Effect of air pollution on daily mortality in Daegu (1993~1997) / 대한산업의학회지

OBJECTIVES: In order to evaluate the relationship between daily mortality and air pollution in Deagu for the period by the data from January 1993 to December 1997. METHODS: Deaths from accident(International Classification of Disease, Revision 9; 800-999 and Revision 10; V01- Y89) were excluded, Daily counts of deaths were analysed by general additive poisson model on the current day to 5 days before death, with controlling for effects of year, season, weather, weekday and holiday. The air pollutants examined included total suspended particulate (TSP), sulfur dioxide (SO,), nitrogen dioxide (NO,), carbon monoxide (CO) and ozone (03). RESULTS: Mortality was associated with NO, SO and CO in the air. Total mortality was estimated to increase by 1. 6 % (95 % CI 0. 3-3 %) with each 10 ppb rise in NOy on the current day and the preceding 1 day, 9. 4 % (95 % CI 7 13 %) with each 100 ppb rise in SOy and 2. 7 % (95 % CI 0. 1 5 %) with each 1 ppm rise in CO on the current day. The NO was more evident for the elderly who were 65 years and more. Cardiovascular-specific mortality was associated with the levels of CO on the current day. Respiratory-specific mortality was associated with the levels of TSP and NO 5 days before death. Excess mortality risk is clearly evident in the upper range of NO levels and increased monotonically with NO. CONCLUSIONS: This study suggested that the air pollution status below the current Korean ambient air quality standard might have an adverse effect on daily mortality. Then, it is impertive that the strategy for control of the air pollution-related daily mortality should be developed.

Senior Medical Students' Attitudes toward and Knowledge about Breastfeeding / 예방의학회지

OBJECTIVES: This study surveyed medical students attending clerkship to assess their attitude toward and knowledge about breastfeeding, and self-confidence to manage common breast-feeding problems. METHODS: A self-report questionnaire was administered to the 323 medical students at four medical colleges in Taegu in May 1997. The response rate was 92.9%, but the respondents used in the final data analysis were 245 (75.8%) due to missing variables. RESULTS: Overall, respondents showed equivocal attitudes toward breastfeeding (mean score 2.9 on a 6-point scale). Knowledge about breastfeeding was substantially low with the median % correct 39.2%. Of nine knowledge areas, weak areas were especially "contraindications and barriers to breastfeeding", "use of breastfeeding aids", "expression and storage of breast milk". Those reported to be confident to manage common breastfeeding problems were only 25.7%. Correlations between knowledge and self-confidence were not statistically significant except in college A (r=0.35, p<0.05). Correlations between knowledge and attitude were not significant. CONCLUSIONS: These results suggest that medical students attending clerkship in Taegu show equivocal attitudes toward breastfeeding, low self-confidence to manage common breastfeeding problems and have substantially limited level of knowledge. There should be more concerted efforts to improve this situation on the part of those involved in breastfeeding education.

Effect of Cadmium and Zinc on IL-6 Secretion in a Human Monocytic Cell Line, THP-1 / 대한산업의학회지

OBJECTIVES: This study was performed to investigate effects of cadmium and zinc on IL-6 secretion using human monocyte in a culture system. METHODS: We have used frypan blue dye exclusion methods to examine the effect of cytotoxicity of CdCl2, ZnCl2 in THP-1 cells. IL-6 was measured by the ELIBA method in the cell culture supernatants and the expression of IL-6 mRNA was examined by reverse transcription-polymerase chain reaction. RESULTS: IL-6 production by THP-1 cells were decreased at 0.1 mM cadmium concentration(p < 0.05) and increased as zinc concentration increased. Zinc prevented cadmiuminduced suppression of IL-6. and the addition of a chelating agent, EDTA, restores IL-6 secretion. The expression of IL-6 mRNA decreased at 0.08 mM and 0.1 mM cadmium concentrations. CONCLUSION: This results suggests that cadmium depressed production and gene expression of IL-6 in stimulates human monocytes, and zinc prevented cadmium-induced suppression of IL-16.

