The Burden of Acute Pesticide Poisoning and Pesticide Regulation in Korea

BACKGROUND: This study aimed to estimate the burden of acute pesticide poisoning and to determine its trend with recently implemented pesticide regulations. METHODS: Disability-adjusted life-years (DALYs) were calculated as the sum of years of life lost (YLLs) and years lived with disability (YLDs) due to acute pesticide poisoning using the methods of the Global Burden of Disease Study 2013. The values of YLLs, YLDs, and DALYs were stratified by sex, age groups, intentionality of poisoning, and causative agents. RESULTS: From 2006 to 2014, DALYs decreased by 69% (from 69,550 to 21,742). The decreasing tendency of DALYs was especially marked from 2011. The total burden of acute pesticide poisoning was mainly caused by YLLs and intentional pesticide poisoning. The highest DALYs due to acute pesticide poisoning occurred in those in their 40s and 50s; however, the decreased rates of DALYs were higher in those aged 10–49 years than in those aged more than 50 years. Herbicides including paraquat contributed to the largest proportion of total DALYs. CONCLUSION: As this is the first study to quantify the burden of acute pesticide poisoning using DALYs, our results provide comprehensive evidence of the importance of using strict regulations to prevent public health hazards due to acute pesticide poisoning.

Reconstruction of Radiation Dose Received by Diagnostic Radiologic Technologists in Korea / 예방의학회지

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

Reviewing and Constructing Clinical Trials Database for Psychotropic Drugs in Korea / 대한정신약물학회지

OBJECTIVE: Evidence-based medicine (EBM) became an important framework to help clinicians judge and decide on what is better or desirable practice under National Insurance Scheme. Clinical trials contribute to building the data for EBM. We tried to investigate the characteristics of clinical trials which had been published in Korean psychiatry journals and constructed them as database form. METHODS: We reviewed all original articles about clinical drug trials regarding human in twenty Korean psychiatric journals published from 1995 to 2010. Inclusion criteria were randomized clinical trials (RCT), controlled clinical trials (CCT), non-controlled clinical trials (NCCT), non-trial naturalistic trials (NTN) including pharmacological intervention. Case reports and case series were excluded. Initial review and classification has been done by EBM researcher and expert review was followed by insurance committee members of Korean College of Neuropsychopharmacology. RESULTS: Total number of clinical trials was 328 and all the articles were classified according to patients subtype and intervention. Among them, NCCT was 151 (46%), NTN was 78 (23.7%), RCT was 59 (17.9%), and CCT was 36 (10.9%). In this study, the articles in The Korean Journal of Psychopharmacology were 130 (39.63%) and the proportion of RCT was the most in Journal of the Korean Neuropsychiatric Association (19.84%). The schizophrenia came with 158 (47.02%), followed by major depressive disorder and other depressive disorder, bipolar disorder, dementia, panic disorder, schizoaffective disorder, and generalized anxiety disorder. The proportion of Institutional Review Board approved study and study with research grant has increased. CONCLUSION: In this study, we investigated the characteristics of clinical trials for psychotropic drugs and finished to construct clinical trial database for psychotropic drugs in Korea. We hope this database should be used for researchers who want to collect clinical evidence data and make clinical guidelines for Korean psychiatric patients. In future, supplementation and management of clinical trial database for psychotropic drugs and quality control of articles are needed.