Factors related with quality on sleep of daytime workers

BACKGROUND: This study was conducted to identify the sleep status of daytime workers who do not work in shifts. This study analyzed factors affecting sleep duration and sleep quality. METHODS: This study was conducted on 1171 daytime workers at a manufacturing workshop. We used a self-administered questionnaire to investigate demographic variables, work type, working period, musculoskeletal symptoms and the Pittsburgh Sleep Quality Index to assess sleep. Regular health checkup was conducted for the worker’s clinical examination. RESULTS: The mean sleep duration was 6.36 h and the mean score on the Pittsburgh Sleep Quality Index was 4.46. Work type and obesity were related to sleep duration. Age, obesity and musculoskeletal pain were significantly related to sleep quality. The prevalence ratio of researcher group for short sleep duration was 1.27 (95% confidence interval: 1.02–1.58). The prevalence ratio of those aged 50 years and over was 0.47 (0.25–0.91) and of those in their 40s was 0.56 (0.35–0.91) for poor sleep quality compared to those in their 20s. The prevalence ratio of the obesity group for poor sleep quality was 1.53 (1.10–2.12). The prevalence ratio of musculoskeletal pain group for poor sleep quality was 1.92 (1.29–2.84). CONCLUSIONS: Age, obesity and musculoskeletal pain were factors affecting the poor quality on sleep of daytime workers. In addition, work type related to short sleep duration.

A Clinical Analysis of Patients Who Visited Emergency Department due to Chemical Incident Occurred at Industrial Place: A Retrospective Study

PURPOSE: The purpose of this study is to understand what kinds of chemical substances have been used annually and to investigate incidents that occurred due to chemical hazard release and to analyze statistically clinically chemical injury patients who visited one regional emergency medical center in Gumi city with documented references review. METHODS: Annual chemical waste emission quantity (Kg/Year) (Cwep) was reproduced using national web site data governed by the Ministry of Environment and 5 years (from 1 .Jan. 2010 to 31. Dec. 2014) of medical records of chemical injury patients who visited our emergency department were reviewed retrospectively. By applying exclusion criteria, 446 patients of 460 patients were selected. RESULTS: Dichloromethane, Toluene, Trichloroethylene, and Xylene were always included within Top 5 of Cweq. Six cases of chemical incidents were reported and in 3 of 6 cases involving Hydrogen fluoride were included during the study period. Male gender and twenties were the most prevalent group. Injury evoking chemicals were Hydrogen fluoride, unknown, complex chemicals (over 2 substances) in sequence. The most frequent site of wounds and injuries was the respiratory tract. Gas among status, intoxication among diagnosis, and discharge among disposition was most numerous in each group. CONCLUSION: There have been no uniform clinical protocols for chemical wounds and injuries due to various kinds of chemicophysical properties and ignorance of antidotes. Therefore conduct of a multicenter cohort study and experiments for ruling out chemicals according to chemicophysical priority as well as development of antidotes and clinical protocols for chemical injury patients is needed.

The Effect of Participatory Approach Program for Cardiovascular Disease Prevention in the Workplace / 대한산업의학회지

OBJECTIVES: The purpose of this study was to develop a program applying participatory action-oriented training (PAOT) methods for the management of cardiovascular disease risk factors and to assess its effectiveness in the workplace. METHODS: The cardiovascular disease risk factors of 817 workers in the workplace were assessed, and periodic health examination was conducted. Sixty-four workers (7.8%) were selected as a moderate-risk group and high risk group, and performed the participatory approach program for cardiovascular disease preventive management. RESULTS: The sixty-four workers who participated in the participatory approach program made a total of 246 action plans, 3.8 action plans per person and 115 action plans were achieved after three months, so that 46.7% of action plans have been achieved. In the intervention group that participated in the program, the rate of smoking decreased from 36.2% to 8.6% and systolic and diastolic blood pressure significantly decreased from 140.0+/-9.4 mmHg to 134.2+/-12.3 mmHg and from 92.6+/-7.1 mmHg to 80.0+/-9.8 mmHg respectfully. In addition, risk factor score also decreased by 0.3, whereas the control group who did not participate in the program also showed a significant reduction in the mean systolic and diastolic blood pressure. Regular exercise increased from 8.5% to 16.0%. CONCLUSIONS: To improve the effectiveness of the participatory approach program for the management of cardiovascular disease risk factors, the need to continues implementing programs and analysis of the long-term effects are required.

