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Brief Report
Long Working Hours and Risk of Ischemic Heart Disease Among Japanese Workers: The Jichi Medical School Cohort Study
Mayumi Saiki, Akizumi Tsutsumi, Jian Li
J Prev Med Public Health. 2026;59(2):211-218.   Published online February 5, 2026
DOI: https://doi.org/10.3961/jpmph.25.577
  • 603 View
  • 80 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Karoshi, or “death from overwork,” has been recognized for decades; however, epidemiological findings regarding long working hours (LWH) and ischemic heart disease (IHD) remain inconsistent. This study aimed to provide new evidence on the association between LWH and IHD, while accounting for job strain among Japanese workers, both male and female.
Methods
This study utilized data from 6670 workers participating in the Jichi Medical School Cohort Study. Baseline working hours were categorized as <5.0, 5.0 to 6.9, 7.0 to 8.9 (reference), 9.0 to 10.9, and ≥11.0 hr/day. Fatal and non-fatal incident IHD cases were determined during follow-up using International Classification of Diseases, 10th revision codes. Multivariable Cox proportional hazards models were used to examine associations, adjusting for socio-demographic factors, lifestyle behaviors, cardiometabolic characteristics, and job strain.
Results
During a mean follow-up of 12 years, 58 incident IHD cases (42 male and 16 female) were documented. Long working hours (≥11.0 hr/day) were significantly associated with an increased risk of IHD in the total sample (hazard ratio, 2.92; 95% confidence interval, 1.15 to 7.39), and the overall pattern of associations was similar in sex-stratified analyses.
Conclusions
These findings suggest that LWH independently increases the risk of IHD among Japanese workers, even after adjustment for job strain, underscoring the importance of managing working hours to reduce karoshi in both male and female workers.
Summary
Key Message
Our study provides new evidence on the association between long working hours (LWH) and ischemic heart disease (IHD), while accounting for job strain among Japanese workers, both male and female, utilizing data from the Jichi Medical School Cohort Study. Our study revealed that LWH (≥11.0 hr/day) were significantly associated with an increased risk of IHD in the total sample (hazard ratio, 2.92; 95% confidence interval, 1.15 to 7.39). These findings suggest that LWH increase the risk of IHD among Japanese workers, underscoring the importance of managing working hours to reduce karoshi in both male and female workers.
Original Articles
Exposure to Benzene, Toluene, Ethylbenzene, and Xylenes and Risk of Depression: A Cross-sectional Study of a National Sample of Korean Adults
Hyun-Wook Park, Byung-Sun Choi, Bomi Park, Wanhyung Lee, Weon-Young Lee
J Prev Med Public Health. 2026;59(1):95-104.   Published online November 6, 2025
DOI: https://doi.org/10.3961/jpmph.25.522
  • 1,379 View
  • 142 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Benzene, toluene, ethylbenzene, and xylenes (BTEX) are co-occurring neurotoxicants that are structurally similar aromatic hydrocarbons sharing common metabolic pathways and mechanisms of toxicity. This study investigated the effects of BTEX exposure on depression and aimed to identify the primary contributors to depression risk.
Methods
We conducted a cross-sectional analysis of 1733 adults from the 2020–2021 Korea National Health and Nutrition Examination Survey. BTEX exposure was quantified based on urinary metabolite concentrations: S-phenylmercapturic acid (SPMA) for benzene, benzylmercapturic acid for toluene, the sum of phenylglyoxylic acid and mandelic acid for ethylbenzene, and methylhippuric acid for xylenes. Depression was defined according to self-reported physician diagnosis. Logistic regression was used to estimate the risk associated with individual chemicals, while weighted quantile sum (WQS) regression was employed to assess mixture effects and identify the primary toxicant. Sensitivity analyses were performed to address potential confounding by tobacco smoke.
Results
Urinary SPMA concentrations were significantly higher in individuals with depression. Logistic regression revealed a significant association between SPMA levels and depression (odds ratio, 2.62; 95% confidence interval, 1.34 to 5.13). Although the overall BTEX mixture was not significantly associated with depression after covariate adjustment in WQS models, SPMA consistently emerged as the major contributor. The association between SPMA and depression remained robust in sensitivity analyses excluding participants exposed to tobacco smoke.
Conclusions
Benzene exposure was associated with an increased risk of depression in the general Korean adult population. Therefore, strengthened environmental regulations on benzene could help reduce the public health burden of depression.
Summary
Korean summary
본 연구는 2020–2021년 국민건강영양조사 자료를 활용하여 한국 성인에서 요중 벤젠, 톨루엔, 에틸벤젠, 자일렌 대사체 농도와 우울증 위험 간의 연관성을 분석하였다. 분석 결과, 벤젠의 대사체인 요중 S-phenyl-mercapturic acid는 우울증 위험 증가와 연관성을 보였다. 흡연 요인을 제외한 민감도 분석에서도 연관성은 일관되게 유지되어, 벤젠 노출 저감을 위한 환경적 관리 강화가 우울증 예방에 기여할 수 있음을 시사한다.
Key Message
This study investigated the association between urinary metabolites of benzene, toluene, ethylbenzene, and xylene and depression risk among Korean adults, using data from the Korea National Health and Nutrition Examination Survey 2020–2021. The findings indicated a significant association between urinary S-phenyl-mercapturic acid, a metabolite of benzene, and an increased risk of depression. This association remained robust after excluding smoking factors, underscoring the potential benefits of improved environmental management in reducing benzene exposure to prevent depression.
Prevalence and Severity of Depression Among Patients With Anemia Attending a Rural Outpatient Clinic in Faridabad, India: A Cross-sectional Study
Prince , Urvashi , Rajat Sharma, Jubair Shamsi, Satya Vir Singh
J Prev Med Public Health. 2025;58(6):629-634.   Published online August 9, 2025
DOI: https://doi.org/10.3961/jpmph.25.363
  • 1,630 View
  • 228 Download
AbstractAbstract AbstractSummary PDF
Objectives
This study was performed to determine the prevalence and severity of depression among patients previously diagnosed with anemia and to explore associated clinical and socio-demographic factors.
Methods
This cross-sectional study was conducted from October 2024 to February 2025, among 300 patients with anemia attending the outpatient clinic at the Rural Health Training Centre, Amrita School of Medicine, Faridabad, Haryana. Data on socio-demographic and clinical variables were collected using a structured questionnaire. Depression was evaluated using the Patient Health Questionnaire-9 (PHQ-9). Associations of anemia severity with depression presence and severity were analyzed using the chi-square test, logistic regression, and ordinal logistic regression, with adjustment for potential confounders.
Results
The prevalence of depression (PHQ-9 score>9) among patients with anemia was 31.3%. Severe anemia was significantly associated with higher odds of depression (adjusted odds ratio [aOR], 3.02; 95% confidence interval [CI], 1.13 to 8.07; p=0.027) and more severe depression (aOR, 2.87; 95% CI, 1.14 to 7.27; p=0.026). Symptoms such as weakness (aOR, 3.57) and shortness of breath (aOR, 2.71) were also significantly associated with depression. Moderate anemia displayed a non-significant trend.
Conclusions
Severe anemia is independently associated with both the presence and severity of depression. Routine mental health screening should be integrated into anemia management protocols, especially in rural healthcare settings.
Summary
Key Message
Anemia is a common problem in India, whereas there is a growing awareness about mental health issues like depression. This study was conducted at a Rural Health Training Centre in India, to estimate the prevalence and severity of depression among patients with anemia. The prevalence of anemia was found to be 31.3% (PHQ-9 score > 9), and severe anemia was associated with higher odds of depression and more severe depression. Our study indicated a need of routine mental health screening in patients with anemia.
Mobile App-based Care Management Training to Improve Family Caregiver Competence in Caring for Children With HIV in Indonesia: A Quasi-experimental Study
Nyimas Heny Purwati, Syamikar Baridwan Syamsir, Mutmainah , Dhea Natashia, Amelia Hartika Rani, Dwi Budiyati, Agus Setiawan
J Prev Med Public Health. 2025;58(5):516-526.   Published online May 7, 2025
DOI: https://doi.org/10.3961/jpmph.24.789
  • 24,445 View
  • 343 Download
AbstractAbstract AbstractSummary PDF
Objectives
Family caregivers play a crucial role in the care of children with human immunodeficiency virus (HIV); however, they frequently face limitations in knowledge, attitudes, and skills. Mobile application (app)-based training may offer an effective solution to enhance caregiver competence. This study aimed to assess the effectiveness of mobile app-based care management training in improving the knowledge, attitudes, and skills of family caregivers caring for children with HIV.
Methods
A quasi-experimental design, including pretest, posttest, and follow-up assessments, was conducted at a national referral hospital for infectious diseases in Jakarta, Indonesia. The study involved 44 respondents, divided equally into intervention and control groups (22 per group). The intervention group received mobile app-based training, while the control group received conventional caregiver education. Questionnaires assessing caregivers’ knowledge, attitudes, and skills in managing children with HIV were utilized. Data were analyzed using independent sample t-tests and repeated measures analysis of variance (ANOVA).
Results
Repeated measures ANOVA revealed that the intervention group experienced significant improvements in knowledge, attitudes, and skills from pretest to posttest, which were maintained at the 1-month follow-up (p<0.001). In contrast, the control group did not exhibit significant changes in any of these variables (knowledge, attitudes, and skills) throughout the study period.
Conclusions
Mobile app-based care management training significantly enhances caregiving competencies among family caregivers of children with HIV. These findings underscore the potential of digital technology as an innovative and sustainable approach for caregiver training in various healthcare settings, supporting the long-term effectiveness of educational interventions.
Summary
Key Message
This quasi-experimental study evaluated the effectiveness of a mobile app-based care management training for family caregivers of children with HIV in Indonesia. The intervention significantly improved caregivers’ knowledge, attitudes, and skills compared to the control group. These findings suggest that digital health tools can empower caregivers, enhance pediatric HIV care, and provide a scalable model for supportive training in resource-limited settings.
Global Trends in Childhood Sexual Abuse and Bullying Victimization in 204 Countries: A Comprehensive Analysis From 1990 to 2019
Nasrin Borumandnia, Mohammadamin Sabbagh Alvani, Payam Fattahi, Mahmood Reza Gohari, Yashar Kheirolahkhani, Hamid Alavimajd
J Prev Med Public Health. 2024;57(6):530-539.   Published online August 15, 2024
DOI: https://doi.org/10.3961/jpmph.24.007
  • 14,630 View
  • 319 Download
  • 6 Web of Science
  • 6 Crossref
AbstractAbstract AbstractSummary PDF
Objectives
No comprehensive analysis has yet been published regarding global trends in childhood sexual abuse (CSA) and bullying victimization (BV). The present study offers a longitudinal perspective on their prevalence worldwide.
Methods
CSA and BV rates were extracted from the Global Burden of Disease study, spanning the years 1990 to 2019 across 204 countries. Trends by gender, region, and human development index (HDI) were examined.
Results
For both boys and girls, and in both high-HDI and low-HDI countries, CSA rates did not significantly change from 1990 to 2019 (p>0.05). However, BV rates increased significantly in high-HDI and low-HDI countries for both genders (p<0.001). Subsequently, we analyzed trends separately by gender across all countries, without considering development level. In this analysis, CSA rates among girls decreased from 1990 to 2000, followed by an increasing tendency after 2000; overall, an upward trend was evident between 1990 and 2019 (p=0.029). In contrast, no significant pattern was observed for boys. Notably, BV demonstrated an increasing trend across all regions when HDI was not considered (p<0.05), with African populations experiencing the most pronounced rise (p<0.001). Globally, boys consistently exhibited higher BV rates than girls.
Conclusions
Our research indicates that, on a global scale, rates of CSA among girls have been rising. Additionally, BV rates have increased in all regions for both boys and girls. Notably, this trend in BV rates is occurring irrespective of HDI. These findings underscore the necessity for targeted interventions in areas with high rates of CSA and BV.
Summary
Key Message
This study analyzes global trends in childhood sexual abuse (CSA) and bullying victimization (BV) from 1990 to 2019 across 204 countries. Results indicate a significant rise in BV rates globally, with boys consistently exhibiting higher rates than girls. While CSA rates among girls show an upward trend, no significant change is observed for boys. These findings highlight the urgent need for targeted interventions to address CSA and BV worldwide.

