Factors Influencing the Wellness of Call Center Employees

Purpose@#This study aimed to identify the factors influencing the wellness of call center employees. @*Methods@#From December 2018 to October 2019, a cross-sectional study was conducted with 155 workers recruited from the call centers in Seoul, South Korea. Data were collected using self-administered questionnaires. The questionnaires were used to measure the following scales: Korean occupational stress scale, emotional labor scale, work-life balance scale and wellness scale. Using the SPSS 26.0 program, the descriptive statistics, independent t-test, ANOVA, correlation analysis, and multiple regression analysis were conducted. @*Results@#The mean score of the wellness level of call center employees was 3.05 out of a maximum of 5.00. More wellness level of call center employees was associated with gender, psychiatric diagnosis, and call characteristics. A multiple regression analysis indicated that the total scores on the wellness scale were predicted by call characteristics, occupational stress and work-life balance, with an explanatory power of 42.2%. @*Conclusion@#Study findings show that it is necessary to promote wellness in call center workers with differentiated strategies according to call characteristics, occupational stress and work-life balance. This implies that it is necessary to understand the call characteristics and patterns of workers and to provide an innovative wellness program tailored to individual characteristics for an effective management of the emotional labor and occupational stress.

Review of the early reports of the epidemiological characteristics of the B.1.1.7 variant of SARS-CoV-2 and its spread worldwide

The variant B.1.1.7 of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the RNA virus causing the pandemic more than a year worldwide, was reported from United Kingdom (UK) in late December 2020. It was reported that mortality increases by 65% and transmissibility increases by 70%, which may result in an increase of reproduction number to 1.13−1.55 from 0.75−0.85. To analyze the global increasing trend of the variant B.1.1.7, we extracted results of B.1.1.7 from GISAID on May 11 and May 12, 2021, and conducted a doseresponse regression. It took 47 days to reach 20% and 121 days to reach 50% among the sequence submitted from UK. In Korea, cases of B.1.1.7 have increased since the first report of three cases on December 28, 2020. Positive rate of B.1.1.7 in Korea was 21.6% in the week from May 9 to May 15, 2021. Detection rate of the variants is expected to increase further and new variants of SARS-CoV-2 are emerging, so a close monitoring and control would be maintained for months.

Review of the early reports of the epidemiological characteristics of the B.1.1.7 variant of SARS-CoV-2 and its spread worldwide

The variant B.1.1.7 of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the RNA virus causing the pandemic more than a year worldwide, was reported from United Kingdom (UK) in late December 2020. It was reported that mortality increases by 65% and transmissibility increases by 70%, which may result in an increase of reproduction number to 1.13−1.55 from 0.75−0.85. To analyze the global increasing trend of the variant B.1.1.7, we extracted results of B.1.1.7 from GISAID on May 11 and May 12, 2021, and conducted a doseresponse regression. It took 47 days to reach 20% and 121 days to reach 50% among the sequence submitted from UK. In Korea, cases of B.1.1.7 have increased since the first report of three cases on December 28, 2020. Positive rate of B.1.1.7 in Korea was 21.6% in the week from May 9 to May 15, 2021. Detection rate of the variants is expected to increase further and new variants of SARS-CoV-2 are emerging, so a close monitoring and control would be maintained for months.

Age-Period-Cohort Analysis of Female Breast Cancer Mortality in Korea / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Despite the low mortality rate of breast cancer among women in Korea, the breast cancer mortality rate has increased. The aim of this study was to examine trends in breast cancer mortality from 1983 to 2012 in Korea, assessing the importance of age, period, and birth cohort as risk factors. MATERIALS AND METHODS: Data on the annual number of deaths due to female breast cancer and on female population statistics from 1983 to 2012 were obtained from Statistics Korea. A log-linear Poisson age-period-cohort model was used to estimate age, period, and cohort effects. RESULTS: The increasing breast cancer mortality can be explained predominantly by a birth cohort effect: the risk of breast cancer death showed a steady increase until the 1968 birth cohort, and decreased thereafter. There was a sharp increase in the magnitude of the age effect up to 60 years old, then a moderate increase in the effect during the sixties, followed by another sharp increase from 70 years old. The period effect on breast cancer mortality seems negligible based on its adjusted relative risk, even though it was statistically significant after adjusting for age and cohort effects. CONCLUSION: In this study, the mortality pattern of breast cancer in Korea can be explained predominantly by a birth cohort effect. Hence, the overall mortality rate of breast cancer may increase for a while, and show a gradual decrease in the future, which will start from the younger age group.

