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Purpose@#To observe and compare the trends in epidemic aspects of imported shigellosis (Sg) cases from overseas travelers (OTs) in Korea and Japan between 2016 and 2020. @*Methods@#We analyzed the raw data of imported Sg cases from the Korea Diseases Control and Prevention Agency and the National Institute of Infectious Diseases in Japan between 2016 and 2020. @*Results@#In Korea, there were a total of 596 Sg infections, including 353 cases from overseas travel-associated imported cases, with a cumulative incidence rate (CIR) of 0.23 per 100,000 populations. The CIR of imported Sg cases was 0.32 per 100,000 OTs. In Japan, during the same period, there were a total of 757 Sg cases, including 388 imported cases, with a CIR of 0.12 per 100,000 populations. The CIR of imported Sg cases was 0.50 per 100,000 OTs. The CIR of total Sg cases in Korea was higher than in Japan, but the CIR of imported cases in Korea was lower than in Japan (P<0.01).Additionally, the imported-to-domestic cases ratio of Sg in Korea (1.45) was higher than in Japan (1.05) (P<0.05). @*Conclusion@#Based on the trends in the epidemiological aspects of domestic and imported Sg infection cases in both countries, a robust information system is needed to provide effective warnings and preventive measures for travelers visiting high-risk areas.
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Purpose@#Melioidosis is a zoonosis that can infect humans or animals. The disease is caused by the bacteria Burkholderia pseudomallei, which is found in contaminated soil and water. We investigated the epidemiological aspects of melioidosis cases among oversea travelers in Korea and Japan during 2011 to 2020. @*Methods@#Raw data were obtained from the website of melioidosis cases from the Korea Diseases Control and Prevention Agency, and the National Institute of infectiousDiseases in Japan, 2011−2020. @*Results@#There were 26 cases of melioidosis cases in Korea and 14 cases in Japan between 2011 and 2020. Cumulative incidence rate per 1,000,000 oversea travelers (OTs) of Korea (0.14) did not substantially differ that of Japan (0.09), respectively.The incidence of melioidosis in males (96.2% of total 26 cases) was much more common than in females (3.8%) in OTs of Korea (P<0.01), while there were significant differences level between males (85.7% of total 14 cases) and females (14.3%) in OTs of Japan (P<0.01). On the other hand, the distribution by adjusted-age groups for melioidosis cases were statistically similar distribution between Korean and Japanese that total cases occurred in the over 40-years old age, clearly showing a more infected of melioidosis (P<0.05). @*Conclusion@#This study demonstrates that there is a similar pattern of imported melioidosis cases in Korea and Japan. Therefore, to prevent melioidosis infections, greater attention should be paid to individuals who are planning to travel to the presumptive regions of melioidosis.
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Since its emergence in Wuhan, China, COVID-19 has spread and had a profound effect on the lives and health of people around the globe. Most people who develop COVID-19 fully recover, but current evidence suggests approximately 10% to 20% of people experience a variety of mid- and long-term effects after they recover from their initial illness. These mid- and long-term effects are collectively known as post covid-19 condition or “long COVID”. Studies have shown that a significant number of patients complain of multiple symptoms over a period of several months or longer. The symptoms of long covid include fatigue or muscle weakness, dyspnea, cognitive impairment, and depression or anxiety. These chronic symptoms can also negatively affect aviation safety. Therefore, this review summarizes studies of the long-term effects of COVID-19, and aeromedical implications of long COVID.
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Purpose@#Zika virus (ZIKV) infection is a mosquito-borne Flavivirus disease. we investigated the epidemiological aspects and status of imported ZIKV infection cases in Korea (Republic of) and Japan during 2016–2020. @*Methods@#Raw data of ZIKV infection cases from the Korea Diseases Control and Prevention Agency, and the National Institute of infectious Diseases in Japan, 2016– 2020. @*Results@#There were 33 cases of ZIKV infection in Korea and 21 cases in Japan between 2016 and 2020. Cumulative incidence rate per 1,000,000 overseas travelers (OTs) of Korea (0.30) did not substantially differ that of Japan (0.27), respectively.We observed the ZIKV infected cases of male (69.7% of total cases) were much more than that for female (30.3%) in OTs of Korea (P<0.05). However, while there was none significant differences level between males (52.4%) and females (47.6%) in OTs of Japan. On the other hands, the distribution by adjusted-age groups for ZIKV infections were similar between Korean and Japanese that total cases occurred in the over 20 to 59-years old age, clearly more showing a higher infected of ZIKV (P<0.01). The presumptive origin imported ZIKV infection cases in Korean were as follows; Southeast Asia (81.8% of total cases) and Central & South Americas (18.2%), and those in Japan, these were Southeast Asia (42.9%) and Central & South Americas (42.9%) and Oceania (4.7%), respectively. @*Conclusion@#This study demonstrates that there is a similar pattern of imported ZIKV disease cases in Korea and Japan. Therefore, to prevent ZIKV infections, greater attention should be paid to individuals who are planning to travel to the presumptive regions of ZIKV.