Citations

Citations to this article as recorded by  
  • Childhood sexual abuse and bullying victimization: National, regional and global trend analysis from global burden of disease data 1990–2021
    Kaleem Maqsood, Azeem Saeed, Mahnoor Fatima, Abdul Quddoos, Bakhtawar Haseeb, Yongze Li
    Child Abuse & Neglect.2026; 175: 107982.     CrossRef
  • Shadows of doubt: Ambivalent acknowledgment of abuse and identification with the aggressor
    Edna Porat-Moeller, Anastasia Keidar, Lee Gafter, Yael Lahav
    Child Abuse & Neglect.2025; 163: 107401.     CrossRef
  • Sensory modulation difficulties and complex PTSD among child abuse survivors
    Nitzan Avigail Kidra, Lee Gafter, Tami Bar-Shalita, Yael Lahav
    European Journal of Psychotraumatology.2025;[Epub]     CrossRef
  • Global burden of noncommunicable diseases attributable to modifiable behavioral risks among adolescents and young adults aged 10–24 years, 1990–2021
    Yunfei Feng, Da Sun, Xuren Sun, Qiqiang Guo, Jing Zhang, Yongze Li
    BMC Medicine.2025;[Epub]     CrossRef
  • Adverse experiences in childhood and young adulthood, genetic susceptibility, and neurodegenerative disease incidence: a lifespan analysis
    Jie Li, Xiaoqin Xu, Ying Sun, Yanqi Fu, Xiao Tan, Ningjian Wang, Yingli Lu, Jiang Li, Bin Wang
    European Journal of Psychotraumatology.2025;[Epub]     CrossRef
  • The mediating role of self-esteem in the link between childhood adversities and criminality among North African adult males: A case-control study
    Imen Mlouki, Arij Soussi, Emna Hariz, Aya Ajmi Blout, Marwa Boussaid, Ahmed Moustafa, Abir Aissaoui, Sana El Mhamdi
    Child Abuse & Neglect.2025; 169: 107718.     CrossRef
The Influence of Family Adversities on Longitudinal Changes in Physical Inactivity Among Korean Adolescents During the COVID-19 Pandemic
Tae Kyoung Lee, Jing Zhu, Young Mi Kim, Ze-Kai Jiang, Meilin Zhang, Won Ha Choi, Tae-Young Pak, Hana Song
J Prev Med Public Health. 2024;57(5):443-450.   Published online August 4, 2024
DOI: https://doi.org/10.3961/jpmph.24.236
  • 23,612 View
  • 274 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Lack of physical activity has a critical effect on the physical and mental health of adolescents. This study examined the influence of family adversities on the longitudinal changes in physical inactivity among adolescents during the coronavirus disease 2019 (COVID-19) pandemic.
Methods
The study used multi-wave data from the Korean Children and Youth Panel Survey, including 2590 Korean adolescents aged 12-14 years. The longitudinal trajectory of physical inactivity among adolescents and the effects of related factors were estimated using a latent growth modeling method.
Results
Our results revealed a significant increase in physical inactivity among adolescents over time. At the onset of the pandemic, approximately one-seventh of Korean middle schoolers reported a lack of physical activity. However, 3 years later, during the quarantine, nearly one-fifth of these adolescents reported a significant increase in their physical inactivity. Initially, low level parental education was predictive of adolescents’ physical inactivity, but this effect diminished over time, becoming statistically insignificant by the end of the 3-year period. Moreover, the increase in physical inactivity over the 3 years was significantly influenced by parental rejection.
Conclusions
These findings suggest that adolescents who experience parental rejection are more likely to report an increase in sedentary behaviors in contexts such as the COVID-19 pandemic.
Summary
Korean summary
본 연구는 팬데믹 기간 동안 청소년의 신체 활동 변화와 신체 활동 부족에 대한 부정적 가정 환경의 영향을 조사했다. 한국 청소년 2,590명을 대상으로 한 3년간의 종단 패널 데이터를 잠재 성장 모형으로 분석하여 신체 활동 부족의 변화를 추적하였다. 그 결과, 팬데믹 기간 동안 청소년들의 신체 활동 부족이 현저히 증가했으며, 부모의 거부가 이러한 증가에 유의한 영향을 미친 것으로 나타났다.
Key Message
This study examined the impact of family adversities on the longitudinal changes in physical inactivity among 2,590 Korean adolescents during the COVID-19 pandemic. Over the 3-year period, physical inactivity increased significantly, with parental rejection playing a key role in this rise. While low parental education initially predicted higher levels of inactivity, its influence diminished over time.
Predictors and Prevalence of Alcohol and Cannabis Co-use Among Filipino Adolescents: Evidence From a School-based Student Health Survey
Yusuff Adebayo Adebisi, Don Eliseo Lucero-Prisno III, Jerico B. Ogaya, Victor C. Cañezo Jr., Roland A. Niez, Florante E. Delos Santos, Melchor M. Magramo, Ann Rosanie Yap-Tan, Francis Ann R. Sy, Omar Kasimieh
J Prev Med Public Health. 2024;57(3):288-297.   Published online May 9, 2024
DOI: https://doi.org/10.3961/jpmph.24.052
  • 22,391 View
  • 446 Download
  • 6 Web of Science
  • 7 Crossref
AbstractAbstract AbstractSummary PDF
Objectives
This study explored the prevalence and predictors of alcohol and cannabis co-use among 9263 Filipino adolescents, using data from the 2019 Global School-based Student Health Survey (GSHS).
Methods
We conducted a cross-sectional secondary analysis of the GSHS, targeting adolescents aged 13-17 years and excluding cases with incomplete data on alcohol and cannabis use. Our analysis employed the bivariate chi-square test of independence and multivariable logistic regression using Stata version 18 to identify significant predictors of co-use, with a p-value threshold set at 0.05.
Results
The weighted prevalence of co-users was 4.2% (95% confidence interval [CI], 3.4 to 5.3). Significant predictors included male sex (adjusted odds ratio [aOR], 4.50; 95% CI, 3.31 to 6.10; p<0.001) and being in a lower academic year, specifically grade 7 (aOR, 4.08; 95% CI, 2.39 to 6.99; p<0.001) and grade 8 (aOR, 2.20; 95% CI, 1.30 to 3.72; p=0.003). Poor sleep quality was also a significant predictor (aOR, 1.77; 95% CI, 1.29 to 2.44; p<0.001), as was a history of attempted suicide (aOR, 5.31; 95% CI, 4.00 to 7.06; p<0.001). Physical inactivity was associated with lower odds of co-use (aOR, 0.45; 95% CI, 0.33 to 0.62; p<0.001). Additionally, non-attendance of physical education classes (aOR, 1.48; 95% CI, 1.06 to 2.05; p=0.021), infrequent unapproved parental checks (aOR, 1.37; 95% CI, 1.04 to 1.80; p=0.024), and lower parental awareness of free-time activities (aOR, 0.63; 95% CI, 0.45 to 0.87; p=0.005) were associated with higher odds of co-use. Factors not significantly linked to co-use included age group, being in grade 9, always feeling lonely, having no close friends, being bullied outside school, and whether a parent or guardian understood the adolescent’s worries.
Conclusions
The findings highlight the critical need for comprehensive interventions in the Philippines, addressing not only physical inactivity and parental monitoring but also focusing on sex, academic grade, participation in physical education classes, sleep quality, and suicide attempt history, to effectively reduce alcohol and cannabis co-use among adolescents.
Summary
Key Message
This cross-sectional study examines the prevalence and key predictors of alcohol and cannabis co-use among 9263 Filipino adolescents using data from the 2019 Global School-based Student Health Survey. Significant predictors of co-use include male sex, lower academic grade, poor sleep quality, history of attempted suicide, physical inactivity, non-attendance in physical education classes, infrequent parental checks, and low parental awareness of adolescents' activities, with a weighted co-use prevalence of 4.2%. The study underscores the need for comprehensive interventions addressing these factors to reduce substance co-use among Filipino adolescents.

Citations

Citations to this article as recorded by  
  • Emotional intelligence and risk-taking engagement among adolescents: Basis for a behavioral intervention framework
    Jun P. Dalisay, Emelyn R. Villanueva, Erwin T. Novo, Jacquelyn Rose A. Fajilagutan, Charry M. Sison, Liza F. Lagade, Marwin D. Sarandin
    Multidisciplinary Reviews.2026; 9(9): 2026445.     CrossRef
  • Comparing self-rated health among exclusive e-cigarette users and traditional cigarette smokers: an analysis of the Health Survey for England 2019
    Yusuff Adebayo Adebisi, Duaa Abdullah Bafail
    Internal and Emergency Medicine.2025; 20(2): 441.     CrossRef
  • Self-rated health differences between exclusive e-cigarette users and exclusive cigarette smokers: evidence from the 2017–2019 Scottish Health Survey
    Yusuff Adebayo Adebisi, Don Eliseo Lucero-Prisno, Isaac Olushola Ogunkola
    Internal and Emergency Medicine.2025; 20(3): 771.     CrossRef
  • Prevalence, drug education, and other associated factors of current illicit drug use among a nationally representative sample of school-aged adolescents in the Philippines in 2019
    Supa Pengpid, Karl Peltzer, Lyndon Esconde Santos, Earl Francis Infante Mallari
    Substance Abuse Treatment, Prevention, and Policy.2025;[Epub]     CrossRef
  • Prevalence Rates, Perceptions of Risk, and Motivations for Nonmedical Cannabis Use in Pediatric Pain
    Joe Kossowsky, Christine Greco, Bridget A. Nestor, Camila Koike, Nicole Tacugue, Andreas M. Baumer, Elissa R. Weitzman
    JAMA Network Open.2025; 8(5): e2512870.     CrossRef
  • Sleep Disturbances Across the Addiction Stages: A Review of Alcohol, Cannabis and their Co-Use
    Claudia B. Padula, Ariel Grayson, Sarah Izabel, Lea-Tereza Tenekedjieva, Emma Zhang, Andrea N. Goldstein-Piekarski
    Current Addiction Reports.2025;[Epub]     CrossRef
  • Prevalence, demographic, socio-economic, and lifestyle factors associated with cigarette, e-cigarette, and dual use: evidence from the 2017–2021 Scottish Health Survey
    Yusuff Adebayo Adebisi, Duaa Abdullah Bafail, Oluwatobi Ebenezer Oni
    Internal and Emergency Medicine.2024; 19(8): 2151.     CrossRef
Sleep Duration, Comorbidities, and Mortality in Korean Health Examinees: A Prospective Cohort Study
Sukhong Min, Woo-Kyoung Shin, Katherine De la Torre, Dan Huang, Hyung-Suk Yoon, Aesun Shin, Ji-Yeob Choi, Daehee Kang
J Prev Med Public Health. 2023;56(5):458-466.   Published online September 26, 2023
DOI: https://doi.org/10.3961/jpmph.23.311
  • 9,387 View
  • 135 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
The association between long sleep duration and mortality is frequently attributed to the confounding influence of comorbidities. Nevertheless, past efforts to account for comorbidities have yielded inconsistent outcomes. The objective of this study was to evaluate this relationship using a large prospective cohort in Korea.
Methods
The study included 114 205 participants from the Health Examinees Study, who were followed for a median of 9.1 years. A composite comorbidity score was developed to summarize the effects of 21 diseases. Using Cox proportional hazards regression, hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause, cancer, and cardiovascular mortality associated with sleep duration were estimated. These estimates were adjusted for socio-demographic factors, lifestyle factors, body mass index, and comorbidity score. Additionally, a stratified analysis by subgroups with and without comorbidities was conducted.
Results
Throughout the follow-up period, 2675 deaths were recorded. After all adjustments, an association was observed between a sleep duration of 8 hours or more and all-cause mortality (HR, 1.10; 95% CI, 1.01 to 1.20). However, no such association was detected in the stratified analysis for the subgroups based on comorbidity status.
Conclusions
Long sleep duration was found to be associated with all-cause mortality among Koreans, even after adjusting for comorbidities. Additional studies are required to explore the mechanism underlying the association between sleep duration and major causes of mortality.
Summary
Korean summary
- 한국의 대규모 코호트 자료를 이용, 긴 수면 시간과 사망률 간의 연관성이 동반 상병으로 인한 교란 효과로 인한 것인지를 검토하였다. - 수면 시간과 총 사망률, 암 사망률, 심혈관질환 사망률 간의 연관성을 확인하였고, 이 중 총 사망률과 긴 수면 시간이 동반 상병 지수로 보정 한 뒤에도 유의한 연관성을 보였다.
Key Message
Using a large prospective cohort in Korea, the association between long sleep duration and mortality was evaluated, after adjusting for the confounding influence of comorbidities. When 114,205 participants from the Health Examinees Study were followed for a median of 9.1 years, sleep duration of 8 hours or more were found to be associated with all-cause mortality (HR, 1.10; 95% CI, 1.01 to 1.20). Additional studies are required to explore the mechanism underlying the association between sleep duration and major causes of mortality.

Citations

Citations to this article as recorded by  
  • Imbalanced sleep increases mortality risk by 14–34%: a meta-analysis
    Zoltan Ungvari, Mónika Fekete, Péter Varga, János Tibor Fekete, Andrea Lehoczki, Annamaria Buda, Ágnes Szappanos, György Purebl, Anna Ungvari, Balázs Győrffy
    GeroScience.2025; 47(3): 4545.     CrossRef
  • Non-linear association of sleep duration with osteoarthritis among U.S. middle-aged and older adults
    Guoliang Ma, Bo Xu, Zhizhuang Wang, Weili Duan, Xin Chen, Liguo Zhu, Bowen Yang, Dian Zhang, Xiaokuan Qin, He Yin, Xu Wei
    BMC Public Health.2024;[Epub]     CrossRef
Special Article
Cohort Study Protocol: A Cohort of Korean Atomic Bomb Survivors and Their Offspring
Seong-geun Moon, Ansun Jeong, Yunji Han, Jin-Wu Nam, Mi Kyung Kim, Inah Kim, Yu-Mi Kim, Boyoung Park
J Prev Med Public Health. 2023;56(1):1-11.   Published online January 31, 2023
DOI: https://doi.org/10.3961/jpmph.22.469
  • 11,199 View
  • 276 Download
  • 3 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
In 1945, atomic bombs were dropped on Hiroshima and Nagasaki. Approximately 70 000 Koreans are estimated to have been exposed to radiation from atomic bombs at that time. After Korea’s Liberation Day, approximately 23 000 of these people returned to Korea. To investigate the long-term health and hereditary effects of atomic bomb exposure on the offspring, cohort studies have been conducted on atomic bomb survivors in Japan. This study is an ongoing cohort study to determine the health status of Korean atomic bomb survivors and investigate whether any health effects were inherited by their offspring. Atomic bomb survivors are defined by the Special Act On the Support for Korean Atomic Bomb Victims, and their offspring are identified by participating atomic bomb survivors. As of 2024, we plan to recruit 1500 atomic bomb survivors and their offspring, including 200 trios with more than 300 people. Questionnaires regarding socio-demographic factors, health behaviors, past medical history, laboratory tests, and pedigree information comprise the data collected to minimize survival bias. For the 200 trios, whole-genome analysis is planned to identify de novo mutations in atomic bomb survivors and to compare the prevalence of de novo mutations with trios in the general population. Active follow-up based on telephone surveys and passive follow-up with linkage to the Korean Red Cross, National Health Insurance Service, death registry, and Korea Central Cancer Registry data are ongoing. By combining pedigree information with the findings of trio-based whole-genome analysis, the results will elucidate the hereditary health effects of atomic bomb exposure.
Summary
Korean summary
해당 연구는 한국인 원폭피해 생존자 및 그 후손에서 피폭이 건강에 미치는 영향과 그것의 유전적 영향 유무를 밝히고자 계획된 연구이다. 이 연구는 연구대상자들에 대한 건강 설문 조사, 신체계측, 가계도 조사, 유전체 조사 뿐 아니라 2차 자료 연계를 통해 폭넓고 정확한 건강 정보를 수집하고 있다. 이 연구를 통해 연구대상자들의 건강 상태 파악 및 개선에 도움이 되고자 한다.