Cognitive function, family function and depression in rural elderly

BACKGROUND: The prevalence of cognitive impairment in the elderly has been increasing in recent years with the growing of the aged population. Clinical assessment of cognitive function and mood is very important because cognitive impairment and depression commonly coexist in the elderly. The elderly interacts with the other family members, so cognitive impairment of the elderly influence family function. The objectives of this study were to delineate the factors correlated with cognitive function and to explore the relationship of depression and family function with cognitive function. METHODS: This study was done during 20 day period from July to August, 1996. The subjects were home residents aged 60 years or more living in a subcounty of Kyungpook Province, Korea. The final analysis included 195 subjects(male 95, female 100). The questionnaire included sociodemographic data, MMSE-K(Korean version of Mini Mental State Examination) for evaluation of cognitive function, BDI for evaluation of depression and family APGAR score for evaluation of family function. The results were analyzed by descriptive, comparative and correlative analysis. RESULTS: Mean MMSE-K score was 25.3+/-4.3 with female subjects(23.9+/-4.8) having significantly higher cognitive impairment when compaired to male subjects(26.6+/-3.2)(P<0.001). MMSE-K score was associated with gender, age, year of education(P<0.001), BDI and APGAR score(P<0.05). Religion, smoking and alcohol use were not associated with MMSE-K score. The prevalence of dementia by MMSE-K was 9.7% in definite dementia (MMSE-K<_19) and 23.1% with questionable dementia(20<_MMSE-K<_23). In male, the prevalence was 1.1% and 20.0% respectively. In female, the prevalence was 18.0% and 26% respectively, indicating difference between male and female subjects(P<0.001). CONCLUSIONS: In the elderly, female gender, older age and lower educational level were associated with cognitive function impairment. There was a positive correlation between cognitive function and family function. The group with impaired cognitive function had more depression than the normal group.

Effect of Cadmium on Cytokine Gene Expression in a Human Monocytic Cell Line, THP-1 / 대한산업의학회지

Cadmium, a potent toxic metal, poses a serious environmental threat but the mechanism of its toxicity remains unclear. Also, cadmium is a known immunotoxic agent in animal studies and induces pathophysiological effects by modulating components of immune system. Cytokines are being increasingly recognized as essential mediators of normal and pathologic immune response. Cells of mononuclear phagocytic system are strategically located at portals of entry in humans and therefore may be particularly at risk for cadmium exposure through contaminated air, food, and drinking water. In the present study, we investigated the effect of cadmium cytotoxicity for the monocyte and expression of cytokine gene in the control and cadmium treated human monocytic cell lines using RT-PCR method. The results showed that cadmium inhibited cell proliferation at 0.1mM cadmium treated cells for 24 hours. The TNF-alpha mRNA was expressed in both control and cadmium treated cells but not IL-6 and IL-1 beta The mRNA levels of TNF-alpha were examined during 24 hours culture period, at different time points. The expression of TNF-alpha mRNA increased in both 0.01mM and 0.1mM cadmium treated cells, but did not show dose-response relationship. According to cadmium treated duration, expression of TNF-alpha mRNA was more decreases in 24 hours than 6 hours. The decreased levels of mRNA of TNF-alpha that cadmium suppresses iris production at the transcription level.