Ocular, Respiratory and Skin Symptoms Among Solderers Employed in Printed Circuit Board Assembly Units / 대한산업의학회지

OBJECTIVES: This study was conducted to evaluate the prevalence of ocular, respiratory and skin symptoms among solderers and to investigate the relationship between symptom prevalence and exposure intensity. METHODS: We analyzed 126 eligible participants out of a population of 146 male solderers who completed the symptom questionnaires. Fourteen symptoms including 'itchy and red eyes', 'itchy or prickly nose', 'sneezing', 'rhinorrhea', 'blocked nose', 'pricklythroat', 'foreign body sensation in throat', 'sudden bouts of coughing', 'exertional breathlessness ', 'wheezing', 'sputum production', 'itchy face or hands', 'acneiform eruptions on the face'and 'red spots on the face or hands'were contained. Blood lead levels of all the 126 participants were tested and the participants'own assessments of the health risk of soldering were collected. RESULTS: Of the 14 investigated symptoms, 'sudden bouts of coughing'was significantly more prevalent in solderers who worked 4 hours or more a day than those who worked less than 4 hours a day, as for the other symptoms, there were no significant differences in the preva1ences related to daily soldering hours. 2.8% of the solderers considered the risk of flux exposure to be serious. The mean blood lead level was 6.05 microgram/dL (maximum 15.50 microgram /dL). CONCLUSIONS: Soldering may increase the risk of respiratory symptoms. Further investigations on the hazards of soldering processes are warranted and solderers should be educated on these hazards.

Toxic Hepatitis Induced by Occupational Dimethylacetamide Exposure / 대한산업의학회지

Dimethylacetamide is widely used in the production of plastics, resins, synthetic fibers, and gums and in purification and crystallization processes. Inhalation of the vapor or skin absorption of the liquid of dimethylacetamide(DMAC) can cause liver damage. Toxic hepatitis possibly attributable to DMAC exposure occurred in seven works among 178 employees who had worked on a new spandex-fiber production line. A large amount of DMAC is used as a spinning solvent for synthetic fibers in the factory. The patients were aged 23-47 years old and composed of five males and two females. They were involved in the process of polymerization(1 patient), spinning(1), take-up(4) and packaging(1). The mean duration of exposure was 10 weeks. They experienced fatigue, dizziness and jaundice. The patients showed elavated total bilirubin, alanine aminotransferase(ALT), and aspartate aminotransferase(AST) levels. The serologic test for viral hepatitis A, B and C were negative, as were the abdominal ultrasonographic scans. Based on the presumptive diagnosis of DMAC-induced toxic hepatitis, they were removed from the workplaces. One or two months after removal from the work, the transaminase levels returned to normal. The patients had no history of significant alcohol use, blood transfusion, recent medication, and drug abuse. As a result, authors could not find any attributable cause of toxic hepatitis but the toxicity by DMAC exposure.

Related factors of high frequency hearing loss in the noise-exposed male workers / 대한산업의학회지

