Adults
Hye Eun Yun, Mi-ah Han, Ki Soon Kim, Jong Park, Myeng Guen Kang, So Yeon Ryu
Journal of Preventive Medicine and Public Health.2010; 43(4): 309. CrossRef
Association of passive and active smoking with incident type 2 diabetes mellitus in the elderly population: the KORA S4/F4 cohort study
Bernd Kowall, Wolfgang Rathmann, Klaus Strassburger, Margit Heier, Rolf Holle, Barbara Thorand, Guido Giani, Annette Peters, Christine Meisinger
European Journal of Epidemiology.2010; 25(6): 393. CrossRef
Diabetes and impaired fasting glucose in Mongolian population, Inner Mongolia, China
Shaoyan Zhang, Weijun Tong, Tan Xu, Burenbatu Wu, Yonghong Zhang
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Fasting Serum Glucose and Subsequent Liver Cancer Risk in a Korean Prospective Cohort.: Jin Gwack, Seung Sik Hwang, Kwang Pil Ko, Jae Kwan Jun, Sue Kyung Park, Soung Hoon Chang, Hai Rim Shin, Keun Young Yoo; J Prev Med Public Health. 2007;40(1):23-28.; DOI: https://doi.org/10.3961/jpmph.2007.40.1.23

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OBJECTIVES
Chronic infections with hepatitis B or C and alcoholic cirrhosis are three well-known major risk factors for liver cancer. Diabetes has also been suggested as a potential risk factor. However, the findings of previous studies have been controversial in terms of the causal association. Therefore, the aim of this study was to evaluate the association between serum glucose levels and liver cancer development in a Korean cohort. METHODS: Thirty-six liver cancer cases were identified in the Korean Multi-Center Cancer Cohort (KMCC). Baseline information on lifestyle characteristics was obtained via questionnaire. Serum glucose levels were measured at the study's enrollment. Relative risks (RRs) were estimated using a Cox proportional hazard regression model. The adjusting variables included age, gender, smoking history, alcohol consumption, body mass index, and hepatitis B surface antigen (HBsAg) seropositivity. RESULTS: The RRs of serum glucose for liver caner were 1.20 (95% CI=0.48-2.99) for the category of 100 to 125 mg/dL of serum glucose and 2.77 (95% CI=1.24-6.18) for the >126 mg/dL serum glucose category (both compared to the <100 mg/dL category). In a subgroup analysis, the RR of serum glucose among those who were both HBsAg seronegative and non-drinkers was 4.46 (95% CI=1.09-18.28) for those with glucose levels >100 mg/dL. CONCLUSIONS: The results of this study suggest that a high level of serum glucose can increase liver cancer risk independently of hepatitis infection and drinking history in Koreans. This study implies that glucose intolerance may be an independent risk factor for liver cancer.

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Kwang‐Pil Ko, Aesun Shin, Sooyoung Cho, Sue K Park, Keun‐Young Yoo
Journal of Gastroenterology and Hepatology.2018; 33(1): 111. CrossRef
Recognition criteria for occupational cancers in relation to hepatitis B virus and hepatitis C virus in Korea
Hogil Kim, Yun Kyung Chung, Inah Kim
Annals of Occupational and Environmental Medicine.2018;[Epub] CrossRef
The association between fasting blood glucose and the risk of primary liver cancer in Chinese males: a population-based prospective study
Xiaoshuang Feng, Gang Wang, Ni Li, Zhangyan Lyu, Shuohua Chen, Luopei Wei, Yuheng Chen, Shuanghua Xie, Wenjing Yang, Jian Yin, Hong Cui, Hongda Chen, Jiansong Ren, Jufang Shi, Shouling Wu, Min Dai, Jie He
British Journal of Cancer.2017; 117(9): 1405. CrossRef
Fasting glucose and risk of colorectal cancer in the Korean Multi-center Cancer Cohort
Hyeree Park, Sooyoung Cho, Hyeongtaek Woo, Sue K. Park, Hai-Rim Shin, Soung-Hoon Chang, Keun-Young Yoo, Aesun Shin, Cheng Hu
PLOS ONE.2017; 12(11): e0188465. CrossRef
Blood glucose concentration and risk of liver cancer: systematic review and meta-analysis of prospective studies
Hedong Han, Tianyi Zhang, Zhichao Jin, Honglei Guo, Xin Wei, Yuzhou Liu, Qi Chen, Jia He
Oncotarget.2017; 8(30): 50164. CrossRef
European Code against Cancer 4th Edition: Alcohol drinking and cancer
Chiara Scoccianti, Michele Cecchini, Annie S. Anderson, Franco Berrino, Marie-Christine Boutron-Ruault, Carolina Espina, Timothy J. Key, Michael Leitzmann, Teresa Norat, Hilary Powers, Martin Wiseman, Isabelle Romieu
Cancer Epidemiology.2016; 45: 181. CrossRef
European Code against Cancer 4th Edition: Alcohol drinking and cancer
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Cancer Epidemiology.2015; 39: S67. CrossRef
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Jin-Kyoung Oh, Min Kyung Lim, E Hwa Yun, Min-Ho Choi, Sung-Tae Hong, Soung-Hoon Chang, Sue Kyung Park, Sung-Il Cho, Dong-Hyun Kim, Keun-Young Yoo, Hai-Rim Shin
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Multicenter Study

Assessment of DNA Viability in Long Term-Stored Buffy Coat Species for the Korean Multicenter Cancer Cohort.: Mihi Yang, Jihyun Yoo, Cheong Sik Kim, Aesun Shin, Daehee Kang, Soung Hoon Chang, Sue Kyung Park, Hai Rim Shin, Keun Young Yoo; Korean J Prev Med. 2003;36(4):373-376.

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Abstract PDF: OBJECTIVES
Peripheral blood-buffy coat fractions (N = 14, 956) have been stored at -70degrees C in the headquarter of the Korean Multicenter Cancer Cohort (KMCC), since 1993. To study the future molecular etiology of cancers using specimens of the cohort, properly stored specimens are necessary. Therefore, the DNA-viability of the buffy coat samples was investigated. METHODS: Buffy coat fraction samples were randomly selected from various collection areas and years (N = 100). The DNA viability was evaluate from the UV-absorbent ratios at 260/280nm and the PCR for beta-globin was performed with genomic DNA isolated from the buffy coat. RESULTS: PCR products were obtained from 85 and 98% of the C and H area-samples, respectively, using 50 or 100mul of the buffy coat. There were significant differences in the yields of the PCR-amplifications from the C and H areas (p < 0.05), which was due to differences in the homogenization of the buffy coat fractions available as aliquots. The PCR-products were obtained from all of the samples (N = 7) stored at the C area-local center, but the other aliquots stored at the headquarter were not PCR-amplified. Therefore, the PCR products in almost all the samples, even including the DNA-degraded samples, were obtained. In addition, an improvement in the DNA isolation, i.e. approx. 1.6 fold, was found after using extra RBC lysis buffer. CONCLUSIONS: PCR products for beta-globin were obtained from nearly all of the samples. The regional differences in the PCR amplifications were thought to have originated from the different sample-preparation and homogenization performance. Therefore, the long term-stored buffy coat species at the KMCC can be used for future molecular studies.; Summary

In Vitro

Exposure Assessment of PCDD/Fs and Monitoring of Health Effects on Workers and Residents near the Waste Incinerators in Korea.: Jong Han Leem, Yun Chul Hong, Kwan Hee Lee, Ho Jang Kwon, Jae Yeon Jang; Korean J Prev Med. 2003;36(4):314-322.

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In this study, the exposure status of the hazardous substances from incinerators, such as polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs), were studied, and the relationship between the exposure of these hazardous substances and their heath effects on the workers and residents near municipal solid waste (MSW) incinerators and an industrial incinerator investigated. METHODS: Between July 2001 and June 2002, 13 workers at two MSW incinerators, 16 residents from the area around the two MSW incinerators, 6 residents from the control area, and further 10 residents near an industrial incinerator, estimated to emit higher levels of hazardous substances, were interviewed. Information, including sociodemographic information, personal habits, and work history, detailed gynecologic and other medical history were collected through interviews. Blood samples were also collected from 45 subjects, and analyzed for PCDD/DFs, by high resolution gas chromatography - high resolution mass spectrometry, using the US EPA 1613 method. In addition to the questionnaire survey, urinary concentrations of 8-hydroxydeoxyguanosine (8-OH-dG) and malondialdehyde (MDA) were measured as oxidative injury biomarkers. The urinary concentrations of 8-OH-dG were determined by in vitro ELISA, and the MDA by HPLC, using an adduct with thiobarbituric acid. RESULTS: The PCDD/DFs concentrations in the residents near the industrial incinerator were higher than those in the controls, workers and residents near the MSW incinerators. The average TEQ (Toxic Equivalencies) concentrations of the PCDD/DFs in residents near the industrial incinerator were 53.4pg I-TEQs/g lipid. The estimated daily intakes were within the tolerable daily intake range (1-4 pg I-TEQ/Kg bw/day) suggested by WHO (1997) in only 30% to the people near the industrial incinerator. Animal studies have already shown that even a low body burden of PCDD/DFs, such as 10ng TEQ/kg bw, can cause oxidative damage in laboratory animals. Our study also showed that the same body burden of PCDD/DFs can cause oxidative damage to humans. CONCLUSIONS: The exposures to PCDD/DFs and the oxidative stress of residents near the industrial incinerator, were higher than those in the controls, workers and residents near the MSW incinerators. Proper protection strategies against these hazardous chemicals are needed. Because a lower body burden of PCDD/Fs, such as 10ng TEQ/kg bw, can cause oxidative damage, the tolerable daily intake range should be restrictedly limited to 1pg I-TEQ/kg bw/day.; Summary

Original Articles

Relationship of Serum Uric Acid to Cardiovascular Risk Factors in Korean Male Workers.: So Yeon Ryu, Jong Gab Oh, Chul Gab Lee, Ki Soon Kim; Korean J Prev Med. 2002;35(3):214-220.