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Purpose@#The medical certification for pilots is required by the aviation safety authority based with the aviation safety act. @*Methods@#In this study, medical examination items of the year of 2021 performed during the aviation medical examination in Korea were reviewed by retrospective analysis. @*Results@#Data from a total of 27 hospitals were collected. The number of inspection items ranged from a minimum of 22 items to a maximum of 57 items, showing a difference of more than double. Data from tertiary general hospitals and large airlines showed a tendency to perform more items of test compared to clinic-level institutions. The ratios for each inspection item are as follows: 1) 100% inspection items: urine test, ophthalmic test (except fundus test), fasting blood sugar, general blood test (complete blood count), electrocardiogram, electoencephalography, chest posterior anterior, pure tone audiometry, and total cholesterol; 2) 65%–74% inspection items: triglyceride, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, blood urea nitrogen/creatinine, and hepatitis B surface antigen; 3) 57% inspection items: hepatitis B surface antibody, human immunodeficiency virus, and venereal disease research laboratory; 4) 50% inspection items: urate and fundus examination. @*Conclusion@#There have been many changes in the medical field over the past 40 years, but in terms of examination items, the aviation physical examination does not reflect the flow of change. Over the past years, the number of pilots has increased significantly, the flight environment has changed, and medical examination methods have been developed and diversified. In accordance with this, it is necessary to change the test items.
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Purpose@#The purpose of this paper is to study the epidemiologic series of Tsutsugamushi disease (TD), also known as scrub typhus in the Republic of Korea (Korea) and Japan. @*Methods@#We investigated raw data of TD outbreaks from the National Notifiable Disease Surveillance System of the Korea Diseases Control and Prevention Agency in Korea, and the National Institute of Infectious Diseases in Japan, 2016 to 2020. @*Results@#There were 36,785 cases of TD with a cumulative infectious rate (CIR) of 14.3 per 100,000 populations in Korea from 2016 to 2020. During the same period in Japan, there were 2,350 cases with a CIR of 0.4. When compared, Korea was much higher than that in Japan (P<0.01). In Korea, more females (60.2% of total cases) were infected than males (39.8%), while there was a significant difference between males (58.8%) and females (41.2%) in Japan, respectively (P<0.01). @*Conclusion@#These differences in TD risk factors reflect differences of vectors/hosts, climate, and geographical and cultural characteristics between the two countries. The surveillance of TD, primarily a zoonotic disease, should be continued in order to obtain a better understanding of its current status. Moreover, guidelines for the prevention of TD, and its control measures should be more established.
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Purpose@#Hepatitis E outbreaks are a serious public health concern in the world. The pilots or air traffic controllers can be incapacitated by severe hepatitis symptoms. If the symptoms of acute hepatitis do not improve, it is not suitable for aviation duties.In this study, we compare of incidence status of hepatitis E virus (HEV) infections, and epidemic aspects between South Korea (from here on, ‘Korea’) and Japan. @*Methods@#The raw data on confirmed of HEV infection cases were obtained from the National Notified Disease Surveillance System of Korea Diseases Control and Prevention Agency, the Ministry of Health and Welfare in Korea, and the National Epidemiological surveillance of Infectious Diseases surveillance system, administered by the National Institute of Infectious Diseases in Japan. Statistically significant differences between the epidemiological aspects and risk factors were determined using the Pearson’s chi-squared test or paired t-test. All data analyses were performed in Microsoft Excel 2010 (Microsoft, Redmond, WA, USA). @*Results@#There were 191 cases of HEV infected cases with a prevalence rate (PR) of 0.37 per 100,000 populations of Korea in 2020. During the same year in Japan, there were 454 cases with a PR of 0.36. When compared, there is statistically none significantly differences. Moreover, both PR per 100,000 populations of HEV infections in habitat of two countries were compared, in the provinces (0.39) of Korea were much higher than that in capital city of Seoul (0.27; P<0.01), but that in Japan were capital city of Tokyo (0.84) was higher than that of the provinces (0.30; P<0.01). Male to female morbidity ratio was 1.65 and 3.78 in Korea and Japan, respectively. The distribution by the age adjusted groups were similar in Korea and Japan that the total cases occurred in the over 40-years-old age bracket, clearly showing a higher incidence in the elderly. @*Conclusion@#We believed that the HEV are a zoonotic virus, and human occurs mainly through the fecal contamination of water and consumption of contaminated meat from infected animals. In addition, HEV infection can be a problem for pilots and air traffic controllers as well, requiring further investigation and research.