Risk Factors and Control Strategies for the Rapidly Rising Rate of Breast Cancer in Korea / 한국유방암학회지

Due to the aging population and tremendous changes in life style over the past decades, cancer has been the leading cause of death in Korea. The incidence rate of breast cancer is the second highest in Korea, and it has shown an annual increase of 6.8% for the past 6 years. The major risk factors of breast cancer in Korean women are as follows: Early menarche, late menopause, late full-term pregnancy (FTP), and low numbers of FTP. Height and body mass index increased the risk of breast cancer in postmenopausal women only. There are ethnic variations in breast cancer due to the differences in genetic susceptibility or exposure to etiologic agent. With the epidemiological evidences on the possibility of further increase of breast cancer in Korea, the Korean Government began implementing the National Cancer Screening Program against breast cancer in 2002. Five-year survival rates for female breast cancer have improved significantly from 78.0% in early 1993-1995 to 90.0% in 2004-2008. This data indicate that improvement of the survival rate may be partially due to the early diagnosis of breast cancer as well as the increased public awareness about the significance of early detection and organized cancer screening program. The current primary prevention programs are geared towards strengthening national prevention campaigns. In accordance with the improvement in 5-year survival rate, the overall cancer mortality has started to decrease. However, breast cancer death rate and incidence rates are still increasing, which need further organized effort by the Korean Government.

Reproductive and Hormonal Factors Associated with Fatty or Dense Breast Patterns among Korean Women / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Dense breasts have been suggested as a risk factor for breast cancer, but controversy still remains. This study evaluates the association of reproductive and hormonal factors with dense breasts among Korean women. MATERIALS AND METHODS: Using a cross-sectional design, 516 women were recruited and classified for breast density patterns as being either fatty or dense, using the Breast Imaging Reporting and Data System (BI-RADS) of the American College of Radiology. Univariate and multivariate logistic regression models were used for statistical analysis. RESULTS: In univariate logistic regression, older age, higher body mass index, older age at menarche, and oral contraceptive use were associated with more fatty breasts. On the contrary, longer duration of education, alcohol consumption, lower parity, menopause and use of hormone replacement therapy were associated with dense breasts. After adjustment, age and body mass index were inversely associated with breast density (p-value for trend or =2 children, nulliparous women had an 11.8-fold increase of dense breasts (p-value for trend <0.01). Compared to postmenopausal women, premenopausal women had 2.4-fold increase of dense breasts (odds ratio, 2.42; 95% confidence interval, 1.36 to 4.32). CONCLUSION: Young age, lower body mass index, lower parity, and premenopausal status were significantly associated with dense breasts in Korea.

Results of Colorectal Cancer Screening of the National Cancer Screening Program in Korea, 2008 / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: This study aims to investigate the current situation of national colorectal cancer screening by analyzing participation rates, positive rates of screening methods and screening rate of secondary screening tests in colorectal screening of the national cancer screening program in 2008. MATERIALS AND METHODS: With database about target population and screened individuals of the national cancer screening program, the results of target population and participants of colorectal cancer screening in 2008 were analyzed. Among adults aged over 50 years of medical aid and beneficiaries of national health insurance paying lower 50% premiums in the total subscribers, 4,640,365 were target population of colorectal cancer screening and the data of 984,915 undergoing fecal occult blood test (FOBT) as a primary screening were analyzed. RESULTS: The colorectal cancer screening rate was 21.2% and the rates of national health insurance subscribers, females and the elderly aged 60-64 years were higher than those of others. The recipients with a positive result in FOBT recorded approximately 7.5%. Medical aid beneficiaries (7.9%), males (8.8%) and seniors aged over 75 years (9.1%) showed higher positive rates than the average one. Out of the FOBT positive recipients, 43.0% took a secondary screening and the rate undergoing colonoscopy (31.4%) was higher than that of doing double-contrast barium enema test (11.6%). CONCLUSION: Colorectal cancer screening rate of medical aid beneficiaries and people paying lower 50% premiums among national health insurance subscribers, was different according to demographic characters (gender, age and types of health insurance). This finding meant that screening for the vulnerable needed to be encouraged by considering socio-demographic characters. Additionally, more efforts were necessary to increase the secondary screening rate of people with a positive result in primary one.

Trends of Mammography Use in a National Breast Cancer Screening Program, 2004-2008 / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Korea started breast cancer screening as part of the National Cancer Screening Program (NCSP) in 1999. In order to identify under-served groups, we investigated mammography uptake in the National Breast Cancer Screening Program. MATERIALS AND METHODS: The study population was participants in the National Breast Cancer Screening Program from 2004 to 2008. We analyzed participation rates by insurance type, age group, and area of residence. RESULTS: Total participation rates for breast cancer screening increased from 18.2% in 2004 to 35.0% in 2008. The participation rate in the group aged 60 to 69 years showed the greatest increase, 21.3%, among the four age groups. Although the screening rate increased continuously, the participation rate of the Medical Aid Program (MAP) group was low compared to the National Health Insurance (NHI) group. Moreover, the increasing trend of mammography uptake in the MAP group was much lower than that of the NHI group. CONCLUSION: The participation rate for breast cancer screening in the NCSP in Korea has increased. However, the participation rate in mammography among MAP recipients is still lower than that of NHI beneficiaries. To increase mammography uptake, it is important to make it available to everyone by ensuring inclusion of all population subgroups.