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Original Articles
Social Contact Patterns Associated With Tuberculosis: A Case-control Study in Southwest Iran
Neda Amoori, Bahman Cheraghian, Payam Amini, Seyed Mohammad Alavi
J Prev Med Public Health. 2022;55(5):485-491.   Published online September 30, 2022
DOI: https://doi.org/10.3961/jpmph.22.335
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AbstractAbstract PDFSupplementary Material
Objectives
Tuberculosis (TB) is a major public health concern worldwide. Social contact patterns can affect the epidemiology and risk of airborne diseases such as TB. This study was designed to investigate the social contact patterns associated with TB.
Methods
In this case-control study, groups of participants with and without TB were matched by age and sex. Participants reported the nature, location, frequency, and average duration of social contacts over 1 month. The duration and number of social and spatial contacts were compared between groups using the chi-square test and the t-test. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to quantify the relationship between social contact time and TB status. Data were analyzed using Stata version 11 statistical software. A p-value of <0.05 was considered to indicate statistical significance.
Results
In this study, 80 patients with TB and 172 control participants were included, and a total of 3545 social contacts were registered. Social contact with family members (OR, 1.72; 95% CI, 1.10 to 2.40), contact with a person with TB (OR, 1.53; 95% CI, 1.16 to 2.01), and contact at the participant’s home (OR, 1.42; 95% CI, 1.19 to 1.82) were significantly associated with TB status.
Conclusions
The duration of long-term social contact, rather than the number of contacts, may be the main contact-related factor associated with TB transmission in this population. The focus of contact-tracing efforts should be on finding and treating both family members and long-term contacts in non-household settings.
Summary

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  • Prevalence of Mycobacterium tuberculosis and risk factors among internally and externally displaced populations in northwestern Ethiopia: The case of Dabat and Metema
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The Korea Cohort Consortium: The Future of Pooling Cohort Studies
Sangjun Lee, Kwang-Pil Ko, Jung Eun Lee, Inah Kim, Sun Ha Jee, Aesun Shin, Sun-Seog Kweon, Min-Ho Shin, Sangmin Park, Seungho Ryu, Sun Young Yang, Seung Ho Choi, Jeongseon Kim, Sang-Wook Yi, Daehee Kang, Keun-Young Yoo, Sue K. Park
J Prev Med Public Health. 2022;55(5):464-474.   Published online September 12, 2022
DOI: https://doi.org/10.3961/jpmph.22.299
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AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
We introduced the cohort studies included in the Korea Cohort Consortium (KCC), focusing on large-scale cohort studies established in Korea with a prolonged follow-up period. Moreover, we also provided projections of the follow-up and estimates of the sample size that would be necessary for big-data analyses based on pooling established cohort studies, including population-based genomic studies.
Methods
We mainly focused on the characteristics of individual cohort studies from the KCC. We developed “PROFAN”, a Shiny application for projecting the follow-up period to achieve a certain number of cases when pooling established cohort studies. As examples, we projected the follow-up periods for 5000 cases of gastric cancer, 2500 cases of prostate and breast cancer, and 500 cases of non-Hodgkin lymphoma. The sample sizes for sequencing-based analyses based on a 1:1 case-control study were also calculated.
Results
The KCC consisted of 8 individual cohort studies, of which 3 were community-based and 5 were health screening-based cohorts. The population-based cohort studies were mainly organized by Korean government agencies and research institutes. The projected follow-up period was at least 10 years to achieve 5000 cases based on a cohort of 0.5 million participants. The mean of the minimum to maximum sample sizes for performing sequencing analyses was 5917-72 102.
Conclusions
We propose an approach to establish a large-scale consortium based on the standardization and harmonization of existing cohort studies to obtain adequate statistical power with a sufficient sample size to analyze high-risk groups or rare cancer subtypes.
Summary
Korean summary
한국 코호트 컨소시엄(KCC)은 “2015년 한국의 생활 습관 및 환경 요인에 따른 암 기여분율” 프로젝트의 3단계 과업으로써, 본 프로젝트에 참여한 기존의 구축된 개인 코호트 연구의 연구자들을 주도로 다수의 대규모 한국 코호트 연구를 기반으로 구성되었다. 따라서 본 연구는 KCC에 포함된 한국 코호트 연구를 소개하는 것을 목표로 하였다. 또한 여러 기 확립된 국제 컨소시엄을 기반으로 빅데이터 기반 코호트 풀링 연구의 중요성을 제시하였다.

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Special Article
Cohort Profile: Korean Tuberculosis and Post-Tuberculosis Cohort Constructed by Linking the Korean National Tuberculosis Surveillance System and National Health Information Database
Dawoon Jeong, Hee-Yeon Kang, Jinsun Kim, Hyewon Lee, Bit-Na Yoo, Hee-Sun Kim, Hongjo Choi
J Prev Med Public Health. 2022;55(3):253-262.   Published online April 22, 2022
DOI: https://doi.org/10.3961/jpmph.21.635
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AbstractAbstract AbstractSummary PDFSupplementary Material
We aimed to review the current data composition of the Korean Tuberculosis and Post-Tuberculosis Cohort, which was constructed by linking the Korean Tuberculosis Surveillance System (KNTSS; established and operated by the Korean Disease Control and Prevention Agency since 2000) and the National Health Information Database (NHID; established by the National Health Insurance Service in 2012). The following data were linked: KNTSS data pertaining to patients diagnosed with tuberculosis between 2011 and 2018, NHID data of patients with a history of tuberculosis and related diseases between 2006 and 2018, and data (obtained from the Statistics Korea database) on causes of death. Data from 300 117 tuberculosis patients (177 206 men and 122 911 women) were linked. The rate of treatment success for new cases was highest in 2015 (86.7%), with a gradual decrease thereafter. The treatment success rate for previously treated cases showed an increasing trend until 2014 (79.0%) and decreased thereafter. In total, 53 906 deaths were confirmed among tuberculosis patients included in the cohort. The Korean Tuberculosis and Post-Tuberculosis Cohort can be used to analyze different measurement variables in an integrated manner depending on the data source. Therefore, these cohort data can be used in future epidemiological studies and research on policy-effect analysis, treatment outcome analysis, and health-related behaviors such as treatment discontinuation.
Summary
Korean summary
TB Post 코호트(Korean Tuberculosis and Post-Tuberculosis Cohort)는 한국의 결핵 모니터링 및 관리에 대한 인구집단 수준에서의 새로운 근거를 마련하고자 구축한 우리나라 결핵 환자 코호트입니다. 국가 결핵감시체계의 일환으로 구축된 질병관리청의 결핵신고자료와 국민건강보험공단의 국민건강정보DB 자료, 통계청 사망원인 자료의 연계로 구축되었으며, 각 자료원이 보유한 정보를 활용하여 통합적인 결핵 환자 연구가 가능할 것으로 기대하고 있습니다. 결핵의 정책 효과 연구뿐만 아니라, 치료 성공, 실패, 중단 등 치료결과에 대한 영향 요인 및 환자들의 건강 관련 행태에 대한 역학 연구 등 향후 다양한 연구에 활용될 수 있을 것으로 기대됩니다.

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Original Articles
Trends and Spatial Pattern Analysis of Dengue Cases in Northeast Malaysia
Afiqah Syamimi Masrani, Nik Rosmawati Nik Husain, Kamarul Imran Musa, Ahmad Syaarani Yasin
J Prev Med Public Health. 2022;55(1):80-87.   Published online January 6, 2022
DOI: https://doi.org/10.3961/jpmph.21.461
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AbstractAbstract PDF
Objectives
Dengue remains hyperendemic in Malaysia despite extensive vector control activities. With dynamic changes in land use, urbanisation and population movement, periodic updates on dengue transmission patterns are crucial to ensure the implementation of effective control strategies. We sought to assess shifts in the trends and spatial patterns of dengue in Kelantan, a north-eastern state of Malaysia (5°15’N 102°0’E).
Methods
This study incorporated data from the national dengue monitoring system (eDengue system). Confirmed dengue cases registered in Kelantan with disease onset between January 1, 2016 and December 31, 2018 were included in the study. Yearly changes in dengue incidence were mapped by using ArcGIS. Hotspot analysis was performed using Getis-Ord Gi to track changes in the trends of dengue spatial clustering.
Results
A total of 10 645 dengue cases were recorded in Kelantan between 2016 and 2018, with an average of 10 dengue cases reported daily (standard deviation, 11.02). Areas with persistently high dengue incidence were seen mainly in the coastal region for the 3-year period. However, the hotspots shifted over time with a gradual dispersion of hotspots to their adjacent districts.
Conclusions
A notable shift in the spatial patterns of dengue was observed. We were able to glimpse the shift of dengue from an urban to peri-urban disease with the possible effect of a state-wide population movement that affects dengue transmission.
Summary

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    Marko Ferdian Salim, Tri Baskoro Tunggul Satoto, Danardono ., D. Daniel
    The Open Public Health Journal.2024;[Epub]     CrossRef
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    Anne Hui Yi Goei, Lay Hoon Goh, See Ming Lim
    Singapore Medical Journal.2024;[Epub]     CrossRef
  • Solid waste management and Aedes aegypti infestation interconnections: A regression tree application
    Fernanda Klafke, Virgínia Grace Barros, Elisa Henning
    Waste Management & Research: The Journal for a Sustainable Circular Economy.2023; 41(11): 1684.     CrossRef
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    André de Souza Leandro, Mario J. C. Ayala, Renata Defante Lopes, Caroline Amaral Martins, Rafael Maciel-de-Freitas, Daniel A. M. Villela
    Pathogens.2022; 12(1): 4.     CrossRef
Hepatitis A Outbreak in a Facility for the Disabled, Gyeonggi Province, Korea: An Epidemiological Investigation
Yeonhwa Chang, Chanhee Kim, Nayoung Kim, Joon Jai Kim, Heeyoung Lee
J Prev Med Public Health. 2021;54(5):370-375.   Published online September 2, 2021
DOI: https://doi.org/10.3961/jpmph.21.349
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AbstractAbstract AbstractSummary PDF
Objectives
The number of cases of hepatitis A virus (HAV) infections has sharply increased in Korea, especially among young adults. In this study, an HAV outbreak in a facility for disabled people was investigated, and we found epidemiological differences both between 2 different generations and between generally abled and disabled groups.
Methods
We analyzed the incubation period and attack rate of an HAV outbreak and investigated the prevalence of HAV antibodies among the staff and residents of a facility for the disabled. We performed a retrospective cohort study during the HAV outbreak, which lasted from February 8 to 25, 2019, including examinations of HAV antibody tests and post-exposure HAV vaccination for the staff or residents of the facility.
Results
There were 9 confirmed cases in 2 staff members and 7 residents. Among 53 people (30 staff and 23 residents), except for the 9 confirmed cases and 1 staff member with a known history of HAV infection, HAV seroprevalence was seen in 16.7% of the staff under 40 years of age and 95.2% of those over 40 years of age, while the corresponding rates in the residents were 0.0% and 58.8%, respectively.
Conclusions
This result implies that it is necessary to prioritize HAV vaccination for vulnerable groups and workers of residential care facilities.
Summary
Korean summary
본 연구는 장애인 거주시설에서 발생한 A형간염 유행 사례를 다루고 있다. 그 결과 거주시설 소속의 장애인들은 종사자들보다 높은 발병률(attack rate)을 나타냈을 뿐만 아니라, 비슷한 연령의 일반 인구집단보다 낮은 항체유병률을 나타내는 것으로 확인되었다. 거주시설 소속의 장애인들과 같이 취약한 인구집단은 예방접종 이력을 확인하기 어려울 뿐만 아니라 병원체에 자연스럽게 노출 기회가 적을 수밖에 없기 때문에, 예방접종 정책 수립 시 우선 접종의 대상으로 고려될 필요가 있다.