OBJECTIVES: The purpose of the study was to assess the risk factors assumed to be related to the high frequency hearing loss in the noise-exposed male workers. METHODS: 712 occupationally noise-exposed male workers were included in this cross sectional study. The subjects filled out a questionnaire on the history of noise exposure, hearing protection, otologic diseases, tobacco smoking, and were tested on height, weight, hematocrit, serum total cholesterol level, fasting plasma glucose level and arterial blood pressure level. Pure tone audiometry and otoscopy were conducted and the subjects were allocated into two groups according to whether they had 4000 Hi hearing loss or not. RESULTS: The multiple logistic regression analysis showed that military noise exposure, poor wearing status of the hearing protection devices, increased age, long noise exposure duration, mean arterial pressure less than 80mmHg, high fasting plasma sugar are the factors significantly related to high frequency hearing loss (P<0.05). On the contrary, there was no significant relationship between noise intensity, body mass index, serum total cholesterol level, smoking and high frequency hearing loss. Low hematocrit was shown to be a significant factor with a p-value less than 0.1. CONCLUSIONS: High frequency hearing loss in the noise-exposed male workers is related to military noise exposure, use of hearing protection devices, age, noise exposure length, fasting glucose level and mean arterial pressure, in this order. Appropriate use of the hearing protection devices has a great impact on the prevention of the noise-induced hearing loss.

Two Cases of Convulsion Associated With Caprolactam / 대한산업의학회지

Two young men were seen with nausea, vomiting, dermatitis, seizure after two-four days of occupational exposure to caprolactam, a nylon fiber precursor. There were no significant results in laboratory test, brain CT, EEG except leukocytosis, hyperglycemia. Caprolactam has been shown to induce convulsive disorder in experimental animal studios and Tuma et al (1981) described that one worker acutely exposed to caprolactam developed generalized tonic-clonic seizure with leukocytosis. The coincidence of typical skin lesion with otherwise unexplained generalized tonic-clonic seizure in those young man strongly suggests that caprolactam was causal agent.

Effect of cigareet smoking on air-conduction hearing threshold level in adult men / 예방의학회지

To investigate the effect of smoking on the hearing threshold, l,887 adult male workers who visited health care center during the period l January 1996 - 31 July 1997 were selected. Air-conduction hearing threshold level, diastolic blood pressure(DBP), total cholesterol, fasting blood sugar(FBS), hematocrit and obesity, were measured. The data on age, occupation, and smoking were collected. Air-conduction hearing threshold in smoker was significantly higher than non-smoker in categories of 250, 500, 1000 and 4000 Hz(p<0.05). Mean values of PTA-low, PTA-mid, and PTA-high in smoker were also significantly higher than non-smoker(p<0.05). In multiple regression analysis, smoking is likely to play a significant role after controlling age, occupation, DBP, FBS, total cholesterol, hematocrit, and obesity,(p<0.05). The hearing threshold was significantly increased with increasing age(p<0.05), the manufacturing worker may have higher hearing threshold(p<0.05). The higher hematocrit and the more obese, the higher hearing threshold(p<0.05). However, DBP, total cholesterol and FBS were not significantly related with hearing threshold level. In conclusion, smoking was significantly related with the hearing threshold level in adult men.

Neurobehavioral Effects of Low Level Lead-exposed Workers at CRT(Cathode Ray Tube) Manufacturing Factory / 대한산업의학회지

To assess neurobehavioral effects of 48 low level lead-exposed workers in CRT manufacturing factory, simple and choice reaction time test with NTOS (Neurobehavioral Tests for Occupational Screening), digit symbol and digit span with K-WAIS (Korean Wechsler Adult Intelligence Scale), and SCL-90-R (Symptom Check List 90 revised) was examined. These screening test battery reflect 3 psychological domain; psychomotor, short term memory, and symptom. Average blood lead level was 17.7 microgram/dl and mean exposure duration was 5.6 years. Nobody exceeded blood lead level over 40 microgram/dl, the guideline. We divided workers to two group, shorts-term exposed group(< or = 5 years) and long-term exposed groups 5 years) for analysis. ANCOVA model of simple reaction time, hostility, phobic anxiety, somatization were statistically significant and coefficient of independent variable of exposure duration was also significant. MANCOVA model of SCL-90-R was significant, too. The results of this study were consistent with previous study; symptoms were early neurobehavioral effects of low level lead exposure. And this study showed that current blood lead level as independent variable was able to mask the early neurobehavioral effects.