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To investigate the relationship of serum uric acid to cardiovascular risk factors in Korean male workers. METHODS: We screened 522 male workers at an electrical manufacturing company by a periodic health examination and a questionnaire survey in 2000. We collected data relating to age, smoking status, alcohol drinking status, body mass index (BMI), blood pressure, serum lipid, fasting blood glucose and serum uric acid. The data were analyzed using a variety of methods, including ANOVA, Pearson's correlation, and multivariate regression analyses, to examine the association between uric acid and cardiovascular risk factors with a cross-sectional study design. RESULTS: The concentration of serum uric acid showed positive associations with BMI, total cholesterol, triglyceride, and LDL-cholesterol; it was also significantly correlated to systolic and diastolic blood pressures. Life-style characteristics, such as smoking and alcohol drinking showed no significant association. From the multivariate regression analyses, BMI, total cholesterol and fasting blood glucose levels were found to be independent positive predictors of uric acid; while age, blood pressure and smoking status give no independent contribution explaining the variability of serum uric acid levels. Conclusions : This study demonstrates that serum uric acid level have a significant association with cardiovascular risk factors, such as BMI, total cholesterol and blood glucose in some Korean male workers.; 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

Association of Blood Pressure with the Social Support of Some Rural Residents.: So Yeon Ryu, Chul Gab Lee, Jong Park, Ki Soon Kim; Korean J Prev Med. 2001;34(4):437-443.

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Abstract PDF: OBJECTIVES
This study was performed to assess the association between the social support and blood pressure(BP) in a rural community. METHODS: A cross-sectional survey, comprising a health examination including BP, height and weight and a questionnaire-based interview which investigated social support, demographic factors, smoking, drinking, and etc. was performed between February 10th and March 5th, 1998. The survey included 318 persons who were over than 30-year-old in the rural community of Kwangju, Republic of Korea. We excluded persons who taking antihypertensive medications or who provided incomplete information; we subsequently analyzed the data from 284 persons. In order to test the hypothesis of an association between BP and social support controlling confounders such as age, educational level, working time, body mass index, smoking and drinking, the data was analyzed using multiple linear regression analysis. RESULTS: The subjects were composed of 109(38.4%) males and 175(61.6%) females with mean ages of 62.0 years and 61.1 years, respectively. The hypertension prevalence was 41.3% among males and 45.1% among females. In the correlation analysis, higher total social support scores correlated significantly with lower systolic BP in both males and females. The hypertension prevalence increased significantly with the decreasing of the social support in males. In multiple regression analysis, systolic and diastolic blood pressure showed a negative association with social support in both males and females, although this was not statistically significant. CONCLUSIONS: Larger and broader studies are required in the future in order to identify the association between the social support and BP.; Summary

A Meta-analysis of the Association between Blood Lead and Blood Pressure.: Sang Baek Koh, Chun Bae Kim, Chung Mo Nam, Hong Ryul Choi, Bong Suk Cha, Jong Ku Park, Ho Sung Jee; Korean J Prev Med. 2001;34(3):262-268.

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Abstract PDF: OBJECTIVES
To integrate the results of studies which assess an association between blood lead and blood pressure. METHODS: We surveyed the existing literature using a MEDLINE search with blood lead and blood pressure as key words, including reports published from January 1980 to December 2000. The criteria for quality evaluation were as follows: 1) the study subjects must have been workers exposed to lead, and 2) both blood pressure and blood lead must have been measured and presented with sufficient details so as to estimate or calculate the size of the association as a continuous variable. Among the 129 articles retrieved, 13 studies were selected for quantitative meta-analysis. Before the integration of each regression coefficient for the association between blood pressure and blood lead, a homogeneity test was conducted. RESULTS: As the homogeneity of studies was rejected in a fixed effect model, we used the results in a random effect model. Our quantitative meta-analysis yielded weighted regression coefficients of blood lead associated with systolic blood pressure and diastolic blood pressure results of 0.0047 (95% confidence interval [CI]: -0.0061, 0.0155) and 0.0004 (95% CI: -0.0031, 0.0039), respectively. CONCLUSIONS: The published evidence suggested that there may be a weak positive association between blood lead and blood pressure, but the association is not significant.; Summary

Trend of the Changes in the Level of Blood Lead, Urinary Arsenic and Urinary Cadmium of Children in Ulsan: 3-year Follow-up Study.: Choong Ryeol Lee, Cheol In Yoo, Ji Ho Lee, Hun Lee, Yangho Kim; Korean J Prev Med. 2001;34(2):166-174.

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Abstract PDF: OBJECTIVES
To obtain basic data on blood lead level and urinary level of arsenic and cadmium of children living near a petrochemical estate and a suburban area in Ulsan, Korea and to observe the trend of the changes in the level of these metals in these children. METHODS: The study subjects comprised 626 children living near a petrochemical estate and 299 children living in a suburban area of Ulsan. We analyzed the level of lead, arsenic and cadmium using atomic absorption spectrometer. RESULTS: The mean levels of blood lead in children living near the petrochemical estate were 5.25 microgram/dl, 5.24 microgram/dl, and 7.24 microgram/dl in the years 1997, 1999, and 2000, respectively, whereas those of children living in the suburban area were 3.81 microgram/dl, 4.75 microgram/dl, and 7.19 microgram/dl respectively. The mean levels of urinary arsenic in children living near the petrochemical estate were 4.57 microgram/g creatinine, 4.78 microgram/g creatinine, and 6.02 microgram /g creatinine in the year 1997, 1999, and 2000 respectively, whereas those of children living in suburban area were 2.35 microgram/g creatinine, 4.75 microgram/g creatinine, and 7.07 microgram/g creatinine, respectively. The mean levels of urinary cadmium in children living near the petrochemical estate were 1.15 microgram/g creatinine, 1.05 microgram/g creatinine, and 1.71 microgram/g creatinine in the year 1997, 1999, and 2000, respectively, whereas those of the children living in the suburban area were 0.74 microgram/g creatinine, 1.29 microgram/g creatinine, and 1.48 microgram/g creatinine, respectively. There were increasing trends in the level of blood lead, urinary arsenic and cadmium of children in Ulsan, and the differences in the level of these metals were disappearing between the children living in other areas year by year. CONCLUSIONS: These results suggest that the amount of exposure to lead, arsenic, and cadmium is increasing from year to year, and there is a need for periodic biological and atmospheric monitoring of these metals in Ulsan.; Summary

Separate and Combined Effect of Cadmium and Nickel on Blood Pressure in Rats.: Seung Jun Wang, Bong Suk Cha; Korean J Prev Med. 2001;34(2):127-130.

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Abstract PDF: OBJECTIVE
To verify the separate and combined effects of cadmium and nickel on blood pressure in rats. METHODS: Following the daily administration of cadmium chloride(CdCl2) and nickel chloride(NiCl2) to rats both individually and in combination with intraperitoneal injection method for one week, systolic blood pressure of the tail was measured at 1 day and 5, 10, 20, 30 days after administration. Each substance was injected into the rats with 0.1 mg/kg bw and 1.0 mg/kg bw concentration. RESULTS: After 0.1 mg/kg bw CdCl2 was injected, a statistically significant difference was found as compared with the control group(only saline) after 1, 5 and 10 days. After 0.1 mg/kg bw NiCl2 was injected, a statistically significant difference was not found compared with the control group. After 0.1 mg/kg bw CdCl2 and 0.1 mg/kg bw NiCl2 were injected simultaneously, a statistically significant difference was found as compared with the control group after 1, 5 and 10 days and compared with 0.1 mg/kg bw CdCl2 group after 5 days and as compared with 0.1 mg/kg bw NiCl2 group after 5 and 10 days. After 1.0 mg/kg bw CdCl2 was injected, a statistically significant difference was found as compared with the control group after 1, 5, 10 and 20 days. After 1.0 mg/kg bw NiCl2 was injected, a statistically significant difference was found as compared with the control group after 1 day and 5 days. After 1.0 mg/kg bw CdCl2 and 1.0 mg/kg bw NiCl2 were injected in combination, a statistically significant difference was found after 1, 5, 10, 20 and 30 days as compared with 1.0 mg/kg bw CdCl2 after 10, 20 and 30 days and as compared with 1.0 mg/kg bw NiCl2 after 5, 10, 20 and 30 days. CONCLUSION: It was found that the effect of CdCl2 on blood pressure was much more than NiCl2 and a high concentration CdCl2 and NiCl2 in combination delayed the recovery of blood pressure.; Summary

Short-term Glycemic Control and the Related Factors in Association with Compliance in Diabetic Patients.: Gui Young Kim, Jae Yong Park, Bo Wan Kim; Korean J Prev Med. 2000;33(3):349-363.