Lifestyle Variables Associated with Anemia in Female Workers / 대한산업의학회지

The study was conducted from May to July in 1995 to investigate lifestyle variables associated with anemia in some female workers of the six large plants in Taegu. Cases were selected by a doctor based on symptoms and physical exmination and controls were matched according to age limits (?) and plant employed. The final subjects analyzed were 385 excluding. 36 who had underlying diseases associated with anemia or many missing values. Anemia was defined by the blood hemoglobin level less than 12 g/dL. Anemic subjects were 190(49.4%) with nonsignificant age distribution between cases and controls. Univariate logistic regression showed that there was no statistically significant difference in sociodemographic and occupational variables. Number of pad used during menstruation (odds ratio, OR=1.03, 95% Confidence interval ei,1.00-l-1.05) was the only significant among the menstruation-related variables. None of the lifestyle variables were significant but those who consume more than 4 cups of coffee a day vs. none and animal iron intake showed borderline statistical significance with the ORs 2.60 and 0.99, respectively. After controlling for marital status, native place and number of pad with the multiple logistic regression, those who consume more than 4 cups of coffee a day vs. none showed statistically significant OR 2.93(95% CI 1.01-8.49). Animal iron intake and diet to lose weight indicated borderline significance with ORs 0.99(p=0.06) and 1.47(p=0.09), respectively. These results suggest that there are some anemia-associated lifestyle variables and these variables may be important for the behavior modification to prevent anemia in female workers.

The Assessment of Acquired Dyschromatopsia among Organic-Solvents Exposed Workers / 예방의학회지

We investigated the occurrence of color vision loss in 70 organic solvent mixtures exposed workers and in 47 controls. Color Vision was assessed with a color arrangement test designed to identify the defective color sense, the Han Double 15-Hue Test. The results of the test were no significant difference between exposed workers and controls in the proportion of subjects who committed one or two errors. Quantitative analysis, using color confusion index(CCI), showed no signifiant difference between exposed workers and controls. A significant linear correlation was present between age and CCI in both exposed workers(CCi=0.0056age + 0.94; r=0.23; p<0.05) and controls(CCI=0.0066age + 0.86; r=0.33; p<0.05). Qualitative analysis of the patterns on the hue circle showed that the prevalence of acquired dyschromatopsia was 21% in both and no significant difference. Multiple regression analyses showed that age was significantly related to color vision loss. These results did not provide evidence of a relationship between organic solvents exposure and incidence of color vision loss. In field studies for monitor the people at risk of the acquired color vision loss involving low-dose organic solvents exposed workers, both quantitative and qualitative information should be considered.

Application of HHIE-S(Hearing Handicap Inventory for the Elderly-Screening version) to screening test of noise-induced hearing loss / 예방의학회지

The study conducted from May to September in 1994 to investigate applicability of the Hearing Handicap Inventory for the Elderly-Screening version(HHIE-S) in parallel with the puretone audiometer to the initial screening test of noise-induced hearing loss(NIHL) in some noise-exposed workers. Subjects were selected by systemic sampling that took every fifth person from 6,700 workers taking the annual occupational health examination by the department of Health Maintenance of Dongsan Hospital Keimyung University in Taegu. The authors administered the pure-tone audiometric test and self-reported questionnaire of HHIE-S including items of sociodemographic and job-related variables concurrently. The final subjects analysed were 1,019(488 males and 531 females) excluding fourteen persons who had many missing values in their questionnaires. The reliability coefficients of HHIE-S scale by Cronbach's alpha were 0.84. In the univariate analysis of hearing handicap measured by the HHIE-S, work duration, military service and the hearing threshold loss at 1kHz and 4kHz was the only selected variable explaining the hearing handicap in males and hearing threshold loss at 1kHz and 4kHz, age, and work duration were selected in females. In ROC curves for HHIE-S scores against NIHL as gold standard which was defined by the follow-up audiogram as more than 30dB of the average of 0.5/1/2kHz and 50dB at 4kHz, the optimal cutoff for the parallel HHIE-S appeared to be 8. The results suggest that HHIE-S appeared to have some reliability and validity in this data and might be used in screening NIHL in parallel with pure-tone audiometer in noise-exposed workers.

Differences of Screening Test Results of Health Examination between Clerks and Laborers / 예방의학회지

The authors conducted a cross-sectional study to evaluate the differences of screening test results between clerks and laborers in an occupational health center in Taegu, 1992. A total of 10,207 workers was included in the study of these, male were 5,597 and female 3,610. Constitutional variables included were items of health examination and some confounding variables(sex, age, body weight and work duration). All analyses were conducted separately for each sex through the use of multiple logistic regression analysis on occupation, controlling for age, work duration, and body weight. laborers showed abnormal hearing test more often than clerks in both sexes. The blood pressure that showed statistical significance in univariate analysis in both sexes lost its significance after controlling covariates. Liver function and urine protein had statistically significant differences between two occupational groups in males and visual correction did in females. The results suggest that there are differences clerks and laborers in some of screening tests and analytic studies are needed to identify the causes of the differences.