Association between air conduction hearing threshold and blood viscosity in normal adult males / 예방의학회지

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

Knowledge, Attitude and Practice according to Types of Occupational Health Management / 예방의학회지

The first purpose of this study was to compare the mean Knowledge, Attitude & Practice(KAP) scores concerning major occupational Health between two types of occupational health management in small & medium-scale textile factories. Sample number was 1,138 workers. In small & medium factories with 300 workers or less, they have two alternatives for occupational health management; Individual Health Management or Vicarious Health Management. The second purpose was to determine if there was a relationship between duration of Vicarious health management and mean kap scores for 694 workers from the Vicarious Health Management group. We used self-administered questionnaires for measuring KAP. The results of this study were; 1. There was significant difference concerning all socioeconomic & occupational variables(gender, age education level, marital status, Blue/White collar, working duration of present factory, working duration of total factories) except for shift. 2. There was no significant difference of mean scores of Knowledge and attitude between the Individual Health Management Group and the Vicarious Health Management. But, the mean score of Practice was significantly different. 3. According to multiple regression analysis, the mean score of Knowledge significantly increased with age, education level, working duration of all factories increased. The mean score of Attitude significantly increased with age, education level and married. The mean score of Practice significantly increased with age, education level, working duration of all factories, married and men. 4. In conclusion, The type of Health management did not significantly affect the mean KAP scores concerning major occupational Health problems. 5. But, the Duration of Vicarious Health management significantly increased the mean KAP scores.

An analysis of liver function test of preemployment screening for office workers / 예방의학회지

This is to analyze and compare the distribution of the liver function test and its abnormal rates of the preemployment screening for office workers in asymptomatic young age groups between female and male. Liver function test(SGPT and SGOT) of 8,184 young adults(2,633 in female and 5,551 in male) were examined during the period from Jan.1,1994 to Dec. 31, 1994. The results were as follows; 1. Mean level of SGPT was 9.l+/-7.6(IU/L) in female, 21.0+/-27.9(IU/L) in male, and that of SGOT was 15.1+/-6.0(IU/L) in female, 20.5+/-26.5(IU/L) in male. There were significant differences(p<0.01) between female and male in both SPT and SGOT. And also there was significant increasing trend(p<0.05) by age groups in male for SGPT, decreasing trend(p<0.01) in female for SGOT. 2. In the abnormal rates of liver function test by the level of cut-off value, there were significant differences up to twice between the lowest and the highest cut-off value in both female(0.4% vs 0.7%) and male(6.5% vs 12.4%) 3. Abnormal rate of SGPT was 0.4% in female and 6.3% in male, and that of SGOT was 0.2% in female and 1.2% in male with significant differences between female and male in both tests.

Pilot Study for the Assessment of Work Ability of Manufacturing Workers and Managerial Workers / 예방의학회지

This study was carried out to assess work ability of manufacturing workers and managerial workers. Subjects were 446 manufacturing workers and 278 managerial workers employed in Gumi industrial complex and the observation period was for 1 month(February to March), 1995. In this study, as a questionnaire for the assessment of work ability, we used the work Ability Index(WAI) which was developed by Institute of Occupational Health in Finland. Major findings obtained from this study were as follows; WAI was poor in lower economic condition, shift work, irregular diet group(p < 0.05). There were no evident trends of WAI in sex, educational level, obesity index, exercise, smoking, and alcohol drinking. In the groups of sensitive to perception of stress, other industrial classification except textile and electronics, the more than 9 hours work, the evident trends of poor WAl were observed(p<0.01). In the groups of 30-39 years old, 40-49 years old, unmarried, high school, shift work, standard body weight, and regular diet, WAl between manufacturing workers and managerial workers was significantly different(p<0.01) and WAI of managerial worker was worse than that of manufacturing worker.