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Abstract PDF: OBJECTIVES
Generally, it seemed that the therapeutic result in diabetic patients was changed by compliance. This study was conducted on the basis of assumption that the therapeutic result in diabetic patients could control according to compliance. This study was conducted to analyze the related factors in association with compliance to drug, diet and exercise therapy. METHODS: 224 diabetic patients in Kyungpook National University Hospital were selected through the interviews and HbA1c values from 1 Jan. to 28 Feb. 1997. The drug compliance was tested by regularity of drug administration, the diet compliance was tested by restriction of food, exactly allocation, balance of nutrient, measuring food and the exercise compliance was tested by regularity of exercise per day. We assessed compliance by percentage, X2-test and generalized logit regression model(method:enter). RESULTS: The significant variable was the satisfaction to medical personnels in drug, the knowledge to disease in diet, the participation of the diabetic education in exercise therapy and the satisfaction to medical personnels in HbA1c. Using the generalized logit model(method : enter) in compliance change, the significant variables were the satisfaction to medical personnels and the complication in drug; the significant variables were the age at the first diagnosis, the family history, the concern of health, the knowledge of disease, the self-exertion for therapy and the complication in diet; the only significant variable was the gender in exercise therapy. CONCLUSIONS: The degree of glycemic control in diabetic patients was influenced by compliance. In order to improve patient's compliance, we must foster the knowledge on the diseases, lead participation for diabetic education. Because the satisfaction to medical personnels was the important variables, we must build up good relationship between doctors and patients.; Summary

A Meta-analysis on the Association between Chronic Noise Exposure and Blood Pressure.: Chun Bae Kim, Sang Baek Koh, Jai Young Kim, Bong Suk Cha, Hong Ryul Choi, Jong Tae Lee, Chung Mo Nam, Sang Yun Lee, Seung jun Wang, Keeho Park, Dae Youl Kim; Korean J Prev Med. 2000;33(3):343-348.

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Abstract PDF: OBJECTIVES
This study was conducted to integrate the results of studies assessing the association between chronic noise exposure and blood pressure. METHODS: Using a MEDLINE search with noise exposure, blood pressure and hypertension as key words, we retrieved articles from the literature that were published from 1980 to December 1999. The criteria for quality evaluation were as follows: 1) the study subjects must have been workers employed at a high noise level area 2) The paper should use average and cumulative noise exposure as method for exposure evaluation. 3) Blood pressure in each article should be reported in a continuous scale Among the 77 retrieved articles, six studies were selected for quantitative meta-analysis. Before the integration of the regression coefficients for the association between blood pressure and noise level, homogeneity tests were conducted. RESULTS: All studies were a cross-sectional design and the study subjects were industrial workers. Five papers used a time-weighted average for noise exposure and only one paper calculated the cumulative noise exposure level. The measurement of blood pressure in the majority of studies were accomplished in a resting state, and used an average of two or more readings. The homogeneity of studies was rejected in a fixed effect model, so we used the results in a random effect model. The results of the quantitative meta-analysis, the weighted regression coefficient of noise associated with systolic blood pressure and diastolic blood pressure were 0.05 (95% confidence interval [CI]: -0.03, 0.13) and 0.06 (95% CI: -0.01, 0.13), respectively. CONCLUSIONS: Our results suggested that chronic exposure to industrial noise does not cause elevated blood pressure.; Summary

Relationship between Blood Pressure and Impairment of Cognitive Function In Some Rural Residents Aged 60-64.: Choong Won Lee, Moo Sik Lee, Jong Chan Chun; Korean J Prev Med. 2000;33(2):208-214.

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Abstract PDF: OBJECTIVES
Face-to-face interviews were conducted to investigate the relationship between blood pressure and the impairment of cognitive function in rural elderly (N=932) aged 60-64 in Dalsung County, April to September in 1996 METHODS: Impairment of cognitive function was defined as a score of less than 23 by the Korean version of the Mini-Mental State Examination (MMSEK). Blood pressure was measured once in each subject using a portable automatic sphygmomanometer. RESULTS: By univariate logistic regression on males, no category of systolic blood pressure bore statistical significance. Groups with diastolic blood pressures of, less than 80 mmHg, 90-94 mmHg, and more than 95mmHg had odds ratios of more than one compared with the reference group (80-89 mmHg). This was most significant in the group with blood pressures lower than 80 mmHg, which had a statistically significant odds ratio of 1.68 (95 % confidence interval Cl; 1.02-2.75). No category of blood pressure was statistically significant in females. Multivariate logistic regression for males, with adjustment for age, educational attainment, smoking, alcoholic drinking, body mass index, atherosclerotic disease, and antihypertensive medication use, did not alter the odds ratios significantly in terms of systolic blood pressure. However, the group with diastolic blood pressure of less than 80 mmHg had an increased odds ratio of 2.01 (95 % Cl; 1.15-3.52) compared with the reference group. In females, systolic blood pressure did not alter the odds ratio, but the group with a diastolic blood pressure of less than 80 mmHg had a statistically significant odds ratio of 0.57 (95% Cl; 0.37-0.89). CONCLUSIONS: These results suggest that the relationship between blood pressure and cognitive function status is stronger diastolic than systolic blood pressure and that there is a complex relationship between blood pressure and cognitive function by sex.; Summary

Blood Lead, Manganese, Aluminium and Silicon Concentrations in Korean Adults.: Jung Man Kim, Jung Mo Ahn, Won Sul Kim, Jung Il Kim, Hai Rim Shin, Kap Yeol Jung, Joon Youn Kim; Korean J Prev Med. 2000;33(2):157-164.

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Abstract PDF: OBJECTIVES
This study was performed to determine the reference values of blood lead, manganese, aluminium, and silicon in healthy adults. METHODS: The subjects were 132 (67 male and 65 female), and classified to three age groups (< or =39, 40~49, and 50< or =). Blood lead, manganese and aluminium were analyzed by atomic absorption spectrophotometer, and blood silicon was analyzed by direct current plasma optical emission spectrometer. RESULTS: Blood lead levels(geometric mean, S.D) were (3.49, 1.70) microgram/dL in male and (3.04, 1.65) microgram/dL in female, but the difference is not significant, and there was no significant difference between age groups. Mean blood manganese level was 0.99+/-0.41 microgram/dL, and there was no significant difference between sex or age groups. Mean blood aluminium level was 0.59+/-0.35 microgram/dL, and there was no significant difference between sex or age groups. Mean blood silicon level was 54.41+/-27.64 microgram/dL in male and 43.34+/- 23.51 microgram/dL in female, and the level in male was significantly higher than that in female (p<0.05). There was significant difference between age groups, and the oldest showed the highest level in male (p<0.05), but no significant difference between age groups in female. CONCLUSIONS: Authors hope that this study would provide basic data for determining reference values and evaluating health effects.; Summary

A Nested Case-Control Study on the High Normal Blood Pressure as a Risk Factor of Hypertension in Korean Middle-aged Men.: Jong Myon Bae, Yoon Ok Ahn; Korean J Prev Med. 1999;32(4):513-525.

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Abstract PDF: OBJECTIVES
'High-normal blood pressure' is a factor influencing decision to initiate targeted intensive intervention strategy in westernized populations. JNC-VI offered the vigorous lifestyle modification for persons with 'high-normal blood pressure', who could be early detected. As a hypertension seems to be the result of multiple genetic factors operating in concert with associated environmental factors, it will be necessary to identify the high-normal blood pressure as a risk factor of hypertension for applying primary prevention strategy in Korean people. METHODS: Although cohort study design might be adequate to recruit incidence cases, to keep time sequence of events, and to prevent information bias, nested case-control study was chosen for avoiding measurement errors because hypertension is a benign disease. Source population was the 'Seoul Cohort' participants and follow-up was done by using Korea Medical Insurance Corporation's database on the utilization of health services from 1Jan93 to 30Jun97. Incidence cases were ascertained through the chart review, telephone contacts, and direct blood pressure measurements. Controls included the pairing of 4 individuals to each case on the basis of age. RESULTS: As 75 % of 247 incident cases had high-normal blood pressure, the crude odds ratio for hypertension was 2.04 (95% CI 1.47-2.83). Another statistically significant risk factors of hypertension were body mass index, dietary fiber, alcohol consumption, weekly activity and history of quitting smoking. The multivariate odds ratio of high-normal blood pressure adjusted for all risk factors was 1.84 (95 % CI 1.31-2.56). Among high-normal blood pressure group, body mass index, weekly ethanol amounts, weekly physical activity, and dietary fiber except history of quitting smoking were still risk factors of hypertension. CONCLUSION: 'High-normal blood pressure' is a risk factor for hypertension in Korean middle-aged men, which represents that the vigorous lifestyle modification for persons with 'high-normal blood pressure' is need.; Summary

Different Effect of Blood Lead on Zinc Protoporphyrin by Gender in Korean Lead Workers.: Hyun Cheol Ahn, Yong Bae Kim, Gap Soo Lee, Kyu Yoon Hwang, Sung Soo Lee, Kyu Dong Ahn, Byung Kook Lee; Korean J Prev Med. 1999;32(4):499-504.