Recognition and attitude to fundtional division between physicians and pharmacists of practising physicians and pharmacists in Taegu city / 예방의학회지

Mail questionnaire was administrated to 370 practising physicians and 388 pharmacists in Taegu city selected by systematic sampling to examine utilization states and opinion of pharmacy under medical care insurance programme and the attitude to the functional division between physicians and pharmacists from April to May 1992. Regarding the opinion on the outcome of drug-store under medical insurance, 71.2 percent of practicing physician answered failure but 13.4 percent of practicing pharmacists answered failure in contrast. Fifty percent of practicing physician asserted introducing functional division between physician and pharmacist while 66.9 percent of practicing pharmacist answered drug-store under medical insurance itself is successful programme. Average daily numbers of preparation of medicine was 32.2 case. Percentage of utilization of drug-store under medical insurance to average daily cases of preparing of medicine was 20 percent, percentage of utilization with physician's prescription was 0.7 percent. And 58.7 percent of practicing physician experienced outside the institute prescription. Regarding the opinion on the pros and cons of enforcing functional division between physician and pharmacist, 59.2 percent of practicing physician preferred pros and 17.7 percent cons ,but 38 percent of practicing pharmacist preferred pros and 45.5 percent cons. And pharmacist know better the content of functional division between physician and pharmacist, practicing emphasized to prevent misuse or abuse of medicine but practicing pharmacist emphasized to display physician and pharmacist's professional ability. And as an opinion on implementation style of functional division between physician and pharmacist in pros respondents, practicing physician favored mandatory enforcement (52.3%), while practicing pharmacist favored partial incomplete functional division (81.7%). As the method of prescription if functional division between physician and pharmacist will be enforced, both practicing physician and pharmacist preferred generic name (44.0%, 89%) mostly, but physician preferred brand name (35.3%) secondly. Regarding the reason for not implementing functional division between physician and pharmacist up to date, both physician and pharmacist answered problem of business right between physician and pharmacist, followed by lack of recognition, and interest of people and lack of the governmental willness. Regarding the opinion on prior decision of condition for enforcing functional division between physician and pharmacist, practicing physician and pharmacist named uneven distribution of medical facilities and drug-store between rural and urban, inequality of physician and pharmacist manpower and the problem of manpower demand and supply mostly, and practicing physician pointed out establishing attitude of acceptance on the part of pharmacist and practicing pharmacist favored establishing attitude of acceptance on the part of physician, which was different attitudes between physician and pharmacist. Following conclusion was reached; 1. Current drug-store under medical insurance program yield insufficient outcome, so we should consider program conversion from drug-store under medical insurance program to functional division between physician and pharmacist. 2. There were problem of business right and conflicts between physician and pharmacist at enforcing functional division between physician and pharmacist, so the government should search for formulating plan to resolve the problem and have neutral willness for the protection of the national health.

Association of Serum Copper and Zinc Levels with Liver Cirrhosis and Hepatocellular Carcinoma / 예방의학회지