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  • CURRENT FEATURES OF THE HEPATITIS EPIDEMIC PROCESS IN THE VINNYTSIA REGION
    Dmytro V. Palii, Iryna G. Paliy, Olena O. Voinalovych, Mariia O. Shostatska
    Clinical and Preventive Medicine.2025; (2): 132.     CrossRef
  • The Shifting Epidemiology of Hepatitis A in the World Health Organization Western Pacific Region
    Nina G. Gloriani, Sheriah Laine M. de Paz-Silava, Robert D. Allison, Yoshihiro Takashima, Tigran Avagyan
    Vaccines.2024; 12(2): 204.     CrossRef
  • A Study on the Detection Rate of Hepatitis A from Gastroenteritis Patients and the Genotype Analysis of Hepatitis A Virus in Busan
    Sun Hee Park, Chanhee Kim, Summi Lee, Jihye Jeong, Junghye Choi, Seung Ju Lee
    Journal of Bacteriology and Virology.2023; 53(2): 74.     CrossRef
  • A Study on the Detection Rate of Hepatitis A from Gastroenteritis Patients and the Genotype Analysis of Hepatitis A Virus in Busan
    Sun Hee Park, Chanhee Kim, Summi Lee, Jihye Jeong, Junghye Choi, Seung Ju Lee
    Journal of Bacteriology and Virology.2023; 53(2): 74.     CrossRef
Brief Report
Reliability and Validity of a Life Course Passive Smoke Exposure Questionnaire in an Australian Cohort From Childhood to Adulthood
Chigozie Ezegbe, Costan G. Magnussen, Amanda Louise Neil, Marie-Jeanne Buscot, Terence Dwyer, Alison Venn, Seana Gall
J Prev Med Public Health. 2021;54(2):153-159.   Published online March 10, 2021
DOI: https://doi.org/10.3961/jpmph.20.559
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AbstractAbstract PDFSupplementary Material
Objectives
Life course exposure to passive smoke may predict health, but there are few validated measures. We tested the reliability and validity of a retrospective life course passive smoking questionnaire.
Methods
Participants from the third follow-up of the Childhood Determinants of Adult Health study (2014-2019, ages 36-49 years) retrospectively reported mother/father/other household member smoking when living at home during childhood, including duration (years) and smoking location (never/sometimes/always inside house). The severity of exposure index (SEI; sum of mother/father/other years smoked multiplied by smoking location), cumulative years of exposure (CYE; sum of mother/father/other years), and total household smokers (THS) were derived. The reliability of retrospective passive smoking reports was examined with intraclass correlation coefficients (ICCs) using household smoking reported 34 years earlier in 1985 by participants when aged 7-15 years. Construct validity was examined by correlating retrospective passive smoking with participants’ smoking in adulthood and lung function in childhood and adulthood.
Results
Among 2082 participants (mean±standard deviation [SD], 45.0±2.5 years; 55.2% females), THS ranged from 0 to 5 (mean± SD, 0.9±1.0), CYE ranged from 0 to 106 (mean±SD, 10.5±13.9), and SEI ranged from 0 to 318 (mean±SD, 24.4±36.0). Retrospective measures showed moderate agreement with total household smokers reported in childhood (ICC, 0.58 to 0.62). The retrospective measures were weakly but significantly (p<0.05) correlated with participants’ smoking (r=0.13 to 0.15) and lung function (r= -0.05 to -0.06).
Conclusions
The retrospective passive smoking questionnaire showed reasonable reliability and validity. This measure may be useful for epidemiological studies.
Summary

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  • Childhood secondhand smoke exposure and respiratory disease mortality among never-smokers: the Japan collaborative cohort study for evaluation of cancer risk
    Haruna Kawachi, Masayuki Teramoto, Isao Muraki, Kokoro Shirai, Kazumasa Yamagishi, Akiko Tamakoshi, Hiroyasu Iso
    Journal of Public Health.2023; 45(3): 604.     CrossRef
Original Articles
Associations Between Thyroid Hormone Levels and Urinary Concentrations of Bisphenol A, F, and S in 6-Year-old Children in Korea
Yoonyoung Jang, Yoon-Jung Choi, Youn-Hee Lim, Kyung-Shin Lee, Bung-Nyun Kim, Choong Ho Shin, Young Ah Lee, Johanna Inhyang Kim, Yun-Chul Hong
J Prev Med Public Health. 2021;54(1):37-45.   Published online November 23, 2020
DOI: https://doi.org/10.3961/jpmph.20.310
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AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Bisphenol A (BPA) is used in the electrical, mechanical, medical, and food industries. Previous studies have suggested that BPA is an endocrine disruptor. Regulation of BPA has led to increased use of bisphenol F (BPF) and bisphenol S (BPS). However, few studies have investigated the associations of BPF and BPS with thyroid dysfunction in children. Our study investigated the associations of prenatal BPA and early childhood BPA, BPF, and BPS exposure with thyroid function in 6-year-old children.
Methods
Prenatal BPA concentrations were measured during the second trimester of pregnancy in an established prospective birth cohort. We measured urinary BPA, BPF, and BPS concentrations and thyroid hormone levels (thyroid-stimulating hormone, total T3, and free T4) in 6-year-old children (n=574). We examined the associations between urinary bisphenol concentrations and percentage change of thyroid hormone concentrations using multivariate linear regression. We also compared thyroid hormone levels by dividing the cohort according to BPA, BPF, and BPS concentrations.
Results
The associations between prenatal BPA and total T3 levels were statistically significant in all models, except for girls when using a crude model. The associations between urinary BPA and BPS concentrations and levels of all thyroid hormones were not statistically significant. However, we observed that lower free T4 levels (-1.94%; 95% confidence interval, -3.82 to -0.03) were associated with higher urinary BPF concentrations in girls only.
Conclusions
Our findings identified significant associations between prenatal BPA exposure and total T3 levels in all children and between BPF exposure and free T4 levels in girls only.
Summary
Korean summary
비스페놀 A의 건강위해성에 대한 역학적 근거들이 축적되어 비스페놀 A 대신 BPF와 BPS와 같은 대체물질이 사용되고 있다. 본 논문에서는 어머니의 산전 비스페놀 A 노출과 6세 어린이의 비스페놀 A, 비스페놀 F, 비스페놀 S 노출 정도에 따라 어린이의 갑상선호르몬 농도에 어떠한 영향을 미치는가 보고자 하였다. 어머니의 산전 비스페놀 A 노출은 어린이의 total T3 농도에 유의하게 영향을 미쳤으며, 특히 여자아이에게서 비스페놀 F 노출이 한 단위 증가할수록 free T4 농도가 유의하게 감소하는 것을 관찰하였다. 본 논문의 의의는 비스페놀 F, S가 어린이의 갑상선기능에 어떠한 영향을 미치는지 역학적 근거를 제시하였다는 점이나, 인과적 연관성을 위해서는 시간적 선후관계를 고려한 더 많은 연구가 필요하다.

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    Zhenggang Li, Lin Deng, Yue Zhang
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  • The hypothalamus-pituitary-thyroid axis is disrupted by exposure to a mix of tributyltin and bisphenol S
    Francisca Diana Paiva-Melo, Denilson de Sousa Anselmo, Mariana Pires Teixeira, Marcelle Novaes Andrade, Jones Bernardes Graceli, Ana Paula Santos-Silva, Paula Soares, Denise Pires de Carvalho, Andrea Claudia Freitas Ferreira, Leandro Miranda-Alves
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Relationship Between Non-alcoholic Fatty Liver Disease and Decreased Bone Mineral Density: A Retrospective Cohort Study in Korea
Jisun Sung, Seungho Ryu, Yun-Mi Song, Hae-Kwan Cheong
J Prev Med Public Health. 2020;53(5):342-352.   Published online July 17, 2020
DOI: https://doi.org/10.3961/jpmph.20.089
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  • 157 Download
  • 22 Crossref
AbstractAbstract PDF
Objectives
The aim of this retrospective cohort study was to investigate whether non-alcoholic fatty liver disease (NAFLD) was associated with incident bone mineral density (BMD) decrease.
Methods
This study included 4536 subjects with normal BMD at baseline. NAFLD was defined as the presence of fatty liver on abdominal ultrasonography without significant alcohol consumption or other causes. Decreased BMD was defined as a diagnosis of osteopenia, osteoporosis, or BMD below the expected range for the patient’s age based on dual-energy X-ray absorptiometry. Cox proportional hazards models were used to estimate the hazard ratio of incident BMD decrease in subjects with or without NAFLD. Subgroup analyses were conducted according to the relevant factors.
Results
Across 13 354 person-years of total follow-up, decreased BMD was observed in 606 subjects, corresponding to an incidence of 45.4 cases per 1000 person-years (median follow-up duration, 2.1 years). In the model adjusted for age and sex, the hazard ratio was 0.65 (95% confidence interval, 0.51 to 0.82), and statistical significance disappeared after adjustment for body mass index (BMI) and cardiometabolic factors. In the subgroup analyses, NAFLD was associated with a lower risk of incident BMD decrease in females even after adjustment for confounders. The direction of the effect of NAFLD on the risk of BMD decrease changed depending on BMI category and body fat percentage, although the impact was statistically insignificant.
Conclusions
NAFLD had a significant protective effect on BMD in females. However, the effects may vary depending on BMI category or body fat percentage.
Summary

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    Ji Won Yoon, Min Joo Kim, Goh-Eun Chung, Jong In Yang, Jeong Yoon Yim, Jin Ju Kim, Sun Mie Kim, Min-Sun Kwak
    Hepatology International.2021; 15(6): 1347.     CrossRef
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Association Between the Frequency of Eating Non-home-prepared Meals and Women Infertility in the United States
Sohyae Lee, Jin-young Min, Hye-Jin Kim, Kyoung-bok Min
J Prev Med Public Health. 2020;53(2):73-81.   Published online February 10, 2020
DOI: https://doi.org/10.3961/jpmph.19.218
  • 14,905 View
  • 294 Download
  • 7 Crossref
AbstractAbstract AbstractSummary PDF
Objectives
The purpose of this study was to determine whether eating non-home-prepared meals (NHPM), including fast food, ready-to-eat foods, and frozen foods, was associated with self-reported infertility in the United States women. Methods: Data on diet and infertility from women aged 20-49 years who participated in the 2013-2014 and 2015-2016 National Health and Nutrition Examination Surveys were analyzed (n=2143). Dietary information, including the number and types of NHPM consumed, was obtained from a self-reported questionnaire, and infertility status was analyzed using the following question, “Have you ever attempted to become pregnant over a period of at least a year without becoming pregnant?” Results: The frequency of NHPM consumption was positively associated with self-reported infertility after adjusting for confounding effects (odds ratio [OR], 2.82; 95% confidence interval [CI], 1.48 to 5.38 of >1 vs. 0 NHPM/d). The odds of infertility were 2-3 times higher in women who consumed fast food than in those who did not consume fast food (OR, 2.73; 95% CI, 1.15 to 6.48 of >1 vs. 0 times/d). Conclusions: The frequency and types of NHPM may be a factor contributing to infertility. Although our findings require confirmation, they suggest that eating out may be deleterious to women fecundity.
Summary
Korean summary
본 연구에서는 미국 국민건강영양조사 자료를 사용하여 패스트푸드, 냉동식품, 그리고 포장하여 판매하는 음식과 같이 집에서 조리하지 않은 음식 섭취와 불임의 연관성을 분석하였다. 잠재적인 교란변수들을 통제하여 분석한 결과 집에서 조리하지 않은 음식 섭취 횟수는 불임과 연관이 있는 것으로 나타났다 (OR 2.82, 95% CI 1.48 to 5.38 of >1 vs. 0 NHPM/d).

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  • Current trends in take-out food consumption and its influencing factors among first-trimester pregnant women in Changsha
    Sheng Teng, Yi Yang, Leshi Lin, Wenjuan Li, Li Li, Fang Peng, Xiao Gao, Dongmei Peng
    BMC Public Health.2025;[Epub]     CrossRef
  • Junk Food Infertility: A Silent Threat to Reproductive Health in Pakistani Youth
    Asifa Hina, Manaal Khalid
    Trends in Social Sciences.2025; 1(1): 18.     CrossRef
  • Diet and female fertility: a population-based study re-evaluating the need for prescriptive dietary patterns
    Simon Alesi, Jessica A. Grieger, Helena Teede, James R. Hébert, R. Kendal Moss, Sherry Price, Allison Hodge, Lisa Moran, Aya Mousa
    Frontiers in Nutrition.2025;[Epub]     CrossRef
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  • Assessing the influence of preconception diet on female fertility: a systematic scoping review of observational studies
    Simon Alesi, Nahal Habibi, Thais Rasia Silva, Nicole Cheung, Sophia Torkel, Chau Thien Tay, Alejandra Quinteros, Hugo Winter, Helena Teede, Aya Mousa, Jessica A Grieger, Lisa J Moran
    Human Reproduction Update.2023; 29(6): 811.     CrossRef
  • Environmental factors in declining human fertility
    Niels E. Skakkebæk, Rune Lindahl-Jacobsen, Hagai Levine, Anna-Maria Andersson, Niels Jørgensen, Katharina M. Main, Øjvind Lidegaard, Lærke Priskorn, Stine A. Holmboe, Elvira V. Bräuner, Kristian Almstrup, Luiz R. Franca, Ariana Znaor, Andreas Kortenkamp,
    Nature Reviews Endocrinology.2022; 18(3): 139.     CrossRef
  • Impact of Ready-Meal Consumption during Pregnancy on Birth Outcomes: The Japan Environment and Children’s Study
    Hazuki Tamada, Takeshi Ebara, Taro Matsuki, Sayaka Kato, Hirotaka Sato, Yuki Ito, Shinji Saitoh, Michihiro Kamijima, Mayumi Sugiura-Ogasawara
    Nutrients.2022; 14(4): 895.     CrossRef
Non-linear Relationship Between Body Mass Index and Lower Urinary Tract Symptoms in Korean Males
Chang Kyun Choi, Sun A Kim, Ji-An Jeong, Sun-Seog Kweon, Min-Ho Shin
J Prev Med Public Health. 2019;52(3):147-153.   Published online March 29, 2019
DOI: https://doi.org/10.3961/jpmph.18.259
  • 13,707 View
  • 197 Download
  • 1 Crossref
AbstractAbstract AbstractSummary PDF
Objectives
The purpose of this study was to evaluate the association between body mass index (BMI) and severe lower urinary tract symptoms (LUTS) in Korean males.
Methods
This study was conducted on males aged ≥50 years who participated in the 2011 Korean Community Health Survey. LUTS severity was assessed using the Korean version of the International Prostate Symptom Score (IPSS) questionnaire, and was dichotomized as severe (IPSS >19) and non-severe (IPSS ≤19). BMI was divided into 6 categories: <18.5, 18.5-22.9, 23.0-24.9, 25.0-27.4, 27.5-29.9, and ≥30.0 kg/m2. To evaluate the relationship between BMI and LUTS, a survey-weighted multivariate Poisson regression analysis was performed to estimate prevalence rate ratios (PRRs). Age, smoking status, alcohol intake, physical activity, educational level, household income, and comorbidities were adjusted for in the multivariate model.
Results
A U-shaped relationship was detected between BMI and severe LUTS. Compared with a BMI of 23.0-24.9 kg/m2, the PRR for a BMI <18.5 kg/m2 was 1.65 (95% confidence interval [CI], 1.35 to 2.02), that for a BMI of 18.5-22.9 kg/m2 was 1.25 (95% CI, 1.09 to 1.44), that for a BMI of 25.0-27.4 kg/m2 was 1.20 (95% CI, 1.00 to 1.45), that for a BMI of 27.5-29.9 kg/m2 was 1.11 (95% CI, 0.83 to 1.47), and that for a BMI ≥30.0 kg/m2 was 1.85 (95% CI, 1.18 to 2.88).
Conclusions
This study showed that both high and low BMI were associated with severe LUTS.
Summary
Korean summary
이 연구는 2011 지역사회건강조사를 기반으로 하였다. 한국인 남성에서 체질량지수와 하부요로증상 간에는 U자형 관련성이 있었으며, 저체중과 비만 모두 높은 하부요로증상 유병률을 보였다. 따라서 전립선 질환의 건강서비스 제공에 있어서 비만 뿐만 아니라 저체중 또한 위험인자로 함께 고려할 필요가 있다.