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Abstract PDF: OBJECTIVES
To evaluate whether a relation between blood lead and zinc proto porphyrin(ZPP) was modified by gender in Korean lead workers. METHODS: A cross-sectional study was conducted with 1,304 male and 101 female subjects in 1997. The relation between blood lead and ZPP were evaluated with linear, exponential, and quadratic models. Then, the different effect of gender on the relation was examined by adding the interaction terms in the each model. RESULTS: Mean+/-SD of blood lead and ZPP level was different between male(27.7+/-10 microgram /dl and 51.3+/-23.4 microgram/dl) and female subjects(22.5+/-9.2 microgram/dl and 78.7+/-38.6 microgram/dl). After adjusting for possible confounders, the effect modification by gender was significant in linear(beta=1.119, p<0.001), exponential(beta=Exp(0.008), p<0.05), and quadratic model(beta= 1.388, p<0.001). In separate analysis, a quadratic relation between blood lead and ZPP was shown in male lead workers(beta=0.036, p<0.001), but an exponential relation in female lead workers(n=Exp(0.029), p<0.001). CONCLUSION: Our data showed that the increasing rate of ZPP in female were always higher than in male lead workers, suggesting that females were more susceptible to occupational lead exposure than males.; Summary

Meta-analysis on the Blood Lipids as Risk Factors of Coronary Heart Diseases in Koreans.: So Yeon Ryu, Ki Soon Kim, Yang ok Kim, Jong Park, Jong Ku Park, Chun Bae Kim, Sun Ha Jee; Korean J Prev Med. 1999;32(4):491-493.

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Abstract PDF: OBJECTIVES
To determine the relations between seven blood lipids such as total cholesterol(TC), triglyceride(TG), HDL-cholesterol(HDL), LDL-cholesterol(LDL), apolipoprotein A-1(Apo A1), apolipoprotein B(Apo B) and lipoprotein(a)(Lp(A)) and the coronary heart diseases(CHD), the quantitative techniques of meta-analysis were applied to studies of blood lipids and CHD in Koreans. METHODS: We searched the Korean and the English literature published from 1980 to August, 1997 by manual search and bibliography review. Information on sample size, study design, participant characteristics(gender, age) and blood lipid levels were abstracted by reviewers using inclusion criteria. Estimates of the effect sizes of blood lipid levels on CHD in Koreans and corresponding 95% confidence intervals were calculated using random-effect models. RESULTS: We identified 16 case-control studies to apply meta-analysis. The overall effect sizes for CHD were 20.3(95% CI : 14.23-26.22) in TC, 24.8(95% CI : 12.6-36.86) in TG, 15.16(95% CI : 3.99 - 26.33) in LDL, -3.48(95% CI : -5.79 - -1.17) in HDL, -9.78(95% CI : -16.98 - -2.58) in Apo-a1, 17.88(95% CI : 9.72 - 26.05) in Apo B and 18.95(95% CI : 17.88 - 20.02) in Lp(a). CONCLUSIONS: Our results suggested that seven blood lipids were significantly associated with CHD in Koreans. Well-designed and prospective studies between blood lipids and CHD in Koreans should be performed.; Summary

Effects of Change in Obestiy and Life Style Factors on Blood Pressure and Serum Cholesterol - 3-year Follow-up among Workers in a Steel Manufacturing Industry -.: Myung Hwa Ha, Duk Hee Lee, Song Kwon Lee; Korean J Prev Med. 1999;32(3):415-420.

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Abstract PDF: OBJECTIVES
We investigated the effects of changes in obesity and life style factors, such as cigarette smoking, alcohol drinking, and exercise, on the changes in blood pressure and serum cholesterol among Korean men. METHODS: This study included 7,205 healthy male employees in the steel manufacturing industry. Each subject underwent health examination in 1994 and was re-examined in 1997. The study subjects were classified into four categories, according to changes in body mass index (BMI) (loss; stable; mild gain; severe gain), cigarette smoking (quitter; non-smoker; smoker continued; smoker started), alcohol drinking (quitter; non-drinker; drinker continued; drinker started) and exercise (more exercise; continuous regular exercise; continuous irregular or no exercise; less exercise), respectively. We evaluated the relationship between the categories of change in those independent variables and the changes in blood pressure and serum cholesterol, adjusted for BMI in 1994 and age by analysis of variance. RESULTS: The change in systolic blood pressure was positively associated with the changes in BMI (p<0.001) and drinking (p=0.001), but negatively with smoking (p=0.004), compared to the first category of each independent variables. The systolic blood pressure was significantly less increased in the continuous smoking group than quitter or non-smoker. The changes in diastolic blood pressure and serum cholesterol appeared to have statistically significant linear relationships only with the change in BMI. The change in exercise showed a marginal significance with diastolic blood pressure (p=0.088). CONCLUSIONS: These prospective data emphasize the importance of obesity as a determinant of the changes in blood pressure and serum cholesterol. In addition, the changes in smoking and drinking habits can affect systolic blood pressure.; Summary

A Distribution of Waist-hip Ratio Associated with the Blood Pressure in Middle-aged Men.: Jong Myon Bae, Dae Sung Kim, Jaiyong Kim, Yoon Ok Ahn; Korean J Prev Med. 1999;32(3):395-399.

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Abstract PDF: BACKGROUND
Excess abdominal fat, expressed as an increased ratio of waist to hip circumferences (WHR), is independently associated with higher levels of blood pressure. Although a WHR greater than 1.0 in men has been shown to predict complications from obesity, the WHR has not been evaluated in all ethnic groups. METHODS: In order to ascertain the association between WHR and classification of blood pressure and to investigate the critical value of WHR as a predictive factor of hypertension in Korean middle-aged men, we compared the mean of WHRs according to the classification of blood pressure in Seoul Cohort participants. RESULTS: Through a survey of direct measurement of waist and hip girth, 452 subjects were recruited from the cohort. The mean of WHR was 0.88 and its standard deviation was 0.04. The mean of WHRs was higher in the systolic blood pressure group (above 140 mmHg), diastolic blood pressure group (above 90 mmHg), and hypertension group than in the systolic blood pressure group (below 140 mmHg), diastolic blood pressure group (below 90 mmHg), and normotensive group, respectively. And WHR of above 0.89 was associated with hypertension (z-value =6.66). CONCLUSIONS: It is necessary for Korean males with WHR greater than 0.89 to recommend the primary prevention and early detection of hypertension.; 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

Lipid Peroxidation and Antioxidants in Workers Exposed to Lead.: Won Jin Lee, Cheon Hyun Hwang, Cheong Sik Kim, Soung Hoon Chang, Yang Ho Kim, Hae Joon Kim; Korean J Prev Med. 1998;31(3):449-459.

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Abstract PDF: This study was started to find out if plasma malondialdehyde(MDA), alpha-tocopherol and erythrocyte superoxide dismutase(SOD) activity could be markers of biological activity resulting from exposed to lead in workers. Blood samples were randomly obtained from lead -exposed workers(n=29), CO2 welders(n=60) and office workers(n=60). We used whole blood to analyse blood lead with atomic absorption spectrophotometer. Superoxide dismutase activity in erythrocyte was measured with spetrophotometer. MDA and alpha-tocopherol in plasma were measured with high performance liquid chromatography. Lead-exposed workers was significantly high in blood lead concentration(29.37 ng/dl) compared with welders(6.42 ng/dl) and office workers(5.01 ng/dl). The level of plasma MDA was significantly higher in the lead-exposed workers(1.87 nmol/g cholesterol) than the welders(1.41 nmol/g cholesterol) and office workers(1.41 nmol/g cholesterol). Erythrocyte SOD activity in lead-exposed workers(56.80 U/g Hb) was significantly increased than those of welders(37.63 U/g Hb) and office workers(20.47 U/g Hb). The plasma alpha-tocopherol level of lead-exposed workers(4.93 ng/g cholesterol) was statistically different from welders(4.25 ng/g cholesterol) and office workers(4.28 ng/g cholesterol). Neither age nor smoking was related to SOD or MDA level. Blood lead was significantly correlated with erythrocyte SOD activity(r=0.405), plasma MDA(r=0.296) and alpha-tocopherol(r=0.207). Plasma MDA was also significantly correlated with SOD (r=0.217). In multiple regression analysis, the change of MDA and SOD activity level related to the blood lead concentration. These results suggested that the increase of plasma MDA and erythrocyte SOD activity in lead-exposed workers had a close relationship with the oxidative stress induced by lead.; Summary

The effect of sodium and potassium intake on blood pressure change in Korean adolescents.: Il Suh, Chung Mo Nam, Kang Hee Lee, Sun Ha Jee, Suk Il Kim, Gyu Sang Kim, Chun Bae Kim; Korean J Prev Med. 1998;31(3):384-394.

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Abstract PDF: In order to investigate the effect of the urinary excretion of sodium and potassium on the change on blood pressure over 3 years, 668 adolescents aged 13 years living in Kangwha area were investigated in a longitudinal follow-up study. Two measurements were taken on each blood pressure (diastolic, systolic) and the average of the two readings was used in the analysis. Sodium and potassium intake were estimated by the determination of those electrolytes in 24hr urine. The mixed model regression analysis was used to identify the effect of urinary sodium and potassium on the change of blood pressure after controlling for BMI of each age. On simple bivariate analysis no relationship was found between urinary sodium excretion and systolic or diastolic blood pressure among both male and female, however, a significant positive association between urinary potassium excretion and systolic blood pressure among male. The results of mixed regression analysis showed that the body mass index (BMI) were more influential that urinary electrolytes among this study subjects. It suggested that risk factors observed from the adults, may not be identical with that of the growing aged population. After control of the BMI and age, significant association between sodium and diastolic BP among male, and association between potassium and systolic BP among female, were found. In summary, the results indicate that growth has been more influential than dietary factor on blood pressure for growing aged population.; Summary

Blood Lead Levels of Children in Ulsan Industrial Area.: Cheol In Yoo, Ji Ho Lee, Choong Ryeol Lee, Sung Ryul Kim, Seon Ho Lee; Korean J Prev Med. 1998;31(2):240-248.