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Pericardial effusion and subsequent cardiac tamponade are recognized as infrequent complications of a ST-elevation myocardial infarction (STEMI) causing hemodynamic instability. The cause of pericarditis is mostly idiopathic which makes up around 90% of cases. Other causes are infections caused by viruses, bacteria or tuberculosis. Other causes could include neoplasms, a connective tissue disorder, renal failure, post-myocardial infarction (also known as Dressler syndrome), open heart surgery (also known as the postpericardiotomy syndrome) and drugs. Acute myocardial infarction is a significant cause of the pilot incapacitation. Pericardial effusion after treatment for acute myocardial infarction is a factor that worsens the prognosis. I present the case of a pilot with a STEMI which was treated with primary percutaneous coronary intervention (PCI) to proximal left circumflex artery. After PCI, the pilot went on to develop pericardial effusion with tamponade.
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When the COVID-19 crisis hit air transport, the whole aviation industry was affected. The change in the behavior of passengers following the COVID-19 crisis, travel restrictions and the ensuing economic crisis have resulted in a dramatic drop in demand for airline services. The COVID-19 pandemic, with all its associated consequences, has had a significant impact on the mental health and well-being of pilots, which could impact operational safety. As the number of international flights has decreased, pilots are exposed to high levels of psychological stress such as job instability, reduced income and increased risk of infection during flight work. Psychological stress lowers work performance and threatens aviation safety. The pilot needs mental health management during the COVID-19 pandemic, but psychological support is weak. For pilot mental health management, it is important to raise awareness about mental health and to continuously respond. To this end, it is necessary to foster a safe and trustworthy culture in which mental health issues are discussed freely and solved together without hiding them. They should also support the establishment of a peer support program that is easily accessible and that allows pilots to discuss their issues with confidence.
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Background@#Obesity is a major public health problem that is causally related to serious medical conditions. In this study, the public health implications of obesitybased on body mass index (BMI) with anthropometric measures among adults in theRepublic of Korea and Japan in 2019 were compared. @*Methods@#A simple cross-section, nationally representative of the raw data from the National Health and Nutrition Examination Survey in 2019 between Korea and Japanwere used. We analyzed the data of those categorized as obese with a BMI of ≥25 kg/m 2 according to the World Health Organization Expert Consultation. @*Results@#The average values of BMI based on body height and body weight amongmales and females in Korea were 24.6±0.08 and 23.3±0.09, respectively; those in Japan were 23.9±0.08 and 22.6±0.08, respectively. The measured anthropometric values were obviously higher in Korean than in Japan (P<0.01). The prevalence rates(PRs) of obesity by sex in Korea were 41.4% among males and 27.3% females; thosein Japan were 32.5% among males and 22.0% among females. The statistically significant results showed that the total obesity rate was higher in males than in females in both countries (P<0.01). The PRs of obesity in Korea were 41.4% in malesand 27.3% in females; those in Japan were 32.5% in males and 22.0% in females. Thestatistically significantly PR of total obesity among Korean adults was greater than that among Japanese adults (P<0.01). @*Conclusion@#The PR of obesity in Korea relative to that in Japan showed a gradually increasing trend. Obesity is a major problem, especially in the pilot group. Reducing the prevalence of obesity among pilots is important for reducing in-flight medical incapacitation and ensuring flight safety. Obesity management is necessary to prevent obesity-related diseases and promote pilot health.