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  • Metabolic syndrome and male lower urinary tract symptoms
    Gallus B. INEICHEN, Fiona C. BURKHARD
    Panminerva Medica.2022;[Epub]     CrossRef
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
  • 11,061 View
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  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary 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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The Risk of Colorectal Cancer After Cholecystectomy or Appendectomy: A Population-based Cohort Study in Korea
Joonki Lee, Sunho Choe, Ji Won Park, Seung-Yong Jeong, Aesun Shin
J Prev Med Public Health. 2018;51(6):281-288.   Published online October 29, 2018
DOI: https://doi.org/10.3961/jpmph.18.105
  • 14,206 View
  • 245 Download
  • 38 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
We investigated the association between cholecystectomy or appendectomy and the subsequent risk of colorectal cancer (CRC) in the Korean population.
Methods
A retrospective cohort study was conducted with the National Health Insurance Service–National Sample Cohort of Korea; this sample was followed up from January 1, 2002, until the date of CRC incidence, loss to follow-up, or December 31, 2015. The exposure status of cholecystectomy and appendectomy was treated as a time-varying covariate. The calculated risk of CRC was stratified by follow-up period, and the association between these surgical procedures and CRC was investigated by a Cox regression model applying appropriate lag periods.
Results
A total of 707 663 individuals were identified for analysis. The study population was followed up for an average of 13.66 years, and 4324 CRC cases were identified. The hazard ratio (HR) of CRC was elevated in the first year after cholecystectomy (HR, 1.71; 95% confidence interval [CI], 1.01 to 2.89) and in the first year and 2-3 years after appendectomy (HR, 4.22; 95% CI, 2.87 to 6.20; HR, 2.34; 95% CI, 1.36 to 4.03, respectively). The HRs of CRC after applying 1 year of lag after cholecystectomy and 3 years of lag after appendectomy were 0.80 (95% CI, 0.57 to 1.13) and 0.77 (95% CI, 0.51 to 1.16), respectively.
Conclusions
The risk of CRC increased in the first year after cholecystectomy and appendectomy, implying the possibility of bias. When appropriate lag periods after surgery were applied, no association was found between cholecystectomy or appendectomy and CRC.
Summary
Korean summary
본 연구는 담낭절제술, 충수돌기절제술 후 대장암의 발생위험에 관한 연구로 국민건강보험공단 표본코호트자료를 사용한 후향적코호트 연구이다. 총 707 663명을 대상으로 연구를 진행하였으며, 담낭절제술을 시행한 환자들은 수술 후 1년 이내에서 대장암의 위험도가 유의하게 증가하였으나 이후 관련성을 보이지 않았고, 충수돌기절제술을 시행한 환자들은 수술 후 1년, 2~3년에서 유의하게 위험도가 증가하였으나, 이후에는 관련성을 보이지 않았다. 이 결과는 역인과관계의 가능성을 시사하며 이것을 고려하였을 때, 담낭절제술과 충수돌기절제술은 대장암의 발생위험과의 연관성을 보이지 않았다.

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Effect of Uric Acid on the Development of Chronic Kidney Disease: The Korean Multi-Rural Communities Cohort Study
Kwang Ho Mun, Gyeong Im Yu, Bo Youl Choi, Mi Kyung Kim, Min-Ho Shin, Dong Hoon Shin
J Prev Med Public Health. 2018;51(5):248-256.   Published online September 7, 2018
DOI: https://doi.org/10.3961/jpmph.18.112
  • 10,951 View
  • 180 Download
  • 12 Crossref
AbstractAbstract PDF
Objectives
Several studies have investigated the effects of serum uric acid (SUA) levels on chronic kidney disease (CKD), with discrepant results. The effect of SUA levels on CKD development was studied in the Korean rural population.
Methods
A total of 9695 participants aged ≥40 years were recruited from 3 rural communities in Korea between 2005 and 2009. Of those participants, 5577 who participated in the follow-up and did not have cerebrovascular disease, myocardial infarction, cancer, or CKD at baseline were studied. The participants, of whom 2133 were men and 3444 were women, were grouped into 5 categories according to their quintile of SUA levels. An estimated glomerular filtration rate of <60 mL/min/1.73 m2 at the time of follow-up was considered to indicate newly developed CKD. The effects of SUA levels on CKD development after adjusting for potential confounders were assessed using Cox proportional hazard models.
Results
Among the 5577 participants, 9.4 and 11.0% of men and women developed CKD. The hazard ratio (HR) of CKD was higher in the highest quintile of SUA levels than in the third quintile in men (adjusted HR, 1.60; 95% confidence interval [CI], 1.02 to 2.51) and women (adjusted HR, 1.56; 95% CI, 1.14 to 2.15). Furthermore, CKD development was also more common in the lowest quintile of SUA levels than in the third quintile in men (adjusted HR, 1.83; 95% CI, 1.15 to 2.90). The effect of SUA was consistent in younger, obese, and hypertensive men.
Conclusions
Both high and low SUA levels were risk factors for CKD development in rural Korean men, while only high levels were a risk factor in their women counterparts.
Summary

Citations

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  • Serum Uric Acid Levels and Nephrosclerosis in a Population-Based Autopsy Study: The Hisayama Study
    Kenji Maki, Jun Hata, Satoko Sakata, Emi Oishi, Yoshihiko Furuta, Toshiaki Nakano, Yoshinao Oda, Takanari Kitazono, Toshiharu Ninomiya
    American Journal of Nephrology.2022; 53(1): 69.     CrossRef
  • U-shaped relationship between serum uric acid level and decline in renal function during a 10-year period in female subjects: BOREAS-CKD2
    Kazuma Mori, Masato Furuhashi, Marenao Tanaka, Keita Numata, Takashi Hisasue, Nagisa Hanawa, Masayuki Koyama, Arata Osanami, Yukimura Higashiura, Masafumi Inyaku, Megumi Matsumoto, Norihito Moniwa, Hirofumi Ohnishi, Tetsuji Miura
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    Po-Ya Chang, Yu-Wei Chang, Yuh-Feng Lin, Hueng-Chuen Fan
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  • Threshold Effects of Serum Uric Acid on Chronic Kidney Disease in US Women without Hypertension and Diabetes: A Cross-Sectional Study
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Urinary Mercury Levels Among Workers in E-waste Shops in Nakhon Si Thammarat Province, Thailand
Somsiri Decharat
J Prev Med Public Health. 2018;51(4):196-204.   Published online June 19, 2018
DOI: https://doi.org/10.3961/jpmph.18.049
  • 11,502 View
  • 191 Download
  • 23 Crossref
AbstractAbstract PDF
Objectives
To determine urinary mercury levels in e-waste workers in Southern Thailand and the airborne mercury levels in the e-waste shops where they worked, to describe the associations between urinary and airborne mercury levels, and to evaluate the prevalence of mercury exposure-related health effects among e-waste workers.
Methods
A cross-sectional study was conducted by interviewing 79 workers in 25 e-waste shops who lived in Nakhon Si Thammarat Province, Thailand. Information on general and occupational characteristics, personal protective equipment use, and personal hygiene was collected by questionnaire. Urine samples were collected to determine mercury levels using a cold-vapor atomic absorption spectrometer mercury analyzer.
Results
The e-waste workers’ urinary mercury levels were 11.60±5.23 μg/g creatinine (range, 2.00 to 26.00 μg/g creatinine) and the mean airborne mercury levels were 17.00±0.50 μg/m3 (range, 3.00 to 29.00 μg/m3). The urinary and airborne mercury levels were significantly correlated (r=0.552, p<0.001). The prevalence of self-reported symptoms was 46.8% for insomnia, 36.7% for muscle atrophy, 24.1% for weakness, and 20.3% for headaches.
Conclusions
Personal hygiene was found to be an important protective factor, and should therefore be stressed in educational programs. Employers should implement engineering measures to reduce urinary mercury levels and the prevalence of associated health symptoms among e-waste workers.
Summary

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    Richard Osae, Timothy Yaw Sablah, Christopher Abasiya, Michael Yaw Peasah, Ebenzer Aboagye Agyare, Seyram Kofi Loh, Michael Owusu, Felix Owusu
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  • Health Effects of Heavy Metal Exposure Among E-waste Workers and Community-dwelling Adults in Thailand: A Cross-sectional Study
    Chonyitree Sangwijit, Parichat Ong-artborirak, Warangkana Naksen, Kraiwuth Kallawicha, Pallop Siewchaisakul
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    Abu Kaisar Md Faisal, Israt Jahan Ankhi, Gazi Arman Hossain, Mim Mashrur Ahmed, Milind Siddhpura, Mahadi Hasan Masud
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  • Recovery of Rare Earth Elements (REEs) From Different Sources of E‐Waste and Their Potential Applications: A Focused Review
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    Perihan Binnur Kurt-Karakus, Merve Ozkaleli Akcetin, Askin Birgul, Melik Kara, Yetkin Dumanoglu, Baris Yaman, Sena Celik, Frank Wania, Jabir Hussain Syed, Mustafa Odabasi
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Housing Conditions Contribute to Underweight in Children: An Example From Rural Villages in Southeast Sulawesi, Indonesia
Tasnim Tasnim, Gouranga Dasvarma, Lillian Mwanri
J Prev Med Public Health. 2017;50(5):328-335.   Published online September 7, 2017
DOI: https://doi.org/10.3961/jpmph.17.046
  • 9,616 View
  • 210 Download
  • 7 Crossref
AbstractAbstract PDF
Objectives
The prevalence of underweight in children under 5 years of age is anomalously high in Konawe District, Southeast Sulawesi Province, Indonesia. This state of affairs may be related to poor housing conditions, such as limited access to clean water, the absence of a sanitary latrine, and the use of poor housing materials. Therefore, this study aimed to examine the effect of housing conditions on underweight in under-5 children in Konawe District. Methods: This study was conducted in 2013 in 5 health centres in Konawe District, Southeast Sulawesi Province, and used a case-control study design. The study recruited 400 under-5 children, including 100 of whom were cases and 300 of whom were age-matched controls (1:3). Cases were underweight children, while the controls were children with a normal nutritional status. The independent variables were the availability and types of water and latrine facilities and housing materials (roof, wall, and floor). The statistical analysis used Cox regression. Results: A lack of water availability (odds ratio [OR], 5.0; 95% confidence interval [CI], 2.7 to 9.5; p<0.001), a lack of latrine availability in the home (OR, 2.5; 95% CI, 1.5 to 4.0; p<0.001), and poor-quality roofing materials (OR, 1.7; 95% CI, 1.1 to 2.7; p<0.02) significantly contributed to underweight in children. In contrast, the walls and the floors did not contribute to under-5 year children being underweight (p=0.09 and p=0.71, respectively). Conclusions: Sanitation facilities and roofing were identified as important factors to address in order to improve children’s nutritional status. Children’s health status was directly impacted by food intake via their nutritional status.
Summary

Citations

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  • Risk factors for childhood underweight: A cross-sectional design-based logistic regression analysis
    Zakariya M. S. Mohammed, Ali Satty, Mohyaldein Salih, Sana A. Mohammed, Ola A. I. Osman, Faroug A. Abdalla, Ashraf F. A. Mahmoud, Ekramy Elmorsy
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    Yoerdy Agusmal Saputra, Mona Lisa, Nailul Hikmi, Septiria Irawati, Achmad Rizki Azhari, Disa Hijratul Muharramah
    Clinical Epidemiology and Global Health.2025; 36: 102211.     CrossRef
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    Ine Rahmadiani, Arulita Ika Fibriana, Alfiana Ainun Nisa, Syed Abdul Shabbir, Mahalul Azam
    International Journal of Preventive Medicine.2025;[Epub]     CrossRef
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    Fitri R. Fadmi, Kuntoro Kuntoro, Bambang Widjanarko Otok, Soenarnatalina Melaniani
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    Ahmad Komarulzaman, Robi Andoyo, Zuzy Anna, Aisyah Amatul Ghina, Putri Riswani Halim, Herlina Napitupulu, Monica Ruth Karunia, Annisa Andriani
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    Ely Nurhidayati, Trida Ridho Fariz
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    Teresia Mbogori, James Muriuki
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Associations Between Preschool Education Experiences and Adulthood Self-rated Health
Jeehye Lee, Jinwook Bahk, Young-Ho Khang
J Prev Med Public Health. 2017;50(4):228-239.   Published online May 10, 2017
DOI: https://doi.org/10.3961/jpmph.16.110
  • 10,322 View
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  • 1 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
This study aimed to examine the association between preschool education experiences and adulthood self-rated health using representative data from a national population-based survey. Methods: Data from the Korean Labor and Income Panel Study in 2006 and 2012 were used. A total of 2391 men and women 21-41 years of age were analyzed. Log-binomial regression analyses were conducted to examine the associations between preschool education experience and self-rated health in adulthood. Parental socioeconomic position (SEP) indicators were considered as confounders of the association between preschool education experience and adulthood subjective health, while current SEP indicators were analyzed as mediators. Age-adjusted prevalence ratios (PRs) and the associated 95% confidence intervals (CIs) were estimated. Results: Compared with men without any experience of preschool education, those with both kindergarten and other preschool education experiences showed a lower prevalence of self-rated poor health (PR, 0.65; 95% CI, 0.47 to 0.89). In women, however, such an association was not evident. The relationship of preschool education experiences with self-rated poor health in adulthood among men was confounded by parental SEP indicators and was also mediated by current SEP indicators. After adjustment for parental and current SEP indicators, the magnitude of the associations between preschool education experiences and adulthood subjective health was attenuated in men. Conclusions: Preschool education experience was associated with adulthood self-rated health in men. However, this association was explained by parental and current SEP indicators. Further investigations employing a larger sample size and objective health outcomes are warranted in the future.
Summary