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Abstract PDF: We conducted this study, to obtain basic data of lead concentrations in children of Ulsan industrial area and to evaluate the difference in blood lead levels between industrial area and suburban area. The study subjects were composed of 348 school children residing in industrial area and 100 school children of suburban area. There is no difference in age and sex distribution of study participants between industrial and suburban area. The obtained results were as follows: l. The geometric means of blood lead levels of study participants were 4.90 ng/dl, which is lower than current acceptable value 10 ng/dl. 2. The children residing in industrial area had the higher blood lead levels(5.26 ng/dl) than suburban children(3.81 ng/dl) with statistical significance(P<0.001).; Summary

A cohort study on blood zinc protoporphyrin concentration of workers in storage battery factory.: Man Joong Jeon, Joong Jeong Lee, Joon Sakong, Chang Yoon Kim, Jung Man Kim, Jong Hak Chung; Korean J Prev Med. 1998;31(1):112-126.

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Abstract PDF: To investigate the effectiveness of the interventions in working environment and personal hygiene for the occupational exposure to the lead, the blood zinc protoporphyrin(ZPP) concentrations of 131 workers ( 100 exposed subjects and 31 controls ) of a newly established battery factory were analyzed. They were measured in every 3 months up to 18 months. Air lead concentration (Pb-A) of the workplaces was also checked for 3 times in 6 months interval from August 1987. Environmental intervention included the local exhaust ventilation and vacuum cleaning of the floor. Intervention of the personal hygiene included the daily change of clothes, compulsory shower after work and hand washing before meal, prohibition of cigarette smoking and food consumption at the work site and wearing mask. Mean blood ZPP concentration of the controls was 16.45+/-4.83 microgram/dashliter at the preemployment examination and slightly increased to 17.77+/-5.59 microgram/dashliter after 6 months. Mean blood ZPP concentration of the exposed subjects who were employed before the factory was in operation (Group A) was 17.36+/-5.20 microgram/dashliter on employment and it was increased to 23.00+/-13.06 microgram/dashliter after 3 months. The blood ZPP concentration was increased to 27.25+/-6.40 microgram/dashliter on 6 months (p<0.01) after the employment which was 1 month after the initiation of intervention program. It did not increase thereafter and ranged between 25.48 microgram/dashliter and 26.61 microgram/dashliter in the subsequent 4 results. Mean blood ZPP concentration of the exposed subjects who were employed after the factory had been in operation but before the intervention program was initiated (Group B) was 14.34+/-6.10 microgram/dashliter on employment and it was increased to 28.97+/-7.14 microgram/dashliter (p<0.01) in 3 months later(1 month after the intervention). The values of subsequent 4 tests were maintained between 26.96 microgram/dashliter and 27.96 microgram/dashliter. Mean blood ZPP concentration of the exposed subjects who were employed after intervention program had been started (Group C) was 21.34+/-5.25 microgram/dashliter on employment and it was gradually increased to 23.37+/-3.86 microgram/dashliter (p<0.01) after 3 months, 23.93+/-3.64 microgram/dashliter after 6 months, 25.50+/-3.01 microgram/dashliter (p<0.01) after 9 months, and 25.50+/-3.10 microgram/dashliter after 12 months. Workplaces were classified into 4 parts according to Pb-A. The Pb-A of part I, the highest areas, were 0.365 microgram/m4, and after the intervention the levels were decreased to 0.216 microgram/m4 and 0.208 microgram/m4 in follow-up test. The Pb-A of part II which was resulted in lower value than part I was decreased from 0.232 microgram/m4 to 0.148 microgram/m4, and 0.120 microgram/m4 after the intervention. The Pb-A of part III was tested after the intervention and resulted in 0.124 microgram/m4 in January 1988 and 0.081 microgram/m4 in August 1988. The Pb-A of part IV was also tested after the intervention and resulted in 0.110 microgram/m4 in August 1988. There was no consistent relationship between Pb-A and blood ZPP concentration. The blood ZPP concentration of the group A and B workers in the part of the highest Pb-A were lower than those of the workers in the parts of lower Pb-A. The blood ZPP concentration of the workers in the part of the lowest Pb-A increased more rapidly. The blood ZPP concentration of the group C workers was the highest in part III. These findings suggest that the intervention in personal hygiene is more effective than environmental intervention, and it should be carried out from the first day of employment and to both the exposed subjects, blue color workers and the controls, white color workers.; Summary

The change of validity of blood zinc protoporphyrin test by different cut-off level in level workers.: Yong Bae Kim, Hyun Cheol Ahn, Young Hwangbo, Gap Soo Lee, Sung Soo Lee, Kyu Dong Ahn, Byung Kook Lee; Korean J Prev Med. 1997;30(4):741-751.

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Abstract PDF: Measurement of blood lead (PbB) and blood zinc protoporphyrin (ZPP) are most common biological indices to identify the individual at risk for excess or the health sequences by lead exposure. Because PbB is known most important and reliable index of lead exposure, PbB is often regarded as a gold standard to detect lead exposure. But in Korea PbB is a secondary test item of detailed health check-up with positive finding of screening test in most occasion. Our lead standard requires all lead workers to take annual heath-check twice a year for investigation of their health effect due to lead exposure. Blood ZPP is one of most important index to detect high lead absorption in lead workers as a screening test. Measurement of blood ZPP is known well to correlate with PbB in steady state of exposure in most lead workers and is often used as a primary screening test to detect high lead absorption of lead workers with the advantage of simplicity, easiness, portability and low cost. The current cut-off criteria of blood ZPP for further detailed health check-up is 100 ng/dl which is supposed to match the level of 40 ng/dl of PbB according to our standard. Authors tried to investigate the validity of current criteria of cut-off level(100 ng/dl) of blood ZPP and possible another better cut-off level of it to detect the lead workers whose PbB level over 40 ng/dl. The subjects in our study were 212 male workers in three small scale storage battery industries. Blood ZPP, PbB and hemoglobin(Hb) were selected as the indices of lead exposure. The results were as follows. 1. The mean of blood ZPP, PbB and Hb in lead workers were 79.5+/-46.7 ng/dl, 38.7+/-15.1 ng/dl, and 14.8+/-1.2 g/dl, respectively. There were significant differences in blood ZPP, PbB and Hb by industry(P<0.01). 2. The percents of lead workers whose blood ZPP were above 100 ng/dl in the group of work duration below 1, 1-4, 5-9 and above 10 years were 8.6%, 17.2%, 47.6%, and 50.0%, respectively. The percents of lead workers whose PbB were above 40 ng/dl in those were 31.4%, 40.4%, 71.4%, and 86.4%, respectively. 3. The percents of lead workers whose PbB were below 40 ng/dl, 40-59 ng/dl and above 60 ng/dl were 54.7%, 34.9% and 10.4%, respectively. Those of lead workers whose blood ZPP were below 100 ng/dl, 100-149 ng/dl and above 150 ng/dl were 79.2%, 13.7% and 7.1%, respectively. 4. Simple linear regression of PbB on blood ZPP was statistically significant(P<0.05) and as PbB was 40 ng/dl, blood ZPP was 82.1 ng/dl. 5. While the highest sensitivity and specificity of blood ZPP test to detect lead workers with PbB over 40 ng/dl were observed in the cut-off level of 50 ng/dl and 100 ng/dl of blood ZPP, respectively, the highest validity(sensitivity+specificity) of blood ZPP to detect lead workers with PbB over 40 ng/dl was observed in the cut-off level of around 70 ng/dl of blood ZPP. But even with optimal cut-off level of around 70 ng/dl of blood ZPP, still 25.0% of false negative and 20.7% false positive lead workers were found. As the result of this study, it was suggested that reconsideration of current blood ZPP cut-off of our lead standard from 100 ng/dl to somewhat lower level such as around 70 ng/dl and the inclusion of PbB measurement as a primary screening test for lead workers was highly recommended for the effective prevention of lead workers.; Summary

Association between air conduction hearing threshold and blood viscosity in normal adult males.: Sang Woo Kim, Jong Young Lee, Wan Seup Park, Kuck Hyeun Woo; Korean J Prev Med. 1997;30(3):623-629.

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Abstract PDF: This is cross-sectional study a potential relationship between air conduction hearing threshold and blood viscosity in normal adult males(n=1677). We measure hearing threshold in frequency level at 500, 1000, 2000, 4000Hz by pure-tone audiometry and RBC profiles contains red cell number, hemoglobin, hematocrit. Blood viscosity replaced by hematocrit that are one major factor of influencing blood viscosity. PTAs(pure-tone averages) measured by hearing threshold averages level at 500Hz, 1000Hz, 2000Hz by pure-tone audiometry. Grades of PTAs(pure-tone averages) are less then 10.0dB group, between 10.0-19.9dB group and excess 20.0dB. The results are significantly association among hematocrit, red cell number and hearing loss(age adjust by ANACOVA).; Summary

Association of Lifestyle with Blood Pressure.: Ree Joo, Jong Hak Chung; Korean J Prev Med. 1997;30(3):497-507.