Pilot Study for the Assessment of Physical Fitness among Male Workers in a TV Component Manufacturing Factory / 예방의학회지

In a TV component manufacturing factory, 102 male workers aged 20~39 years old were participated in testing for physical fitness. At the same time, worker's periodic health examination was done. Test battery for physical fitness include grip strength, trunk flexing, standing long jump, side step, single leg balance with eye close, push ups and Harvard step test. As a result of testing for physical fitness, synthetically, there is no difference between manufacturing workers and officers. By bioelectrical impedance test, it means a declining tendency to all 7 factors in the obese workers, and so, it is important for obese workers not only to promote physical fitness but also to promote health. Excluding grip strength and single leg balance with eye close, 5 fitness factors are negatively associated with degree of diastolic Blood pressure, but it is statistically not significant. And levels of SGOT & SGPT have no association with physical fitness factors.

Comparison of Subjective Symptoms of Workers in Rapidly and Weekly Rotating Shift Systems / 예방의학회지

Some circadian rhythms can become disorganized due to rotating shift work. This lack of organization, termed desynchronization, can produce a group of symptoms such as insomnia, GI disturbance and fatigue among many rotating shift workers. The magnitude of these symptoms are influenced by personal and environmental factors and the patterns of shift work. This study was carried out to investigate the subjective symptoms related to rotational schedules of shift work after personal and environmental factors adjusted. 182 male workers in rapidly rotating shift system and 86 male workers in weekly rotating shift system were conducted the questionnaire on personal factors and subjective sleep, GI and fatigue symptoms. Major findings obtained from this study are as follows: 1. The symptoms of 'feeling tired at work' and 'being irritable' were more frequent in weekly rotating shift workers(P<0.05), and the mean of symptom score was significantly higher in weekly rotating shift workers(P<0.01). 2. According to 6 hours of sleeping which is a definite elevation point of fatigue, there was not a significant difference between two groups in sleeping hours. Among workers in rapidly rotating shift system, the mean of symptom score was significantly higher in workers of less than 6 hours of sleeping(P<0.05), but it was not different among weekly rotating shift workers. 3. The symptoms of GI disturbance were more frequent in weekly rotating shift workers but statistically mot significant. 4. The positive rate of mental and physical fatigue symptoms were significantly higher in weekly rotating shift workers(P<0.01) and mental and physical fatigue symptoms were more frequent in them(P<0.01). 5. After the effect of the factors that were significantly different between two groups by X2-test were controlled, the mean score of sleep disturbance was significantly higher in weekly rotating shift workers(P<0.01) and mental physical fatigue symptoms were more frequent in them(P<0.01). Based on these study results, subjective symptoms were more common in the weekly rotating shift workers. In future, medical examination and laboratory test will be also administered to evaluate a more accurate health outcomes and the review of current shift schedules will be required.

The Effect of VDT Work on Vision and Eye Symptoms among Workers in a TV Manufacturing Plant / 예방의학회지

This study was conducted to evaluate the effect of VDT work on eyes and vision among workers in a TV manufacturing plant. The study subjects consisted of 264 screen workers and 74 non-screen workers who were less than 40 years old male and had no history of opthalmic diseases such as corneal opacities, trauma, keratitis, etc and whose visual acuity on pre-employment health examination by Han's test chart was 1.0 or above. The screen workers were divided into two groups by actual time for screen work in a day; Group 1, 60 workers, lesser than 4 hours a day and group 11, 204 workers, more than 4 hours a day. From July to October 1992 a questionnaire was administered to all the study subjects for the general charateristics and subjective eye symptoms after which the opthalmologic tests such as visual acuity, spherical equivalent, lacrimal function, ocular pressure, slit lamp test, fundoscopy were conducted by one opthalmologist. The proportion of workers whose present visual acuity was decreased more than 0. 15 in comparison with that on the pre-employment health examination by Han's test chart was 20.6% in Group Ii, 15.0% in Group I and 14.9% in non-screen workers. However, the differences in proportion were not statistically significant. The proportion of workers with decreased visual acuity was not associated with the age, working duration, use of magnifying glass and type of shift work (independent variables) in all of the three groups. However, screen workers working under poor illumination had a higher proportion of persons with decreased visual acuity than those working under adequate illumination (P<0.05). The proportion of workers whose near vision was decreased was 27.5% in Group II, 18.3% in Group I, and 28.4% in non-screen workers and these differences in proportion were not statistically significant. Changes of near vision were not associated with 4 independent variables in all of the three groups. Six out of sever-subjective eye symptoms except tearing were more common in Group I than in non-screen workers and more common in Group II than in Group I (P<0.01). Mean of the total scores for seven subjective symptoms of each worker (2 points for always, 1 point for sometimes, 0 point for never) was not significantly different between workers with decreased visual acuity and workers with no vision change. However, mean of the total scores for Group II was higher than those for the Group I and non-screen workers (P < 0. 01). Total eye symptom scores were significantly correlated with the grade of screen work, use of magnifying glass, and type of shift work. There was no independent variable which was correlated with the difference in visual acuity between the pre-employment health examination and the present state, the difference between far and near visions, lacrimal function, ocular pressure, and spherical equivalent. Multiple linear regression analysis for the subjective eye symptom scores revealed a positive linear relationship with actual time for screen work and shift work(P<0.01). In this study it was not observed that the VDT work decreased visual acuity but it induces subjective eye symptoms such as eye fatigue, blurred vision, ocular discomfort, etc. Maintenance of adequate illumination in the, work place and control of excessive VDT work are recommended to prevent such eye symptoms.