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  • Self-rated health and its determinants in patients with hypertension in Isfahan in 2019
    Asieh Mansouri, Alireza Khosravi Farsani, Noushin Mohammadifard, Fatemeh Nouri, Mahnaz Jozan, Ghazaal Alavi Tabatabaei, Rezvan Salehidoost, Hamed Rafiee
    BMC Public Health.2024;[Epub]     CrossRef
Metabolic Risk Profile and Cancer in Korean Men and Women
Seulki Ko, Seok-Jun Yoon, Dongwoo Kim, A-Rim Kim, Eun-Jung Kim, Hye-Young Seo
J Prev Med Public Health. 2016;49(3):143-152.   Published online May 18, 2016
DOI: https://doi.org/10.3961/jpmph.16.021
  • 15,500 View
  • 311 Download
  • 44 Crossref
AbstractAbstract PDF
Objectives
Metabolic syndrome is a cluster of risk factors for type 2 diabetes mellitus and cardiovascular disease. Associations between metabolic syndrome and several types of cancer have recently been documented.
Methods
We analyzed the sample cohort data from the Korean National Health Insurance Service from 2002, with a follow-up period extending to 2013. The cohort data included 99 565 individuals who participated in the health examination program and whose data were therefore present in the cohort database. The metabolic risk profile of each participant was assessed based on obesity, high serum glucose and total cholesterol levels, and high blood pressure. The occurrence of cancer was identified using Korean National Health Insurance claims data. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, adjusting for age group, smoking status, alcohol intake, and regular exercise.
Results
A total of 5937 cases of cancer occurred during a mean follow-up period of 10.4 years. In men with a high-risk metabolic profile, the risk of colon cancer was elevated (HR, 1.40; 95% CI, 1.14 to 1.71). In women, a high-risk metabolic profile was associated with a significantly increased risk of gallbladder and biliary tract cancer (HR, 2.05; 95% CI, 1.24 to 3.42). Non-significantly increased risks were observed in men for pharynx, larynx, rectum, and kidney cancer, and in women for colon, liver, breast, and ovarian cancer.
Conclusions
The findings of this study support the previously suggested association between metabolic syndrome and the risk of several cancers. A high-risk metabolic profile may be an important risk factor for colon cancer in Korean men and gallbladder and biliary tract cancer in Korean women.
Summary

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Brief Reports
Depressive Symptoms on the Geriatric Depression Scale and Suicide Deaths in Older Middle-aged Men: A Prospective Cohort Study
Sang-Wook Yi
J Prev Med Public Health. 2016;49(3):176-182.   Published online April 12, 2016
DOI: https://doi.org/10.3961/jpmph.16.012
  • 14,473 View
  • 155 Download
  • 22 Crossref
AbstractAbstract PDF
Objectives
Prospective evaluations of the associations between depressive symptoms and suicide deaths have been mainly performed in high-risk populations, such as individuals with psychiatric disorders or histories of self-harm. The purpose of this study was to prospectively examine whether more severe depressive symptoms assessed using the Geriatric Depression Scale (GDS) were associated with a greater risk of death from suicide in a general-risk population.
Methods
A total of 113 478 men from the Korean Veterans Health Study (mean age, 58.9 years) who participated in a postal survey in 2004 were followed up for suicide mortality until 2010.
Results
Over 6.4 years of follow-up, 400 men died by suicide (56.7 deaths per 100 000 person-years). More severe depressive symptoms were associated with greater risk of suicide death (p for trend <0.001). The unadjusted hazard ratios (HRs) in comparison to the absence of depression were 2.18 for mild depression, 2.13 for moderate depression, 3.33 for severe depression, and 3.67 for extreme depression. After adjusting for potential confounders, men with a potential depressive disorder had an approximate 90% higher mortality from suicide (adjusted HR, 1.92; 95% confidence interval [CI], 1.38 to 2.68; p<0.001) than men without depression. Each five-point increase in the GDS score was associated with a higher risk of death by suicide (adjusted HR, 1.22; p<0.001). The value of the area under the receiver operating characteristics curve of GDS scores for suicide deaths was 0.61 (95% CI, 0.58 to 0.64).
Conclusions
Depressive symptoms assessed using the GDS were found to be a strong independent predictor of future suicide. However, the estimate of relative risk was weaker than would be expected based on retrospective psychological autopsy studies.
Summary

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Month and Season of Birth as a Risk Factor for Alzheimer’s Disease: A Nationwide Nested Case-control Study
Anna-Maija Tolppanen, Riitta Ahonen, Marjaana Koponen, Piia Lavikainen, Maija Purhonen, Heidi Taipale, Antti Tanskanen, Jari Tiihonen, Miia Tiihonen, Sirpa Hartikainen
J Prev Med Public Health. 2016;49(2):134-138.   Published online March 23, 2016
DOI: https://doi.org/10.3961/jpmph.16.018
  • 10,274 View
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  • 9 Crossref
AbstractAbstract PDF
Objectives
Season of birth, an exogenous indicator of early life environment, has been related to higher risk of adverse psychiatric outcomes but the findings for Alzheimer’s disease (AD) have been inconsistent. We investigated whether the month or season of birth are associated with AD.
Methods
A nationwide nested case-control study including all community-dwellers with clinically verified AD diagnosed in 2005 to 2012 (n=70 719) and up to four age- sex- and region of residence-matched controls (n=282 862) residing in Finland. Associations between month and season of birth and AD were studied with conditional logistic regression.
Results
Month of birth was not associated with AD (p=0.09). No strong associations were observed with season (p=0.13), although in comparison to winter births (December-February) summer births (June-August) were associated with higher odds of AD (odds ratio, 1.03; 95% confidence interval, 1.00 to 1.05). However, the absolute difference in prevalence in winter births was only 0.5% (prevalence of those born in winter were 31.7% and 32.2% for cases and controls, respectively).
Conclusions
Although our findings do not support the hypothesis that season of birth is related to AD/dementia risk, they do not invalidate the developmental origins of health and disease hypothesis in late-life cognition. It is possible that season does not adequately capture the early life circumstances, or that other (postnatal) risk factors such as lifestyle or socioeconomic factors overrule the impact of prenatal and perinatal factors.
Summary

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    Aline Marileen Wiegersma, Amber Boots, Miranda W. Langendam, Jacqueline Limpens, Susan D. Shenkin, Aniko Korosi, Tessa J. Roseboom, Susanne R. de Rooij
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Original Articles
Determinants of Poor Self-rated Health in Korean Adults With Diabetes
Hwi-Won Lee, Minkyo Song, Jae Jeong Yang, Daehee Kang
J Prev Med Public Health. 2015;48(6):287-300.   Published online October 23, 2015
DOI: https://doi.org/10.3961/jpmph.15.048
  • 14,410 View
  • 125 Download
  • 20 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
Self-rated health is a measure of perceived health widely used in epidemiological studies. Our study investigated the determinants of poor self-rated health in middle-aged Korean adults with diabetes.
Methods
A cross-sectional study was conducted based on the Health Examinees Study. A total of 9759 adults aged 40 to 69 years who reported having physician-diagnosed diabetes were analyzed with regard to a range of health determinants, including sociodemographic, lifestyle, psychosocial, and physical variables, in association with self-rated health status using multivariate logistic regression models. A p-value <0.05 was considered to indicate statistical significance.
Results
We found that negative psychosocial conditions, including frequent stress events and severe distress according to the psychosocial well-being index, were most strongly associated with poor self-rated health (odds ratio [OR]Frequent stress events, 5.40; 95% confidence interval [CI], 4.63 to 6.29; ORSevere distress, 11.08; 95% CI, 8.77 to 14.00). Moreover, younger age and being underweight or obese were shown to be associated with poor self-rated health. Physical factors relating to participants’ medical history of diabetes, such as a younger age at diagnosis, a longer duration of diabetes, insulin therapy, hemoglobin A1c levels of 6.5% or more, and comorbidities, were other correlates of poor reported health.
Conclusions
Our findings suggest that, in addition to medical variables, unfavorable socioeconomic factors, and adverse lifestyle behaviors, younger age, being underweight or obese, and psychosocial stress could be distinc factors in predicting negative perceived health status in Korean adults with diabetes.
Summary

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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
  • 11,582 View
  • 89 Download
  • 3 Crossref
AbstractAbstract 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
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Serum Uric Acid Level and the Incidence of Metabolic Syndrome in Middle-aged Korean Men: A 5-Year Follow-up Study
Jong-Keun Lee, Jae-Hong Ryoo, Joong-Myung Choi, Sung Keun Park
J Prev Med Public Health. 2014;47(6):317-326.   Published online November 4, 2014
DOI: https://doi.org/10.3961/jpmph.14.028
  • 13,505 View
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AbstractAbstract PDF
Objectives
Elevated serum uric acid (UA) has been known to be associated with the prevalence of metabolic syndrome (MetS). However, no prospective studies have examined whether serum UA levels are actually associated with the development of MetS. We performed a prospective study to evaluate the longitudinal effects of baseline serum UA levels on the development of MetS.
Methods
A MetS-free cohort of 14 906 healthy Korean men, who participated in a medical check-up program in 2005, was followed until 2010. MetS was defined according to the Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention. Cox proportional hazards models were performed.
Results
During 52 466.1 person-years of follow-up, 2428 incident cases of MetS developed between 2006 and 2010. After adjusting for multiple covariates, the hazard ratios (95% confidence intervals) for incident MetS for the second, the third, and the fourth quartile to the first quartile of serum UA levels were 1.09 (0.92-1.29), 1.22 (1.04-1.44), and 1.48 (1.26-1.73), respectively (p for trend <0.001). These associations were also significant in the clinically relevant subgroup analyses.
Conclusions
Elevated serum UA levels were independently associated with future development of MetS in Korean men during the 5-year follow-up period.
Summary

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    Xiao-fen Lian, Jia-yu Huang, Dong-hui Lu
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    Jurgita Mikolaitytė, Jolita Badarienė, Roma Puronaitė, Alma Čypienė, Irma Rutkauskienė, Jolanta Dadonienė, Aleksandras Laucevičius
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    Nurshad Ali, Rakib Miah, Mahmudul Hasan, Zitu Barman, Ananya Dutta Mou, Jaasia Momtahena Hafsa, Aporajita Das Trisha, Akibul Hasan, Farjana Islam
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Brief Report
Epidemiological Investigation of an Outbreak of Salmonellosis in Gyeongju, Korea
Seok-Ju Yoo, Hyun-Sul Lim, Kwan Lee
J Prev Med Public Health. 2014;47(3):177-181.   Published online May 30, 2014
DOI: https://doi.org/10.3961/jpmph.2014.47.3.177
  • 12,544 View
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AbstractAbstract PDF
Objectives

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

Methods

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

Results

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

Conclusions

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

Summary

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Original Articles
Levothyroxine Dose and Fracture Risk According to the Osteoporosis Status in Elderly Women
Young-Jin Ko, Ji Young Kim, Joongyub Lee, Hong-Ji Song, Ju-Young Kim, Nam-Kyong Choi, Byung-Joo Park
J Prev Med Public Health. 2014;47(1):36-46.   Published online January 29, 2014
DOI: https://doi.org/10.3961/jpmph.2014.47.1.36
  • 17,883 View
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AbstractAbstract PDF
Objectives

To evaluate the association between fracture risk and levothyroxine use in elderly women with hypothyroidism, according to previous osteoporosis history.

Methods

We conducted a cohort study from the Korean Health Insurance Review and Assessment Service claims database from January 2005 to June 2006. The study population comprised women aged ≥65 years who had been diagnosed with hypothyroidism and prescribed levothyroxine monotherapy. We excluded patients who met any of the following criteria: previous fracture history, hyperthyroidism, thyroid cancer, or pituitary disorder; low levothyroxine adherence; or a follow-up period <90 days. We categorized the daily levothyroxine doses into 4 groups: ≤50 µg/d, 51 to 100 µg/d, 101 to 150 µg/d, and >150 µg/d. The hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated with the Cox proportional hazard model, and subgroup analyses were performed according to the osteoporosis history and osteoporosis-specific drug prescription status.

Results

Among 11 155 cohort participants, 35.6% had previous histories of osteoporosis. The adjusted HR of fracture for the >150 µg/d group, compared with the 51 to 100 µg/d group, was 1.56 (95% CI, 1.03 to 2.37) in osteoporosis subgroup. In the highly probable osteoporosis subgroup, restricted to patients who were concurrently prescribed osteoporosis-specific drugs, the adjusted HR of fracture for the >150 µg/d group, compared with the 51 to 100 µg/d group, was 1.93 (95% CI, 1.14 to 3.26).

Conclusions

While further studies are needed, physicians should be concerned about potential levothyroxine overtreatment in elderly osteoporosis patients.