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Abstract PDF: This study was conducted to evaluate the association of various lifestyle with blood pressure. The data were obtained from the individuals who got routine health examination in Department of Occupational Medicine, Yeungnam University Hospital from June to September, 1996. Among these people, we selected 130 cases of hypertensives(97 males, 33 females) and 150 normotensives(70 males, 80 females) and study was conducted. The authors collected the information of the risk factors related to hypertension such as age, family history of hypertension, fasting blood sugar, serum total cholesterol, alcohol consumption(g/week), smoking history, relative amount of salt intake(low, moderate, high), the frequency of weekly meat consumption, BMI, daily coffee consumption(cups/day) and the frequency of regular exercise(frequency/week) through questionnaire and laboratory test. By simple analysis, BMI was significantly associated with hypertension in male(p<0.05), and the frequency of weekly meat consumption was significantly associated with hypertension in female(p<0.05). Using logistic regression model, elevated odds ratio was noted for fasting blood sugar, serum total cholesterol, family history of hypertension, alcohol consumption, salt intake and BMI, and reduced odds ratio was noted for coffee consumption and exercise in male but fasting blood sugar(odds ratio=1.022, 95% CI=1.000-1.044), family history in both of parents(odds ratio=3.301, 95% CI=1.864-4.738), salt intake(odds ratio=1.690, 95% CI=1.082-2.298) and BMI(odds ratio=1.204, 95% CI=1.065-1.343) were statistically significant(p<0.05). In female, elevated odds ratio was noted in serum total cholesterol, family history of hypertension, BMI and meat consumption. Of all these variables, the family history of hypertension in either of parents(odds ratio=4.981, 95% CI=3.650-6.312), family history in both of parents(odds ratio=16.864, 95% CI=14.577-19.151), BMI(odds ratio=1.167, 95% CI=1.016-1.318) and meat consumption(odds ratio=2.048, 95% CI=1.133-2.963) showed statistically significant association with hypertension in female(p<0.05).; Summary

The effects of aircraft noise on the hearing loss, blood pressure and response to psychological stress.: Sang Hwan Han, Soo Hun Cho, Kyungshim Koh, Ho Jang Kwon, Mina Ha, Yeong Su Ju, Myung Hee Shin; Korean J Prev Med. 1997;30(2):356-368.

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Abstract PDF: In effort to determine whether aircraft noise can have health effects such as hearing loss, hypertension and psychological stress, a total of 111 male professors and administrative officers working a college near a military airport in Korea(exposed group) and a total of 168 males and 112 females matched by age groups(control groups) were analyzed. Personal noise exposure and indoor and outdoor sound level of jet aircraft noise were measured at the exposed area. And pure tone, air conduction test and measurement of blood pressure were given to the exposed(males) and matched control groups(males and females). BEPSI(Brief Encounter Psychological Instrument) and psychological response to aircraft noise were examined for the exposed group. The noise dosimetry results revealed time-weighted averages(TWAs) that ranged from 61 to 68 dBA. However the levels encountered during taking off jet airplanes reached 126 dBA for two half minutes time period. The audiometric test showed that mean values of HTL(hearing threshold level) in exposed group at every frequency(500, 1,000, 2,000, 4,000, and 8,000 Hz were much lower than them of male and female control groups. And in old age groups, interaction of age and noise was observed at 8,000 Hz in both ears(p< 0.05). Conclusively, aircraft noise does not appear to induce hearing loss directly, but may decreased hearing threshold level by interaction of aging process and noise exposure. However, difference of mean values of exposed and control groups on blood pressure was not significantly. In psychological test, annoyance was the most severe psychological response to noise in exposed group, but mean value of BEPSI was not correlated with job duration in exposed group; Summary

Exposed level of workers in the factory next to a led recycling factory.: Jin Ha Kim, Duk Hee Lee, Yong Hwan Lee; Korean J Prev Med. 1996;29(3):693-700.

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Abstract PDF: The purpose of this study was to determine whether workers at a factory next to a lead recycling factory in Pusan, were affected by lead contamination. The mean air lead concentration of lead recycling factory was 0.21mg/m3(TWA=0.05mg/m3). Thirty-nine male workers of Factory A, Cr. plating factory next to the lead recycling factory were exposed group and a comparison group, 62 male workers of Factory B were selected from another Cr. plating factory about 8.5km away from lead recycling factory. Air lead concentration of each workplace was checked for 4 times from August 5 to August 20 in 1995 by low volume air sampler. Each subject was interviewed about age, life-style, smoking, work history, and residence etc, and venous blood was drawn for lead measurement by graphite furnace atomic absorption spectrometry. We have observed that air lead concentration and blood lead concentration of Factory A was higher than Factory B(2.6 +/- 1.6 Vs. 1.2 +/- 0.2 microgram/m3, 14.9 +/- 1.6 Vs. 12.2 +/- 1.6 microgram/dl). We believe that other environmental lead sources such as transportation and residence did not affect air lead and blood lead concentration differences of both factory. We concluded that high air lead and blood lead concentration of Factory A were caused by lead contamination generated by the neighboring lead recycling factory.; Summary

The Estimation of Prevalence of Diabetes Mellitus in a Rural Adult Population.: Sue Kyung Park, Joung Soon Kim; Korean J Prev Med. 1996;29(3):483-494.

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Abstract PDF: The objectives of this study are to estimate the prevalence of diabetes mellitus(DM) and to identify risk factors associated with fasting blood sugar in a rural adult population. We carried out a cross-sectional study on the residents over 30-year old. Among the 1077 eligible subjects, 725 persons responded to the study; the study consisted of interview on family and past history of DM, anthropometry, blood pressure, and blood sugar level in each subjects. Only 707 subjects of 725 participants had fasting blood sugar(FBS) examined and the rest, 18 subjects were had casual blood sugar examined due to failure of fasting over 8-hour. When subjects had FBS >or= 140mg/dl, 2 hours postprandial blood sugar level was checked after 75g oral glucose loading. The prevalence of DM was 8.9%, and age standardized prevalence rate adjusted to Korean population of 1995 was 5.8%. Mean and SD of fasting blood sugar in men was 99.8 +/- 22.6, and in women was 111.5 +/- 29.9. Mean levels of fasting blood sugar were significantly higher in women than in man and as their ages advanced the prevalencies in creased in both sexes. PP2 blood sugar levels were significantly higher in elder age and in persons with higher FBS levels than others. The risk factors associated with FBS were past history of diabetes, sex, socioeconomic status and waist-to-hip circumference ratio; the risk of diabetes was increased in female, people with past DM history, central obesity and low socioeconomic state. The low socioeconomic status associated with DM in this study, which is different from other study results, should be pursued in further studies.; Summary

In Vivo Preperation of Standard Reference Materials of Lead in Blood.: K C Chung, H C Choi; Korean J Prev Med. 1995;28(4):863-874.

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Abstract PDF: This report describes a preperation and characterization of canine blood lead(pb) standard reference material(SRM). Three adult beagle dogs(A, B, and C)were orally dosed with gelatin capsules containing pb(No3)2, equivalent to 10~80mg Pb/kg body weight. Blood was drawn 24 hours after the dose from the cephalic vein into lead free 500ml Pyrex beaker in which EDTA.K was contained as an anticoagulant. The amount of lead given to individual dog was varied arbitrarily. Three month later, 3 canine animals were orally dosed with lead secondarily to make mixed SRM(Dl) which was mixed different concentrations of lead in bloods with Al, B1, and C1 in vitro. The SRMs for A, B, C, Al, Bl, Cl, and Dl were distributed 2ml each into more than 300 lead free bottles, and were stored in refrigerator at 4 degrees C. The amount of lead in canine whole blood samples were determined using a Varian 30A atomic absorption spectrophotometer(AAS) with a model GTA-96 graphite tube atomizer with D2 background correction and a Hitachi Z-8100 AAS with Zeemaan background correction. The sensitivity and detection limits for lead determination of varian 30A were 0.46 microgram/L,0.34 microgram/L, and 0.56 microgram/L,0.14 microgram/L of Hitachi Z-100, respectively. Day to day variations in determination of blood lead concentration in a certain sample were 31.11+/-1.36 microgram/100ml by Varian 30A, and 33.08+/-0.82/100ml by Hitachi Z-8100, show ing the difference of 3% between the two results. At the blood lead concentrations of 56.31+/-1.98 microgram/100ml(A), 40.89+/-0.80 microgram/100ml(B), 59.01+/-1.38/100ml(C), the precisions of replicated measurements by AAS were 3.52%, 1.96%, and 2.34% respectively. Coefficient variation(CV) of SRMs(A, B, and C) within a standard sample were ranged from 0.92% to 7.50%, and those between 5 standard samples were l.21%, 2.64%, and 1.11%, respectively, showing inter-vial variation of 1 microgram/100ml. Lead levels in SRMs during one month storage were unchanged. The overall recoveries were 89.6-100.4%, 91.6-101.9%, 90.3-100.0% for A, B, and C SRMs, means were 56.46+/-2.69 microgram/100ml, 39.35+/-1.89 microgram/100ml, 57.40+/-2.31 microgram/100ml, and measurement ranges were 52.88-59.26 microgram/100ml, 37.47-41.68 microgram/100ml, 54.80-60.69 microgram/100ml, respectively. Those results were laid within confidence limits values. The lead concentrations in the mixed sample(Dl) stored over one month period were ranged from 32.76 microgram/100ml to 33.54/100ml, with CV ranging from l.2% to 2.7%. The results were similar to each of single samples(Al, Bl, and Cl) in respect of homogeneity and stability. Results of the mixed blood sample analysed after 1 month storage at 4 degrees C by four other laboratories(Ll, L2, L3, L4) were similar with those of our laboratory(L5 ;31.18+/-0.24 microgram/100ml, acceptable range by CDC; 25.18-37.18 microgram/100ml), showing the concentrations of 25.91+/-1.19 microgram/100ml(L1), 34.16+/-0.22 microgram/100ml(L2), 35.68+/-0.85 microgram/100ml(L3), 30.95+/-0.46 microgram/100ml(L4) in a each samples.; Summary

A study on renal function indices in lead exposed male workers.: Sung Soo Lee, Young Hwangbo, Kyu Dong Ahn, Byung Kook Lee, Joung Soon Kim; Korean J Prev Med. 1995;28(2):421-432.