Assessment of the Activities of General Physicians in Health Subcenters and a Scheme to Improve the Training Program / 예방의학회지

The activities of general physicians (GPs) in health subcenters and their competency for clinical skills were assessed to develop a scheme to improve the training program. One hundred-twenty GPs in southern four provinces (Kyungpook Kyungnam, Chunpook, Chunnam) were randomly selected and 97 were interviewed between January 9 and February 10, 1984. Of the 97 GPs, 86 provided all the information we requested. Average number of patient visits per health subcenter in a day was 30-40 in the demonstration project area for the class II medical insurance whereas it was 3-4 visits in other area. The interviewees asked to rate their competency in 63 clinical skills. The skills in which over 50% of the interviewees rated themselves competent were only 12 items including IM injection, IV injection, wound dressing, etc. Less than 10% of the interviewees rated themselves competent in such skills as maternal health care, emergency medical care, preventive and promotive health services. Most part of the training program of the NIH for the GPs were not applicable to their field work as the training contents were unrealistic. Clinical training at a local general hospital was of great help in 38.8% and the rest of training was not much helpful as the training was inadequate due to lack of trainer or indifference of the trainer. For more effective training of the GPs, the training program of the NIH should be modified to be more realistic and utilize competent field workers as the instructors. It may be more effective if the training is carried out at several local centers. Ideal length of the clinical training for the GPs is 4 months. A pocketbook should be developed that includes specific skills to master during the clinical training and require the trainer to confirm the achievement. The Ministry of Health and Social Affairs should provide the training hospitals with a training guideline and evaluate the training activities and make sure that the training hospital has specialist for each of the 4 major clinical departments. The Ministry of Health and Social Affairs shuld provide the GPs with a continuing education to assist the problem solving in the field and motivate them to activitely carry out the health program. A province may be divided into several regions and a supervisory committee may be organized with specialists in each region. The committee may hold a meeting for the GPs periodically and respond to the specific questions of the GPs by mail.

A Comparison Study of childhood Immunizational level between Urban and Rural Areas / 예방의학회지