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Atopic dermatitis is a condition that makes skin red and itchy. It is common in children but can occur at any age. Atopic dermatitis is chronic and tends to flare periodically. The pathogenesis of the disease has not yet been clearly elucidated but genetic predisposition, immunological dysfunction, and environmental factors are presumed to be involved in the pathogenesis. In general, it is difficult to cure, but as time passes, most of them heal naturally and the symptoms disappear, but the symptoms continue to recur. So, the basic treatment is to relieve the pruritus and prevent it from reoccurring. Treatment involves avoiding things that make the condition worse, daily bathing with application of moisturizing cream afterwards, applying steroid creams when flares occur, and medications to relieve itching sensation. Steroid pills or creams based on calcineurin inhibitors may occasionally be used if other measures are not effective. When examining a pilot with atopic dermatitis, the dermatitis condition, the treatment being used, and the side effects of the medications should be considered. This case involves an otherwise healthy applicant for the 1st class medical certification who has had atopic dermatitis.
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The coronavirus disease-19 (COVID-19) vaccine is expected to play an important role in stopping the pandemic. Studies show that COVID-19 vaccines are effective at keeping you from getting COVID-19. Getting a COVID-19 vaccine will also help keep you from getting seriously ill even if you do get COVID-19. Efforts to find an effective vaccine against severe acute respiratory syndrome coronavirus 2 have progressed unprecedentedly through active support from public research grants and private-public partnership programs. Clinical studies have been actively conducted, and some vaccines are being vaccinated with approval for urgent use.The WHO has approved and supplied the Pfizer-BioNTech COVID-19 vaccine and the Oxford-AstraZeneca COVID-19 vaccine. In Korea, the Oxford-AstraZeneca vaccine was approved for urgent use, and vaccination began on February 26, 2021. In this paper, the efficacy and side effects of each vaccines and the effect on pilots and air traffic controllers related to COVID-19 vaccination were investigated in terms of aviation medicine.
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This study aimed to quantify the causes of Korean airline pilots' medical disqualification during 2015~2019. The airline pilot disqualification data is important for grasping what health problems are common to pilots and establishing preventive health care programs. We were able to obtain data from official sources at the Korean Civil Aviation Authority during 2015~2019. The total number of pilots was 29,095, and the number of disqualified professional pilots in Korea was 36. Looking at airline pilots'status by age group, the 40s were the highest with 38%. However, the disqualification rate per 1,000 pilots was the highest in the 60s, at 4.6. When the different diagnostic categories classified the disqualification results, cardiovascular disease was the highest with 12 cases (33.3%), followed by eye disease, malignancy, neurology,psychiatry, otorhinolaryngology, and respiratory disease. The total number of pilots during 2015~2019 was 29,095, and the overall disqualification rate of 1.6/1,000 pilots.
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This study focuses on the comparative and quantitative analysis of the epidemiologic trends and aspects of severe fever with thrombocytopenia syndrome (SFTS) outbreaks between Korea and Japan from 2013 to 2017. The following factors were analyzed; cumulative incidence rate (CIR), cases-fatality rate (CFR), and the epidemic aspects, including cases related to gender, male-to-female morbidity ratio (MFMR), age, seasonal,and geographical distributions. We observed 607 SFTS cases with CIR in Korea during the period 2013 to 2017 were as 0.24 per 100,000 populations and with a 127 fatal-cases (F.C.s), corresponding to a CFR of 20.9%, respectively. During the same period in Japan, 319 SFTS cases with a CIR of 0.05 and with 60 F.C.s to a CFR of 18.8% observed. When compared, the CIR of SFTS in Korea was significantly higher than in Japan (P<0.01), but there were no significant differences levels of the CFR and MFMR between Korea and Japan. Also, a higher incidence of SFTS was observed in people aged over 50-years or elders in Korea and those of 60-years or elders in Japan (P<0.01). The seasonal distribution of SFTS outbreak cases showed that the incidence in summer through autumn in Korea (92.4% of total cases) was higher than in Japan (65.2%), while the outbreaks of SFTS in spring was much higher in Japan (31.0%) than in Korea (7.4%), (P<0.01). The regional distribution revealed no significant difference between the eastern area (44.8%) and the western area (46.8%) of the Korean peninsula except Jeju-island (8.4%). However,in Japan, the incidence only occurred in Chubu-Kinki-Chugoku (30.3%), Shikoku (25.7%),Kyushu (42.6%) and Okinawa (0.3%), which are the western and southern areas of Japan.These differences in SFTS occurrence may reflect the influences of vector/hosts, climate, and geographical and cultural characteristics between the two countries.
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The cabin environment has many physiological effects on commercial aircraft passengers and medical providers, and environmental stress factors exist. Therefore, it is important for medical providers to understand the effects of aviation physiology and cabin environment on the human body. It should also be remembered that these physiological changes and environmental stress factors can affect passengers as well as flight crew and also medical equipment. Providing medical assistance during a flight offers a number of unique challenges including lower cabin pressure, tight quarters, crowded conditions, and loud background noise. The purpose of this Korean guideline is to offer an overview on various in-flight emergencies that could be anticipated and to outline treatment priorities.