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Abstract PDF: The influence of lead exposure on renal function was studied. Eighty nine lead exposed workers who worked in 2 storage battery factories, and seventy one control workers were chosen for this study. Blood lead(pbB) and zinc protoporphyrin in whole blood(ZPP) were selected as indicators of lead exposure. As indicators of renal function, urinary N-acetyl-beta-D-glucosaminidase(NAG), blood urea nitrogen(BUN), serum creatinine(S-Cr), total protein in urine(U-Tp),and serum uric acid(S-Ua) were selected. The results obtained were as follows: 1. while the mean values of lead exposure indicators of lead workers were significantly different from non-exposed ones, the mean values of NAG, U-TP, BUN and S-Cr of renal function indicators of exposed were also significantly different from non-exposed but their mean values were all within normal limits. 2. BUN, logarithmic U-TP, logarithmic NAG and S-Cr showed statistically significant correlation with pbB. 3. The proportion of workers whose values of renal function indicators were over the normal limits(NAG7.5 U/g cr; U-TP 10.9mg/dl; BuN20 mg/dl; S-Cr1.2 mg/dl; S-Ua7.0 mg/dl) by the level of lead absorption in terms of pbB and ZPP were calculated. The proportion of workers with over the normal limits of U-TP among total workers showed the dose-response relationship. when age is adjusted, U-TP showed significantly strong dose-response relationship with the level of pbB and ZPP.; Summary

Blood Lead Level and Intelligence among Children.: Duk Hee Lee, Yong Hwan Lee, Jin Ha Kim, In Geun Park, Tae Young Han, She Han Jang; Korean J Prev Med. 1995;28(2):373-385.

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Abstract PDF: The association between blood lead children and Intelligent Quotient(IQ) was investigated in a sample of l00 boys and girls aged 6-8 years from one primary school within an industrial area of Pusan. The trained undergraduates in school of public health administered an I.Q. test one by one. Parents answered a questionnaire on demographic, perinatal and socioeconomic variables. Atomic Absorbtion spectrophotometer was used to determine blood lead levels. The geometric mean of blood lead value was 7.99 microgram/dl. In total children, there was no significant relationship between blood lead level and I.Q. But in the children who were born of gestational age of less than 38 weeks, children with higher levels of blood lead performed more poorly on I.Q. test with correlation coefficient from -0.68 to -0.71. But, the children who were born of gestational age of 38 weeks and more were same as total children. These results suggest that exposure to low levels of lead in the children who were born premature probably may result in impaired intelligent development. But, we think that more profound study should be performed with sufficient numbers of subjects.; Summary

Lead Level in Blood, Scalp Hair and Toenail of Elementary Schoolchildren.: Jae Uk Kim, Jung Jeung Lee, Chang Yoon Kim, Jong Hak Chung; Korean J Prev Med. 1995;28(1):73-84.

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Abstract PDF: This study was conducted to measure the lead level in the blood, scalp hair and toenail of the elementary schoolchildren and assess the relationship among those samples. Lead concentration of the blood, scalp hair and toenail was measured for l00(male 50, female 50) fourth grade elementary schoolchildren in Taegu city. The mean lead level in the blood, scalp hair and toenail was 6.00+/-2.44 microgram/dl, 6.28+/-3.54 microgram/dl 6. 68 and 7.33+/-3.18 microgram/g. The mean lead level in the blood of schoolboys was 6.43+/-2.77 microgram/dl and that of schoolgirls was 5.59+/-2.01 microgram/dl. The mean lead level in the scalp hair of schoolboys was 7.66+/-2.97 microgram/dl and that of schoolgirls was 6.88+/-3.54 microgram/g. The mean lead level in the toenail of schoolboys was 8.19+/-3.5 microgram/g and that of schoolgirls was 6.47+/-2.52 microgram/g and their difference was statistically significant. In schoolboys, the correlation coefficient between the lead level in the blood and scalp hair was 0.4909, and the data were fitted best by the regression equation Y=0.5255X+4.2810, where Y and X are scalp hair and blood concentration. In schoolgirls the correlation coefficient between the lead level in the blood and scalp hair was 0.3778, and the data were fitted best by the regression equation Y=0.6655X+2.9632, where Y and X are scalp hair and blood concentration. In schoolboys. the correlation coefficient between the lead level in the blood and in the toenail was 0.5533, and the data were fitted best by the regression equation Y=0.7076X+3.6472, where Y and X are toenail and blood concentration. In schoolgirls the correlation coefficient between the lead level in the blood and in the toenail was 0.2738, and the data were fitted best by the regression equation Y=0.3431X+4.5570 where Y and X are toenail and blood concentration. In schoolboys, the correlation coefficient between the lead level in the scalp hair and in the toenail, in the schoolboys was 0.4148, and the data were fitted best by the regression equation Y=0.4956X+4.3986, where Y and X are toenail and scalp hair concentration. In schoolgirls the correlation coefficient between the lead level in the scalp hair and in the toenail 0.1159, and the data were fitted best by the regression equation Y=0.0825X+5.9214 here Y and X are toenail and scalp hair concentration. Correlation among lead concentration in the blood, scalp hair and toenail of schoolchildren were statistically significant except between scalp hair and toenail in schoolgirls. These finding suggest that blood, scalp hair and toenail can be used substitutive samples between each others.; Summary

An Analytic Study on the Effect of Carbon Disulfide on the Blood Pressure.: Jong Tae Park, Hae Joon Kim, Yong Tae Yum, Do Myung Paek; Korean J Prev Med. 1994;27(3):581-596.

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Abstract PDF: To investigate the effect of carbon disulfide on blood pressure, the BP measurements in the periodic health examination results and the medical records of factory clinic were reviewed The study subjects were composed of 1336 male and 544 female workers, who were categorized into three groups by the exposure status-highly exposed, moderately exposed and non-exposed group. The results of the study were as follows; 1. The age-adjusted mean systolic and diastolic BP of male workers were 122.35 mmHg/79.11mmHg in highly exposed, 121.57mmHg/79.05mmHg in moderately exposed and 122.67mmHg/82.27mmHg in non-exposed group. For female workers, BP were 115.13mmHg/74.49mmHg in moderately exposed and 113.48mmHg/74.30mmHg in non-exposed group. 2. In multiple regression analysis of maximum BP against Age and tenure, the slope coefficients of age and tenure on the systolic BP were 0.379, 0.667 respectively and those on the diastolic BP were 0.331, 0.405 respectively in highly exposed male workers. Tenure was a significant variable in this study. For female workers, however, the slope coefficients of tenure on BP were significant only for systolic BP of moderately- expected group. 3. In multiple regression analysis of Bp against age, cumulative exposure index(CEI), cholesterol, all the variables showed significant slope coefficients in male, but age and CEl on systolic BP were significant for female workers (P<0.05). 4. In the multiple analysis of the amount of Bp change and the velocity of Bp change among male workers, the slope coefficients of tenure tended to increase as exposure level increased. Among female workers, the slope coefficients of tenure were significant on the amount of Bp change and the velocity of Bp change in moderately exposed group.; Summary

A Study of Working Environments and Workers Exposed to Chromium.: Byung Chul Yu, Byung Chul Son, Jin Ho Jun, Yong Soo Han, Hye Sook Son, Chae Eun Lee, Woon Jeong; Korean J Prev Med. 1994;27(3):517-530.