To assess the childhood immunization level of uran and rural areas, 250 mothers of 6-23 months old children residing in Namsan 1 Dong, Taegu, and 264 mothers of the same age children residing in five areas of Kyungsan Gun where community health practitioners are assigned were interviewed in March, 1984. Immunization rate for BCG was 98.0% in urban area and 95.8% in rural area. Among children who had BCG vaccination 91.4% of them were immunized within 1 month after birth in urban area and 88.1% in rural area. The percentage of children who received three doses of DPT vaccine was 83.2% in urban, and 87.5% in rural area and that for the polio vaccine was 80.8% in urban and 87.9% in rural area. Only a few children have never been immunized with either BCG or DPT or polio vaccine. Overall immunization rate for measles was 64.4% in urban area while it was 55.3% in rural area and that for mumps and rubella was 50.4% in urban area as compared with 36.0% in rural area. However, among children of 15 months old and above the percentage of measles vaccination was 85.3% in urban area and 73.7% in rural area. Mumps and rubella vaccination rate was 77.6% in urban area and 62.4% in rural area. These differences in measles, mumps and rubella vaccination rates between urban and rural areas were statistically significant (p<0.05). Such findings as improved immunization level, no significant differences in BCG, DPT and polio vaccination rate between urban and rural areas, and fewer mothers in rural area have not vaccinated their children than mothers in urban area because of their ignorance may be attributed to the general improvement of living standard and implementation of the maternal and child health services of the government. Nevertheless many of the mothers in rural as well as urban area have not immunized their children on time and measles, mumps and rubella vaccination rates are substantially lower than other childhood immunizations. Future immunization activity should be geared to reinforcing these areas.

Morbidity Patterns and Health Care Behavior of Residents in Urban Low Income Area / 예방의학회지

This study was conducted to assess the morbidity and medical facilities utilization patterns of the residents in urban low income area. Study population included 2,002 family members of 468 households in the low income area(LA) of Nam-san 4 Dong, JungGu of Taegu city and 1,709 family members of 374 households in surrounding neighbourhood control area(CA). Well trained nursing school students interviewed mainly with housewives according to the pretested questionnaire between July 1 and July 30, 1984. Age-sex distribution of the study population in LA was similar to that in CA. The average monthly income of a household in LA was 236,000 won and 356,000 won in CA. Educational level of the residents in LA was lower than that in CA; average years of school education of the 20 years old or above in LA was 6.9 years compared with 8.5 years in CA. The average family members per room in LA was 2.6 and 2.2 in CA, and proportion of Medicaid program beneficiary was 29.4% in LA and 1.9% in CA. Prevalence rate of illness during 15-day period was 131 per 1,000 population in LA and 71 in CA(p<0.01) and that of the chronic illness for 1 year was 134 per 1,000 population in LA and 89 in CA (p<0.01). The most common illness experienced during 15 days was respiratory disease(24.0% in LA and 29.8% in CA) and followed by gastro-intestinal disorders(21.0% in LA, 20.6% in CA). Injury or poisoning was 10.3% in LA and 3.3% in CA. Gastro-intestinal disorder was the most common chronic illness in both LA (22.7%) and CA (21.7%), and followed by musculoskeletal disease in LA and neuralgia in CA. Mean activity restricted days among the persons with illness during 15-day period was 4.0 days in LA and 2.2 days in CA. Among persons with illness during 15 days, 17.9% in LA and 11.6% in CA did not seek any medical treatment and the most frequently utilized medical facility was pharmacy in LA (35.5%) and local clinic or hospital OPD in CA (42.1%). Among persons with chronic illness, 15.2% in LA and 9.2% in CA did not seek for medical treatment, and residents in LA as well as residents in CA utilized local clinic or hospital OPD more frequently than pharmacy or drugstores, especially those who have medical insurance. The most common reason for not treating illness experienced during 15-day period and chronic illness was economical constraint in both LA and CA. The higher prevalence rate of illness during 15-day period and chronic illness in LA than that in CA seems to be highly correlated with their lower economic status and educational level and crowded living condition. The utilization pattern of medical facilities was associated with the medical security status. A program to improve the economic status and living condition should be integrated with the health program to promote the health of the population in low income area.

Evaluation of Community Health Practitioners' Activities

In order to evaluate community health practitioners, activities through community clients, a household interview survey was done at eight areas in four counties surrounding Daegu city. A total of 1,016 households were interviewed on health service utilization, home visiting activities, work within the health posts, antenatal care and so on. The activities of community health practitioners were mostly curative services either within or out of the health post. Activities of the community health practitioners were related to their past experience as nurses/ midwives/public health nurses and attitudes to health maintenance and promotion. Activities related to preventive services are strong1y recommended.