This study was done to identify the association between serum copper and zinc levels and the cirrhosis and hepatocellular carcinoma(HCC), and to evaluate its diagnostic value on liver diseases. Sixty-three healthy persons, 60 patients with cirrhosis and 33 patients with hepatocellular carcinoma were rendomly selected and investigated for their general characteristics from October 1990 to August 1991. For analysis of the biochemical markers in liver function test and the serum copper and zinc levels, their fasting venous blood were sampled at 9:00 to 11:00 in the morning and centrifuged to separate the serum within one hour. All the samples were immediately analysed for biochemical markers and stored at -20 C in polypropylene tubes further copper and zinc analysis. Mean of serum copper levels was 91.97+/-4.76 microgram/dl in control, 106.21+/-2.73 microgram/dl in cirrhosis and 127.05+/-0.77 microgram/dl in HCC. The value of HCC was statistically significantly higher than that of the control and cirrhosis(p<0.05). Serum zinc levels were 110.82+/-7.24 microgram/dl in control, 68.10+/-5.43 microgram/dl in cirrhosis and 63.78+/-2.20 microgram/dl in HCC. The values of cirrhosis and HCC were statistically significantly different among three groups(p<0.05). Test total protein, albumin, ALP and total bilirubin of biochemical markers of liver function were statistically significantly different among three groups(p<0.05). Differences between cirrhosis and HCC for ALT and AST, and between the control and HCC for direct bilirubin were not statistically significant. Biochemical markers statistically significantly correlated with serum copper and zinc levels and Cu/Zn ratio(p<0.05), were variable in three groups. In multiple logistic regression, odds ratio of serum copper level and Cu/Zn ratio had no statistically significance on the cirrhosis and the HCC, but that of serum zinc was statistically significant as 0.951 and 0.952 (p<0.05). Serum copper and zinc levels and Cu/Zn ratio were not statistically significantly different between the cirrhosis and HCC. Albumin, ALP, zinc, total bilirubin and age among all variables were selected as main variables for three-group discriminant analysis. Percentage of "grouped" cases correctly classified by these five variables was 98.4 for control, 73.4 for cirrhosis, 75.7 for HCC and 84.0 for all subjects. This study suggests that zinc may has an independently inhibitory effect on the liver disease and serum zinc level is considered to play a role as diagnostic marker on the hepatic disorders and be more useful than serum copper level and Cu/Zn ratio in diagnosis of the liver diseases.

A Study of Immunological Function in Workers Occupationally Exposed to Toluene / 예방의학회지

To assess the immunological function of toluene exposed group, the proportions of T lymphocyte, B lymphocyte, CD 4 cell, CD 8 cell, the ratio of CD4 to CD8 (CD4/CD8) in peripheral blood were measured on twenty-one toluene exposed workers and twelve healthy workers who did not have previous history of toluene exposure. In addition, to evaluate the present status of toluene exposure, urinary hippuric acid concenturations were measured in exposed group. The mean concenturation of urinary hippuric acid was 2.84 g/creatinine g in exposed group. The proportions of T lymphocyte, B lymphocyte, CD8 cell and CD4/CD8 of exposed group were slightly lower than non-exposed group except the proportion of CD4 cell which was similar in both groups. But these differences were not statistically different in both groups. The proportions of T lymphocyte and CD4 cell were significantly correlated with the length of duration in exposed group (P<0.05)

Psychiatric symptoms of workers exposed to organic solvents / 예방의학회지

To assess the pattern of psychiatric symptoms and to evaluate the relationship between exposure related variables(duration of work and urinary hippuric acid concenturation) and psychiatric symptoms in organic solvent exposed workers, case control study of forty-two solvent exposed workers and ninety-six non-exposed workers was conducted. The general health questionnaire 28(GHQ28) was administered to evaluate psychiatric symptoms and urinary hippuric acid concenturations was measured to estimate the present status of solvent exposure in exposed group and to estimate normal level in non-exposed group. The meand concenturation of urinary hippuric acid was significantly higher in exposed group (2.953g/creatinine g) than non-exposed group (0.395g/creatinine g) (P<0.01). The total positive rates of symptoms were significantly higher in exposed group(28.2%) than non-exposed group(17.5%) (P<0.05). The positive rates of symptoms for four sub-scales of GHQ 28 in exposed group were in the order of somatic symptoms, anxiety, social dysfunction, depression and in the order of social dysfunction, anxiety, depression, somatic symptoms in non-exposed group.The positive rates of symptoms for somatic symptoms and anxiety were significantly higher in exposed group than non-exposed group (P<0.05) and the proportion of workers with six or more positive symptoms(dysthymic states) in exposed group were significantly higher than non-exposed group (P<0.01). After the effect of age, sex, level of income, level of education, and duration of work were controlled, the total score of GHQ28 was still significantly different between exposed and non-exposed group(P<0.01). In multiple logistic regression analysis on the dysthymic state, the odds ratio of level of income was statistically significant in both group. The odds ratios of exposure related variables such as duration of work and hippuric acid concenturations were not statistically significant but there was a tendency that exposure related variables had an effect on dysthymic state in exposed group.In future, comtinuous evaluation of psychiatric symptoms on organic solvent exposed workers and studies to detect the factors that affect on psychiatric symptoms are required.