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Abstract PDF: For the purpose of providing the basic data for health management of workers who are exposed to chromium and for improving the quality of working environment, the authors evaluated blood and urinary level of chromium, the occupational history, AST, ALT, Hb, Hct, nasal specular examination on 287 workers who have been dealed chromium compounds in 56 manufacturing industries of five types, that is, 38 metal plating services(plating), 4 manufacture of other fabricated metal products (fabricated metal product), 5 manufacturing of dyestuff(dyestuff), 6 dressing and dyeing of leather (leather), 3 others (manufacture of pottery and ceramic household wares, motor vehicles, electronic valves and tubes and other electronic components) and also measured the level of chromium in air from February to october 1993. The results were as follows; 1. The utilized type of chromium compounds was the hexavalent state in plating, fabricated metal product, dyestuff leather and the trivalent state in other, and atmospheric chromium concentration as geometric mean was 0.0138m3(0.001~0.068 mg/m3) in plating, 0.0115 mg/m3(0.006~0.015 mg/m3) in fabricated metal product, 0.068 mg/m3 (0.002~0.019 mg/m3)in dyestuff, 0.0083 mg/m3(0.002~0.028 mg/m3) in leather, 0.0039 mg/m3(0.003~0.005 mg/m3) in other by the type of industry and it exceeded TLV-TWA (0.05 mg/m3) in five(13.6%) of plating services. 2. The geometric mean of chromium in blood was 1.54 microgram/dl(0.10~3.62 microgram/dl) in planting, 0.94 microgram/dl(0.27~2.82 microgram/dl) in fabricated metal product, 0.51 microgram/dl(0.10~3.25 microgram/dl) in dyestuff, 0.87 microgram/dl(0.15~8.00 microgram/dl) in leather 0.55 microgram/dl(0.20~2.28 microgram/dl) in other by the type of industry(P<0.001). 3. The geometric mean of chromiurn in urine was 14.47 microgram/l(6.90~28.00 microgram/l) in planting, 4.63 microgram/l(0.24~43.00 microgram/l) in fabricated metal product, 5.93 microgram/l(1.00~33.00 microgram/l) in dyestuff. 11.09 microgram/l(0.80~48.00 microgram/l) in leather, 12.41 microgram/l(10.10~41.00 microgram/l) in other by the type of industry(P<0.001). 4 As the result of nasal specular examination, twenty four cases(8.4%) of nasal septal perforation among 287 total subjects was observed, and there were 17(9.7%) cases in plating, 4 cases(14.3%) in dressing and dyeing of leather. In the comparison of chromium concentration in blood and urine between the perforated group and nonperforated group the perforated group showed a significantly higher value as 1.883+/-3.055 microgram/dl and 0.793+/-0.815 microgram/dl(P<0.001). 21.31+/-34.610 microgram/L and 9.304+/-11.079 microgram/L(P<0.001). 5. The mean concentration of chromium in blood, urine and the mean level of AST, ALT, Hb and Hct in exposure group were higher than those of control group(P<0.001).; Summary

The Effect of Coffee Consumption on Serum Total Cholesterol Level in Healthy Middle-Aged Men.: Myung Hee Shin, Dong Hyun Kim, Jong Myun Bae, Hyung Ki Lee, Moo Song Lee, Joon Yang Noh, Yoon Ok Ahn; Korean J Prev Med. 1994;27(2):200-216.

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Abstract PDF: In present study, the authors investigated the possible effect of coffee consumption on serum cholesterol level in 1017 men between the ages of 40 and 59 years, who were randomly selected from the members of Seoul Cohort Study. Serum total cholesterol data was collected with other serologic indices(e.g. systolic blood pressure, diastolic blood pressure, hight, weight, etc.)through the program of biennial health check-up offered by Korean Medical Insurance Corporation(KMIC). The amount of coffee consumption was assessed by a self-administered questionnaire through mailing. Other confounding factors, such as age, body mass index, cigarette smoking, alcohol consumption, physical activity, and other dietary intake pattern were also determined by the questionnaire. The differences in means of serum total cholesterol in compared to non consumers were -0.4+/-3.56mg/dl for those drinking less than 1 cup a day, -0.6+/-3.60mg/dl for those drinking 1 cup a day, and 7.1+/-3.41mg/dl for those drinking more than 2 cups a day. Since smoking interacted the relationship between coffee consumption and serum total cholesterol, we re-analyzed those relationship in smokers and non-smokers separately. Other atherogenic behaviors were well correlated with total cholesterol, so we adjusted the mean values of serum total cholesterol through multivariate model selection with age(r=0.12), total cigarette index(cigarette-years; r=0.10), Quetelet's index(kg/m2, r=0.16), daily calory expenditure(kcal/day, r=0.06), weekly meat and poultry consumption(g/week, r=0.05), weekly fish consumption(g/week, r=0.08), other caffeinated beverage intake(cups/week), and the amount of sugar and prim added to the coffee. Among those variables only age, Quetelet's index, fish consumption, and total cigarette index(in smokers)were remained in the models. After adjustment, the corresponding differences of total cholesterol in smokers were changed to 0.4+/-5.24mg/dl, -0.5+/-4.97mg/dl, and 8.9+/-4.78mg/dl, which were significantly different among themselves(P=0.011). In non-smokers, however, the differences were not statistically significant(P=0.76). Adjusted mean values of systolic blood pressure and diastolic blood pressure were also determined to evaluate the direct effect of coffee to cardiovascular system, but their means were not significantly different by coffee consumption(p=0.18 for SBP, P=0.48 for DBP). Assuming instant coffee on the most popular type of coffee in Korea, the association observed in our study between coffee and serum total cholesterol, especially in smokers , is very interesting finding for the connection between coffee and serum total cholesterol, because only 'boiled coffee' tend to show significant lipid raising effect rather than to other types of coffee, like filtered or espresso, in most of the western countries. We concluded that people who drink coffee more than 2 cups a day have significantly higher serum total cholesterol level than those who never drink coffee, especially in smokers.; Summary

10-year analysis of blood lipid profile and other risk factors among aircrew members in Korea.: In Ho Kwak, Yong Ho Lee; Korean J Prev Med. 1993;26(3):387-399.

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Abstract PDF: This study was conducted to analyzed blood lipid profile and other risk factors among crew members who are currently active and had more than 10 years of experience as crew members. Data was analyzed using medical record files in an airline medical department. The results are as follows. 1. The total number of crew members studied was 392. Among age groups, those below age 40 consisted of 26(6.9% of the total), those in age 41~50 were 135(34.4%) and those over age 51 were 230(58.7%). 263 were former air force pilots consisting 66.9%. Those who had captain status numbered 211 comprising 53.7% of the total. The type of aircraft most of the crew members involved were large size aircraft which totaled 268(68.2%). With respect to the number of working years as crew members, 488(48.9%) comprised the largest group with 11~15 years. 2. The rate of smoking among crew members has shown gradual decrease with 50.3% smoking in 1983 to 33.6% in 1993. Among 41~50 age group the rate has shown a decrease from 20.9% to 13.3%. In those group over age 51 it decreased from 25.5% to 16.6%. But group below age 40 were within the range of 3.6~3.8% with no significant change in the rate of smoking. 3. Body Mass Index in age group over 51 was slightly higher than other age groups. On the whole, BMI over 25 was not found. 4. The total cholesterol levels of those below age 40 were 196.9+/-38.5 mg/dl, 216.2+/-39.2 mg/dl in ages 41~50, and 225.1+/-42.5 mg/dl in age group over 51. No significant difference was found among age groups. 5. HDL-cholesterol levels of over age 50 were higher than other age group and ranged from 40~55 mg/dl. 6. LDL-cholesterol levels of those over 51 were 126.7+/-37.7 mg/dl higher than other age groups. But there were no significant changes in all age during 10 years of follow up. 7. Cardiac index of age group below age 40 was 3.8, 4.3 in age group 41~50 and 4.5 in those over age 51 group. No significant changes among groups were found during the follow up period. 8. Triglyceride levels of age group below age 40 was 142.2+/-70.1, 167.3+/-77.5 in age group of 41~50 and 173.6+/-89.7 in age group over 50 showing that triglyceride levels increased with age. No significant changes in pattern were noted.; Summary

The blood pressure level and sexual maturity in the children at puberty.: Kyoo Sang Kim, Soon Young Lee, Ill Suh, Chung Mo Nam, Sun Hwa Jee; Korean J Prev Med. 1993;26(3):347-358.

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Abstract PDF: The purpose of this study is to analyze the relationship between the blood pressure level and their sexual maturity and physical growth in the children at puberty. For this purpose, we estimated the blood pressure, physical growth and sexual maturity of the boys of 335 and girls of 373 who are in the middle schools which are located in Kang-wha County, KyungKi-Do. Both systolic and diastolic pressure were measured twice. Such physical growth as height, body weight, skin fold thickness, waist circumference, hip circumference and arm circumference were measured. The sexual maturity was estimated according to the classification of Tanner's 5-phase-sexual-maturity; in boys, their pubic hair development phase; in girls, their pubic hair and breast development phase and the menstrual experience. In the phase of the pubic hair development, the boy's sexual maturity was distributed into this; the 1 st 56.4%, the 2nd 29.3%, the 3rd 9.9%, the 4th 4.1% and the 5th 0.3%. While the girls sexual maturity was distributed into this : the 1 st 20.5%, the 2nd 34.9%, the 3rd 30.6% the 4th 12.6% and the 5th 1.3% in the phase of the pubic hair development, and the 1 st 0.8%, the 2nd 13.7%, the 3rd 36.2%, the 4th 18.8% and the 5th 30.5% in the phase of the breast development. This indicated that the girls sexual maturity was higher than those of the boys. The girls menstrual experience rate accounted to the 58.2%. In order to see the relationship between the children's sexual maturity and blood pressure level, we regress blood pressure level on physical growth(i.e., height, BMI) and sexual maturity. Sexual maturity in treats as dummy variables. As the result of this analysis, the boys' sexual maturity has nothing to do with the blood pressure either systolic or diastolic. But the girl's systolic pressure was statistically significant; the 9% of the physical growth, the 5% of the pubic hair development and the 4% of the breast development in sexual maturity was explained. In the girls' diastolic pressure, only their pubic hair development was statistically significant; the 7% of the physical growth and the 7% of the pubic hair development in the diastolic was explained and the 5% of the physical growth in the diastolic Korotokoff phase was explained, especially, the girls experienced menstruation, their systolic and diastolic pressure were significantly high(P<0.01). Conclusively, in the first grade children attending middle schools who are in the early process of the sexual development, the sexual maturity was not related to blood pressure level, on the other hand, the blood pressure level of the girls who are more sexual development than those of the boys' have something to do with sexual maturity and physical growth.; Summary

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