Summary

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Cardiovascular Health Metrics and All-cause and Cardiovascular Disease Mortality Among Middle-aged Men in Korea: The Seoul Male Cohort Study
Ji Young Kim, Young-Jin Ko, Chul Woo Rhee, Byung-Joo Park, Dong-Hyun Kim, Jong-Myon Bae, Myung-Hee Shin, Moo-Song Lee, Zhong Min Li, Yoon-Ok Ahn
J Prev Med Public Health. 2013;46(6):319-328.   Published online November 28, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.6.319
  • 19,757 View
  • 162 Download
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AbstractAbstract PDF
Objectives

This study estimated the association of cardiovascular health behaviors with the risk of all-cause and cardiovascular disease (CVD) mortality in middle-aged men in Korea.

Methods

In total, 12 538 men aged 40 to 59 years were enrolled in 1993 and followed up through 2011. Cardiovascular health metrics defined the following lifestyle behaviors proposed by the American Heart Association: smoking, physical activity, body mass index, diet habit score, total cholesterol, blood pressure, and fasting blood glucose. The cardiovascular health metrics score was calculated as a single categorical variable, by assigning 1 point to each ideal healthy behavior. A Cox proportional hazards regression model was used to estimate the hazard ratio of cardiovascular health behavior. Population attributable risks (PARs) were calculated from the significant cardiovascular health metrics.

Results

There were 1054 total and 171 CVD deaths over 230 690 person-years of follow-up. The prevalence of meeting all 7 cardiovascular health metrics was 0.67%. Current smoking, elevated blood pressure, and high fasting blood glucose were significantly associated with all-cause and CVD mortality. The adjusted PARs for the 3 significant metrics combined were 35.2% (95% confidence interval [CI], 21.7 to 47.4) and 52.8% (95% CI, 22.0 to 74.0) for all-cause and CVD mortality, respectively. The adjusted hazard ratios of the groups with a 6-7 vs. 0-2 cardiovascular health metrics score were 0.42 (95% CI, 0.31 to 0.59) for all-cause mortality and 0.10 (95% CI, 0.03 to 0.29) for CVD mortality.

Conclusions

Among cardiovascular health behaviors, not smoking, normal blood pressure, and recommended fasting blood glucose levels were associated with reduced risks of all-cause and CVD mortality. Meeting a greater number of cardiovascular health metrics was associated with a lower risk of all-cause and CVD mortality.

Summary

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Cancer Incidence in Korean Vietnam Veterans During 1992-2003: The Korean Veterans Health Study
Sang-Wook Yi
J Prev Med Public Health. 2013;46(6):309-318.   Published online November 28, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.6.309
  • 24,831 View
  • 153 Download
  • 23 Crossref
AbstractAbstract PDF
Objectives

The aim of this study was to investigate the association between Vietnam experience including exposure to military herbicides and cancer incidence in Korean Vietnam War veterans.

Methods

The cancer cases of 185 265 Vietnam veterans from January 1, 1992 to December 31, 2003 were confirmed from the Korea National Cancer Incidence Database. The age-adjusted incidence and standardized incidence ratios (SIRs) were calculated using the male population during 1992 to 2003 as a standard population.

Results

The age-adjusted overall cancer incidence per 100 000 person-years was 455.3 in Vietnam veterans. The overall cancer incidence was slightly yet significantly lower in veterans (SIR, 0.97; 95% confidence interval, 0.95 to 0.99) than in the general population. The overall cancer incidence in enlisted soldiers was not lower (SIR, 1.00), whereas that in officers was significantly lower (SIR, 0.87) than in the general population. The incidences of prostate cancer and T-cell lymphoma in all veterans, and lung cancer and bladder cancer in enlisted soldiers, and colon cancer and kidney cancer in non-commissioned officers, and colon cancer, kidney cancer, and prostate cancer in officers, were higher than in the general population. The SIR for overall cancer among Vietnam veterans rose from 0.92 for 1992-1997 to 0.99 for 1998-2003.

Conclusions

The overall cancer incidence in Vietnam veterans was not higher than in the general male population. Vietnam veterans and military rank subcohorts experienced a higher incidence of several cancers, including prostate cancer, T-cell lymphoma, lung cancer, bladder cancer, kidney cancer, and colon cancer than the general population. The SIR for overall cancer increased over time in Vietnam veterans.

Summary

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Brief Report
Is Caffeine Intake Associated With Urinary Incontinence in Japanese Adults?
Fumi Hirayama, Andy H. Lee
J Prev Med Public Health. 2012;45(3):204-208.   Published online May 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.3.204
  • 13,909 View
  • 79 Download
  • 11 Crossref
AbstractAbstract PDF
Objectives

To investigate whether caffeine intake is associated with urinary incontinence (UI) among Japanese adults.

Methods

A total of 683 men and 298 women aged 40 to 75 years were recruited from the community in middle and southern Japan. A validated food frequency questionnaire was administered face-to-face to obtain information on dietary intake and habitual beverage consumption. Urinary incontinence status was ascertained using the International Consultation on Incontinence Questionnaire-Short Form.

Results

Mean daily caffeine intake was found to be similar between incontinent subjects (men 120 mg, women 94 mg) and others without the condition (men 106 mg, women 103 mg), p=0.33 for men and p=0.44 for women. The slight increases in risk of UI at the highest level of caffeine intake were not significant after adjusting for confounding factors. The adjusted odds ratios (95% confidence interval) were 1.36 (0.65 to 2.88) and 1.12 (0.57 to 2.22) for men and women, respectively.

Conclusions

No association was evident between caffeine intake and UI in middle-aged and older Japanese adults. Further studies are required to confirm the effect of caffeine in the prevention of UI.

Summary

Citations

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Original Article
Impact of Individual and Combined Health Behaviors on All Causes of Premature Mortality Among Middle Aged Men in Korea: The Seoul Male Cohort Study
Chul Woo Rhee, Ji Young Kim, Byung Joo Park, Zhong Min Li, Yoon-Ok Ahn
J Prev Med Public Health. 2012;45(1):14-20.   Published online January 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.1.14
  • 14,400 View
  • 116 Download
  • 21 Crossref
AbstractAbstract PDF
Objectives

The aim of this study was to evaluate and quantify the risk of both individual and combined health behaviors on premature mortality in middle aged men in Korea.

Methods

In total, 14 533 male subjects 40 to 59 years of age were recruited. At enrollment, subjects completed a baseline questionnaire, which included information about socio-demographic factors, past medical history, and life style. During the follow-up period from 1993 to 2008, we identified 990 all-cause premature deaths using national death certificates. A Cox proportional hazard regression model was used to estimate the hazard ratio (HR) of each health risk behavior, which included smoking, drinking, physical inactivity, and lack of sleep hours. Using the Cox model, each health behavior was assigned a risk score proportional to its regression coefficient value. Health risk scores were calculated for each patient and the HR of all-cause premature mortality was calculated according to risk score.

Results

Current smoking and drinking, high body mass index, less sleep hours, and less education were significantly associated with all-cause premature mortality, while regular exercise was associated with a reduced risk. When combined by health risk score, there was a strong trend for increased mortality risk with increased score (p-trend < 0.01). When compared with the 1-9 score group, HRs of the 10-19 and 20-28 score groups were 2.58 (95% confidence intervals [CIs], 2.19 to 3.03) and 7.09 (95% CIs, 5.21 to 9.66), respectively.

Conclusions

Modifiable risk factors, such as smoking, drinking, and regular exercise, have considerable impact on premature mortality and should be assessed in combination.