Type A behavior pattern and social control of parents / 예방의학회지

Associations between type A behavior pattern (TABP) and parental social control were examined by a questionnaire survey in a sample of 803 undergraduates of the three universities in Daegu city in 1988. TABP was assessed by the Student Jenkins Activity Survey (SJAS, short from) and social control of parents by Bernstein and Brandis' Index of control and communication which were both dichotomized by median. The mean age of the sample was 20.7 (standard deviation, 2.2) and mean of total score of SJAS was 5.6 with it standard deviation and median, 2.7 and 5, respectively. In stratified analysis for TABP-social control association by the native place, sex and socioeconomic status (SES), males of rural origin with low SES showed odds ratio (OR), 2.49 but those with high 0.40. For females of rural origin, those with low SES showed OR, 1.02, whereas those with high SES did 0.35. For those who was of urban origin, males with low SES had OR 1.27, and those with high SES did 1.29. Females with high SES showed 0.85 and those with low SES 0.67. None of the TABP-social control associations among the strata showed confidence intervals not including unity. In multiple logistic regression by native place, for those with rural origin the only term showed a statistically significance was the social control-SES of parents interaction, OR 3.99 (95% confidence interval, 1.03-15.46). For those of urban origin, none of the terms are statistically significant. These results suggest a social upward mobility by education of the rural disadvantaged group and a Confucian idea that regards academic achievement as one of social virtues, both of which may reflect the different sociocultural structures from the West.

A Study on industrial Accidents of Workers in Jeonbug Areas / 예방의학회지

Of 2,740 industries in Jeonbug area which are covered by industrial insurance policy, 462 facilities which the accidents related to industry occurred during the year of 1979 were studied, and the results are summarized as follows; 1. The accidents related to industry occurred in 462 industries of the total 2,740 industrial facilities in Jeonbug area as of 1979. 2. The incidence rate accident per 1,000 workers was 34.3(49.2 in male workers and 12.8% in female workers), the frequency rate of the total industries in Jeonbug area was 13.36, and severity rate was 1.3. 3. The frequency rates and severity rates by type of industry in study area were quit different to compare with those of national rates. 4. The incidence rate of construction industry was 223.6 per 1,000 workers, and that of transportation-communication industries were 78.6. 5. The proportion of industrial accidents of 20-24 age group was 22.1 percent of the total accidents, and the proportions decreased according to age increase. 6. The incidence rate in the industry having less than 49 workers was 20.6 per 1,000 workers, that of industry with 50-99% workers was 26.7, that of industry with100-199 was 51.9, that of industry with 200-499 was 80.2 and that of with more than 500 workers was 40.7. 7. The accidents which occurred in the workers with experience of less than one year was 69.4 percent of the total accidents, otherwise, the longer the workers have worked the less accident they have. 8.The most accidents occurred in the shift between 10 to12 o'clock, and 16 to 18 hour. 9. The primary causes of the industrial accidents were found to be collisions, machinery, falling objects and falls. 10. The site of injury by type of industry were quit different, and the major site of injury was finger. 11. The laceration and open injuries of the accidents related to industry were 37.2 percent of the total ceases, and fractures or dislocations were 28.5 percent, and contusions were 6.5% percent. 12. Death rate of industrial accident was 5.0 per 1,000 workers, and those of industry were 47.6 in transportation, 42.8 in construction industry, 24.4 in mine industry, and 2.0 in manufacturing industry.