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In 2019, the Aerospace Medical Association of Korea celebrated its 30th anniversary. On the other side of the world, it was also the 62nd anniversary of Russian launch Sputnik 1 of the world’s first artificial satellite on October 4, 1957. In additionally, the world, especially the United States was shocked, when on November 3, 1957, Sputnik 2 blasted into Earth orbit with a dog named “Laika”; it was the role of veterinarian’s activities for aerospace medical research and exploration. Veterinarians (Vets) are responsible for the health of all the animals for aerospace medicine whether on the ground or in space. Vets can enhance animal and public health and this knowledge of Vets and astronauts can extend their mission durations, go to nearby Earth Asteroids, Mars and other heavenly bodies to study their living and non-living characteristics. This review article is the brief history of the original growth of the veterinarian’s activities for the aerospace medical research, in order to stimulate future strategies for improvements in the space life sciences and exploration.
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The Republic of Korea is rapidly entering an aging society. With the aging of society, the overseas travel of the elderly is increasing rapidly. According to the Korea Tourism Organization, the number of overseas tourists aged 61 or older last year exceeded 2.5 million, of which over 80 were over 200,000. Age is no longer a limiting factor for traveling abroad, but traveling to unfamiliar places is certainly a challenge. Old people may experience a variety of problems, so special care should be taken. In particular, the aircraft cabin environment is different from the ground, so elderly travelers with respiratory or heart disease require special attention. In this paper, we want to know the precautions and how to prepare for the safe air travel for the elderly.
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In accordance with ICAO SARPs, the states should implement appropriate aviation-related health promotion for airmen subject to an aviation medical examination to reduce future medical risks to flight safety. We aimed to analyze the results of the aviation medical examination to use as objective evidence for establishing an aviationrelated health promotion plan. The results of the final issuance of airmen medical certificate from 2015~2017 were collected from the e-sky computer system. The 30 cases (0.3%) in 2015, 22 cases (0.2%) in 2016, 38 cases (0.3%) in 2017 were unfit for flight duty. The 34 unfit out of the total 90 cases were renewal physical examinations. The cardiovascular disease was most commonly in 11 cases, followed by 8 tumors, 4 psychiatric diseases, 3 ophthalmic diseases, 2 respiratory diseases, 2 neurologic diseases, 2 otolaryngological diseases, 1 endocrine disease and 1 digestive disease. The results of this study can be used as objective data in aviation-related health promotion plan. The health promotion activities based on objective data can contribute to improving aviation safety by improving the lifestyles of airmen.
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Coronavirus disease 2019 (COVID-19) has had a significant impact on our society as a whole. The COVID-19 pandemic is not only a health crisis, it is also an economic, social and humanitarian crisis. Considering the dramatic global economic and social impact that the crisis has engendered, the aviation system is standing on the doorstep of rapid transformation. In particular, the impact on the aviation and travel industries is enormous. Air travel to most countries has been suspended and blocked. Looking at Korea’s current situation, COVID-19 has wholly changed the aviation industry. As COVID-19 spreads around the world, countries have come up with aviation safety measures. Infectious disease safety measures were established to protect passengers and crew members, and countries with collapsed medical systems extended the validity period for aviation medical examinations. In Korea, on August 11, the Ministry of Land, Infrastructure and Transport provided guidance on medical measures related to COVID-19 through an official letter of “Notification of cautions for pilots and air traffic control officers (ATCO) when COVID-19 is confirmed”. Overseas countries such as the United States and the United Kingdom have announced regulations for aviation medical examination regulations in relation to COVID-19, and have set standards for returning to aviation after COVID-19 is confirmed. In this paper, we would like to investigate the regulations for aviation medical examination related to COVID-19.
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“Incapacitation” means any reduction in medical fitness to a degree or of a nature that is likely to jeopardize flight safety. Incapacitation of flight crew during flight is a serious threat to aviation safety. The focus of the periodic medical examination has been to detect medical conditions, and almost exclusively the emphasis has been on detecting physical medical conditions that may pose a threat to flight safety during the ensuing period of validity of the Medical Assessment. Therefore, the aviation medical examiner should be able to understand the incapacitation to utilize it for flight crew health evaluation and promotion.