Summary

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English Abstract
Power Estimation and Follow-Up Period Evaluation in Korea Radiation Effect and Epidemiology Cohort Study.
In Seong Cho, Minkyo Song, Yunhee Choi, Zhong Min Li, Yoon Ok Ahn
J Prev Med Public Health. 2010;43(6):543-548.
DOI: https://doi.org/10.3961/jpmph.2010.43.6.543
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AbstractAbstract PDF
OBJECTIVES
The objective of this study was to calculate sample size and power in an ongoing cohort, Korea radiation effect and epidemiology cohort (KREEC). METHOD: Sample size calculation was performed using PASS 2002 based on Cox regression and Poisson regression models. Person-year was calculated by using data from '1993-1997 Total cancer incidence by sex and age, Seoul' and Korean statistical informative service. RESULTS: With the assumption of relative risk=1.3, exposure:non-exposure=1:2 and power=0.8, sample size calculation was 405 events based on a Cox regression model. When the relative risk was assumed to be 1.5 then number of events was 170. Based on a Poisson regression model, relative risk=1.3, exposure:non-exposure=1:2 and power=0.8 rendered 385 events. Relative risk of 1.5 resulted in a total of 157 events. We calculated person-years (PY) with event numbers and cancer incidence rate in the non-exposure group. Based on a Cox regression model, with relative risk=1.3, exposure:non-exposure=1:2 and power=0.8, 136 245PY was needed to secure the power. In a Poisson regression model, with relative risk=1.3, exposure:non-exposure=1:2 and power=0.8, person-year needed was 129517PY. A total of 1939 cases were identified in KREEC until December 2007. CONCLUSIONS: A retrospective power calculation in an ongoing study might be biased by the data. Prospective power calculation should be carried out based on various assumptions prior to the study.
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Multicenter Study
Cigarette Smoking and Mortality in the Korean Multi-center Cancer Cohort (KMCC) Study.
Eun Ha Lee, Sue K Park, Kwang Pil Ko, In Seong Cho, Soung Hoon Chang, Hai Rim Shin, Daehee Kang, Keun Young Yoo
J Prev Med Public Health. 2010;43(2):151-158.
DOI: https://doi.org/10.3961/jpmph.2010.43.2.151
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AbstractAbstract PDF
OBJECTIVES
The aim of this study was to evaluate the association between cigarette smoking and total mortality, cancer mortality and other disease mortalities in Korean adults. METHODS: A total of 14 161 subjects of the Korean Multi-center Cancer Cohort who were over 40 years of age and who were cancer-free at baseline enrollment reported their lifestyle factors, including the smoking status. The median follow-up time was 6.6 years. During the follow-up period from 1993 to 2005, we identified 1159 cases of mortality, including 260 cancer mortality cases with a total of 91 987 person-years, by the national death certificate. Cox proportional hazard regression model was used to estimate the hazard ratio (HR) of cigarette smoking for total mortality, cancer mortality and disease-specific mortality, as adjusted for age, gender, the geographic area and year of enrollment, the alcohol consumption status, the education level and the body mass index (BMI). RESULTS: Cigarette smoking was significantly associated with an increased risk of total mortality, all-cancer mortality and lung cancer mortality (p-trend, <0.01, <0.01, <0.01, respectively). Compared to non-smoking, current smokers were at a higher risk for mortality [HR (95% CI)=1.3 (1.1-1.5) for total mortality; HR (95% CI)=1.6 (1.1-2.2) for all-cancer mortality; HR (95% CI)=3.9 (1.9-7.7) for lung cancer mortality]. CONCLUSIONS: This study's results suggest that cigarette smoking might be associated with total mortality, all-cancer mortality and especially lung cancer mortality among Korean adults.
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English Abstracts
'Informed Consent' in Public Health Activities: Based on the Universal Declaration on Bioethics and Human Rights, UNESCO.
Kwang Ho Meng
J Prev Med Public Health. 2008;41(5):339-344.
DOI: https://doi.org/10.3961/jpmph.2008.41.5.339
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AbstractAbstract PDF
OBJECTIVES
The objective of this paper is to discuss the importance of obtaining informed consent for conducting epidemiological studies and public health activities, based on the Report of the UNESCO's Working Group on Informed Consent. METHODS: The Report of the UNESCO's Working Group on Informed Consent was reviewed and discussed in connection with the ethical considerations of public health activities and epidemiological research. RESULTS: It was at the Nuremberg Trial for the German war criminals of the Second World War that the principle of 'consent' was first stated as a consequence of the medical abuses carried out during the War. As a result of the Trial, the Nuremberg Code came out in 1947. Since then, various international declarations or ethical principles on 'informed consent' have been developed and published. These ethical principles on 'informed consent' have mostly to do with the clinical research that involves human subjects, and not with epidemiological studies and public health activities. However, UNESCO recently issued a comprehensive Report on Informed Consent based on the Universal Declaration on Bioethics and Human Rights adopted in 2005, and this included detailed guidelines on informed consent in epidemiological studies and public health activities. CONCLUSIONS: Universal Declaration on Bioethics and Human Rights emphasizes the principle of autonomy to protect the human rights of the human subjects involved in any public health activities and epidemiological research. As a practical guideline, obtaining informed consent is strongly recommended.
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    Holly Bianca Goldberg, Allison Shorten
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  • A European study on alcohol and drug use among young drivers: the TEND by Night study design and methodology
    Roberta Siliquini, Simone Chiadò Piat, Francisco Alonso, Axel Druart, Marcin Kedzia, Antonio Mollica, Valeria Siliquini, Daniel Vankov, Anita Villerusa, Lamberto Manzoli
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Health-related Quality of Life Assessment by the EuroQol-5D in Some Rural Adults.
Mi Ah Han, So Yeon Ryu, Jong Park, Myung Geun Kang, Jong Ku Park, Ki Soon Kim
J Prev Med Public Health. 2008;41(3):173-180.
DOI: https://doi.org/10.3961/jpmph.2008.41.3.173
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AbstractAbstract PDF
OBJECTIVES
The purposes of this study were to examine the health-related quality of life(HRQoL) and to identify its related factors for a group of rural adults. METHODS: The study subjects were 1,901 adults who were aged 40-70 years and who were living in Naju City, Jeollanamdo. The sociodemographic characteristics, health-related behavior, health status and global self-rated health were collected for statistical analysis. The healthrelated quality of life was measured by the Euroqol EQ-5D instrument. The differences on the EQ-5D index between the groups were assessed with t-test, ANOVA and hierarchical multiple regression analysis. RESULTS: Overall, the mean value of the EQ-5D index was 0.884+/-0.140 and this score was significantly different according to the socioeconomic characteristics, the healthrelated behavior, the health status and the global self-rated health. According to the results from the hierarchical multiple regression analysis, the HRQoL was significantly reduced for females, older subjects, and other subjects with no spouse and the subjects with osteoporosis, obesity, mental distress or poorer global self-rated health. CONCLUSIONS: The HRQoL for rural adults was related to the socioeconomic characteristics, the health status and the global self-rated health. A better understanding of the factors related to the HRQoL would help to improve the rural adults' quality of life.
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A Prospective Cohort Study of Exercise and the Incidence of Type 2 Diabetes in Impaired Fasting Glucose Group.
Hong Dae Um, Duck Chul Lee, Sang Yi Lee, Yeon Soo Kim
J Prev Med Public Health. 2008;41(1):45-50.
DOI: https://doi.org/10.3961/jpmph.2008.41.1.45
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AbstractAbstract PDF
OBJECTIVES
To determine the relationship between exercise and the incidence of type 2 diabetes in an impaired fasting glucose group. METHODS: This prospective cohort study was conducted in 19,440 men and 4,297 women, aged 30-69 years, with impaired fasting glucose at baseline who had undergone biennial medical evaluation through the National Health Insurance Corporation from 2000 to 2004. Impaired fasting glucose was defined as fasting glucose of 100 to 125 mg/dl and the subjects were divided into 3 groups depending on weekly exercise frequency. Multivariate logistic regression analysis was used to evaluate the association between the baseline exercise status and incidence of type 2 diabetes. RESULTS: During the 4-year follow-up, a total of 3,239 men and 283 women developed type 2 diabetes, a cumulative incidence of 16.6% for men, and 6.5% for women. Also, 1,688 men (21.2%) and 127 women (15.2%) developed type 2 diabetes in the obese group. The adjusted relative risk (RR) of developing type 2 diabetes in non-exercising men was significantly higher than exercising men regularly (RR= 1.375, 95% CI=1.236-1.529)(p<0.0001), and the RR for non-exercising women was higher than exercising women regularly (RR=1.124, 95% CI=0.711-1.778). The RR for non-exercise men/women in the obese group was 1.571 (95% CI=1.351-1.827)(p<0.0001)/1.869(95% CI=0.846-4.130). CONCLSIONS: Regular exercise is effective in preventing type 2 diabetes in people with impaired fasting glucose, and particularly in obese people. People with risk factors for diabetes should participate in a regular exercise program.
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Multicenter Studys
Cigarette Smoking and Gastric Cancer Risk in a Community-based Cohort Study in Korea.
Yeonju Kim, Aesun Shin, Jin Gwack, Jae Kwan Jun, Sue Kyung Park, Daehee Kang, Hai Rim Shin, Soung Hoon Chang, Keun Young Yoo
J Prev Med Public Health. 2007;40(6):467-474.
DOI: https://doi.org/10.3961/jpmph.2007.40.6.467
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AbstractAbstract PDF
OBJECTIVES
Gastric cancer is the most common incident cancer in Korea. Although Helicobacter pylori infection is the most important risk factor for the development of gastric cancer, cigarette smoking has also been suggested to play an important role in the development of gastric cancer. The objective of this study is to evaluate the relationship between cigarette smoking and gastric cancer risk in a Korean population. METHODS: The study population consisted of 13,785 subjects who had been enrolled in the Korean Multi-Center Cancer Cohort between 1993 and 2002. As of December 2002, 139 incident gastric cancer cases were ascertained through the Korea Central Cancer Registry and the National Death Certificate Database. Relative risks (RR) and 95% confidence intervals (CI) for gastric cancer were estimated using CoxZs proportional hazard model adjusted for age, education, alcohol drinking status and history of gastritis or ulcer. RESULTS: Significant dose-response relationships were observed between the duration of smoking and the risk of gastric cancer among the male subjects in comparison to non-smokers: men who smoked for 20-39 years had a 2.09- fold (95% CI 1.00-4.38) increase, and those who smoked for more than 40 years had a 3.13-fold (95% CI 1.59-6.17) increase in the risk of gastric cancer (Ptrend<0.01). CONCLUSIONS: This study suggests that a longer duration of cigarette smoking may increase the risk of gastric cancer development in a dose-response manner in Korean men. The association between smoking and gastric cancer risk in women should be verified in future studies with a larger number of cases.
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Cigarette Smoking, Alcohol Consumption, Tuberculosis and Risk of Lung Cancer: The Korean Multi-center Cancer Cohort Study.
Jisuk Bae, Jin Gwack, Sue Kyung Park, Hai Rim Shin, Soung Hoon Chang, Keun Young Yoo
J Prev Med Public Health. 2007;40(4):321-328.
DOI: https://doi.org/10.3961/jpmph.2007.40.4.321
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AbstractAbstract PDF
OBJECTIVES
The aim of this study was to evaluate the roles of cigarette smoking, alcohol consumption, tuberculosis, and their interactions in the risk of lung cancer in a Korean cohort. METHODS: The study subjects comprised 13,150 males and females aged above 20 years old. During the follow up period from 1993 to 2002, 79 lung cancer cases were identified by the central cancer registry and the national death certificate database. Information on cigarette smoking, alcohol consumption and the history of physiciandiagnosed tuberculosis was obtained by interview. Indirect chest X-ray findings were also evaluated to ascertain tuberculosis cases. Cox proportional hazard models were used to estimate relative risks (RR) and 95% confidence intervals (CI) after adjusting for age and gender. RESULTS: Cigarette smoking was statistically significantly associated with an increased risk of lung cancer [for current smokers, RR = 2.33 (95% CI = 1.23 - 4.42) compared to non-smokers]. After further adjustment for cigarette smoking, both alcohol consumption and tuberculosis showed no statistically significant association with the risk of lung cancer [for current drinkers, RR = 0.80 (95% CI = 0.48 - 1.33) compared to non-drinkers] [for tuberculosis cases, RR = 1.17 (95% CI = 0.58 - 2.36) compared to noncases]. There was no statistically significant interaction between cigarette smoking and alcohol consumption (pinteraction = 0.38), or cigarette smoking and tuberculosis (p-interaction = 0.74). CONCLUSIONS: Although cigarette smoking was confirmed as a risk factor of lung cancer in this cohort study, this study suggests that alcohol consumption and tuberculosis may not be associated with the risk of lung cancer.
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English Abstracts
Seroprevalence of Brucellosis among Risk Population in Gyeongsangbuk-do, 2006.
Kwan Lee, Hyun Sul Lim, Woo Won Park, Sung Hwan Kim, Do Young Lee, Mi Yeoun Park, Youngju Hur
J Prev Med Public Health. 2007;40(4):285-290.
DOI: https://doi.org/10.3961/jpmph.2007.40.4.285
  • 6,196 View
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AbstractAbstract PDF
OBJECTIVES
Cases of human brucellosis in Korea have recently increased due to the increasing incidence of bovine brucellosis. The authors conducted this study to elucidate the status of brucellosis through seroepidemiologic study. METHODS: We selected our study population from a high risk group. We conducted a questionnaire survey and obtained blood samples to determine the seroprevalence of brucellosis antibodies for 10 days in February, 2005. The titers of brucellosis were measured by the combination of standard tube agglutination test (STA) and enzyme-linked immunosorbent assay (ELISA) test. RESULTS: Our study subjects comprised 1,075 cases: 971 livestock workers, 51 veterinarians, and 53 artificial inseminators. In the STA test, 27 cases (2.5%) had titers of greater than or equal to 1:20. Of 1,068 cases (7 cases were excluded due to previous brucellosis), 7 cases of brucellosis were diagnosed with titers of 1:160, giving a seroprevalence of brucellosis of 0.66%. The seroprevalence in the male group was 0.95%, and that of livestock workers, veterinarians, and artificial inseminators was 0.52%, 4.17%, and 0.00%, respectively. The Spearman's correlation coefficient between the positive rate of bovine brucellosis per capita and household and human brucellosis was 0.806 and 0.744, respectively. The concordance rate between the Korea National Institute of Health and the Gyeongsangbuk-do Institute of Health and Environment by the STA and ELISA tests was 94.7% and 100.0%, respectively. CONCLUSIONS: The study results indicated in higher seroprevalence rate among veterinarians than among livestock workers and artificial inseminators. Because veterinarians may be exposed to this high risk, effective working guidelines for veterinarians to guard against brucellosis must be developed. Moreover, more extensive epidemiologic research for laboratory workers and meat handlers is needed.
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    Jeoung-Ha Sim, Mi-A Son
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Strategy Considerations in Genome Cohort Construction in Korea.
Joohon Sung, Sung Il Cho
J Prev Med Public Health. 2007;40(2):95-101.
DOI: https://doi.org/10.3961/jpmph.2007.40.2.95
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AbstractAbstract PDF
Focusing on complex diseases of public health significance, strategic issues regarding the on-going Korean Genome Cohort were reviewed: target size and diseases, measurements, study design issues, and followup strategy of the cohort. Considering the epidemiologic characteristics of Korean population as well as strengths and drawbacks of current research environment, we tried to tailor the experience of other existing cohorts into proposals for this Korean study. Currently 100,000 individuals have been participating the new Genome Cohort in Korea. Target size of de novo collection is recommended to be set as between 300,000 to 500,000. This target size would allow acceptable power to detect genetic and environmental factors of moderate effect size and possible interactions between them. Family units and/or special subgroups are recommended to parallel main body of adult individuals to increase the overall efficiency of the study. Given that response rate to the conventional re-contact method may not be satisfactory, successful follow-up is the main key to the achievement of the Korean Genome Cohort. Access to the central database such as National Health Insurance data can provide enormous potential for near-complete case detection. Efforts to build consensus amongst scientists from broad fields and stakeholders are crucial to unleash the centralized database as well as to refine the commitment of this national project.
Summary
Change of Cognitive Function and Associated Factors among the Rural Elderly: A 5-Year Follow-up Study.
Sang Kyu Kim, Pock Soo Kang, Tae Yoon Hwang, Joon Sakong, Kyeong Soo Lee
J Prev Med Public Health. 2007;40(2):162-168.
DOI: https://doi.org/10.3961/jpmph.2007.40.2.162
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AbstractAbstract PDF
OBJECTIVES
This prospective population-based cohort study was conducted to evaluate the risk factors of cognitive impairment and the degree of cognitive function change through a 5-year follow-up. METHODS: The baseline and follow-up surveys were conducted in 1998 and 2003, respectively. Among 176 subjects who had normal cognitive function in the baseline study, 136 were followed up for 5 years. The cognitive function was investigated using the Korean version of the Mini-Mental State Examination (MMSE-K). The collected data were analyzed using SPSS and Stata. RESULTS: Of the 136 subjects analyzed, 25 (18.4%) were cognitively impaired. Old age and low social support in the baseline survey were risk factors for cognitive impairment after 5 years. In the generalized estimating equation for 128 subjects except severe cognitive impairment about the contributing factors of cognitive function change, the interval of 5 years decreased MMSE-K score by 1.02 and the cognitive function was adversely affected with increasing age, decreasing education and decreasing social support. CONCLUSIONS: Although the study population was small, it was considered that the study results can be used to develop a community-based prevention system for cognitive impairment.
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    Nam-Kyou Bae, Young-Soo Song, Eun-Sook Shin, Young-Chae Cho
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Statistical Issues in Genomic Cohort Studies.
Sohee Park
J Prev Med Public Health. 2007;40(2):108-113.
DOI: https://doi.org/10.3961/jpmph.2007.40.2.108
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AbstractAbstract PDF
When conducting large-scale cohort studies, numerous statistical issues arise from the range of study design, data collection, data analysis and interpretation. In genomic cohort studies, these statistical problems become more complicated, which need to be carefully dealt with. Rapid technical advances in genomic studies produce enormous amount of data to be analyzed and traditional statistical methods are no longer sufficient to handle these data. In this paper, we reviewed several important statistical issues that occur frequently in large-scale genomic cohort studies, including measurement error and its relevant correction methods, cost-efficient design strategy for main cohort and validation studies, inflated Type I error, gene-gene and gene-environment interaction and time-varying hazard ratios. It is very important to employ appropriate statistical methods in order to make the best use of valuable cohort data and produce valid and reliable study results.
Summary
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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AbstractAbstract PDF
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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Original Article
Factors Associated with Hypertension Control and Antihypertensive Medication among Hypertensive Patients in a Community.
Dong Han Lee, Youn Hee Choi, Kang Hee Lee, Dae Ryong Kang, Sun Ha Jee, Chung Mo Nam, Il Suh
Korean J Prev Med. 2003;36(3):289-297.
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AbstractAbstract PDF
OBJECTIVES
The main objectives of this study are to identify the factors associated with hypertension control and to determine the influencing factors associated with antihypertensive therapy. METHODS: The study was conducted on 107 subjects who participated in the 1999 and 2002 Gwacheon Study and who had had uncontrolled hypertension (systolic > or=140 or diastolic > or= 90mmHg) in 1999. We compared the characteristics of the controlled and uncontrolled hypertensive group and investigated the characteristics of those taking antihypertensive medication. Univariate associations between hypertension control and its characteristics and the association between antihypertension treatment and its characteristics were tested with x2-test. We also performed logistic regression analysis. RESULTS: The participants who had their blood pressure checked within 6 months before their first measurement and those who had taken the antihypertensive medication showed significantly better hypertension control during the follow-up. The multivariate analysis showed that baseline antihypertensive therapy was the most important determinant factor of hypertension control during the follow-up. Socioeconomic level and life style did not affect hypertension control when controlled by the treatment variable in this study. The factors associated with antihypertensive therapy at follow-up were previous antihypertensive therapy, old age, and high educational level. CONCLUSIONS: Those who received antihypertensive therapy and those who had their blood pressure re-checked within 6 months both showed well controlled hypertension. The subjects with high educational level complied well with the antihypertensive regimen, but those in their forties did not.
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JPMPH : Journal of Preventive Medicine and Public Health
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