Breast Cancer Screening in Korean Women: Report of the National Cancer Screening Program in 2008 / 한국유방암학회지

PURPOSE: The Korean National Cancer Screening Program began in 1999. To provide essential evidence related to breast cancer screening in Korean women, we analyzed data from the KNCSP in 2008. METHODS: Using data obtained from the National Cancer Screening Information System, breast cancer screening participation rates were calculated. Recall rates were estimated with 95% confidence intervals (CI). RESULTS: The target population of breast cancer screening in 2008 included 3,706,062 women, 1,294,060 of whom utilized mammography as a screening tool (participation rate, 34.9%). Compared to the participation rate of women covered by the National Health Insurance Program (37.3%), women covered by the Medical Aid Program was lower (21.3%). The overall recall rate of breast cancer screening was 6.4% (95% CI, 6.39-6.47). CONCLUSION: According to our study, efforts to facilitate the participation and to reduce disparities in breast cancer screening among Korean women are needed. These results will provide essential data for evidence-based strategies in breast cancer control in Korea.

Epidemiologic Characteristics of the Breast Cancer in Korea

Breast cancer has been the most common cancer among Korean women since 2001 and will continue to increase for the next 20 years, at the least. Many of the established risk factors are linked to the exposure to female hormones: breast cancer risk is increased by early menarche, late menopause, nulliparity and later first full-term pregnancy, and obesity in postmenopausal women. In addition, other established risk factors such as alcohol consumption and family history of breast cancer are associated with an increased risk of breast cancer. Physical activity, breast feeding, higher number of children, and fruit and vegetable consumption seem to reduce breast cancer risk. Smoking also probably increases the risk. Both oral contraceptives in premenopausal women and hormonal replacement therapy in postmenopausal women may increase risk. Above-mentioned risk and protective factors were reported in Korean populations and the breast cancer risk by those factors is similar to that in western population. Currently, a study is being done in Korea to examine the associated risk, and population attributable risk of genetic variants in high penetrance genes including BRCA 1 and 2 and breast cancer risk among Koreans will be reported soon. Other studies conducted in Korea that investigated low penetrance genes have already been published. While the individual risk was small, there was an effect from interaction with environmental factors. Numerous Korean studies about these risk factors helped to establish a model to predict individual breast cancer risk that is utilized in the Personalized Preventive and Predictive medicine.

Reliability of a Questionnaire for Women's Reproductive History / 예방의학회지

OBJECTIVES: This study was performed to evaluate the reproducibility of a questionnaire concerned with reproductive history and to ascertain which characteristics of the subjects (age, the visit-revisit intervals, education and chronic disease) are associated with good reliability in the Korean Multi-Center Cancer Cohort (KMCC) study. MATERIALS AND METHODS: A total of 19,688 participants were enrolled between 1993 and 2004. Among them, we selected 386 participants who were aged 40 or more and who re-visited within 8 years after the first visit. Reliability was measured by the percent agreement according to error range for the continuous variables and the percent agreement and kappa statistics for the categorical variables. RESULTS: The pregnancy histories were reliable (kappa=0.67) and the reasons for being menopausal among the postmenopausal women were also reliable (kappa=0.92). The percent agreement of the breast-feeding history was high (96.1%), although the kappa statistic was low. For the continuous variables, when the error range of one variable was considered to be reliable, the percent agreement of the age at menarche and the age at the first full term pregnancy was good (69.4% and 83.6%), whereas that of the age at menopause was low (51.5%). The factors associated with high reliability were a younger age, the presence of chronic disease and a short visit-revisit time interval. CONCLUSIONS: The agreements for parity, the reasons for menopause, and the breastfeeding history in the reproductive history questionnaire used in the KMCC were relatively good. The questionnaire for the menarche age and the menopausal age might have lower reliability due to the difference between Korean age and American age. To obtain reliable information, more attention should be given to the items in questionnaire-based surveys, and especially for surveying old-aged women.

Temporal Changes of Lung Cancer Mortality in Korea

The lung cancer mortality in Korea has increased remarkably during the last 20 yr, and, it has become the first leading cause of cancer-related deaths since 2000. The aim of the current study was to examine time trends of lung cancer mortality during the period 1984-2003 in Korea, assessing the effects of age, period, and birth cohort. Data on the annual number of deaths due to lung cancer and on population statistics from 1984 to 2003 were obtained from the Korea National Statistical Office. A log-linear Poisson age-period-cohort model was used to estimate the effects of age, period, and birth cohort. The both trends of male and female lung cancer mortality were both explained by age-period-cohort models. The risks of lung cancer mortalities for both genders were shown to decline in recent birth cohorts. The decreasing trends begin with the 1939 birth cohort for men and 1959 for women. The mortality pattern of lung cancer was dominantly explained by a birth cohort effect, possibly related with the change in smoking pattern, for both men and women. Finally, the mortality of lung cancer in Korea is expected to further increase in both men and women for a while.

Correction: Long Term Trends and the Future Gastric Cancer Mortality in Korea: 1983~2013 / Journal of the Korean Cancer Association, 대한암학회지

This article was published with an error.

Cigarette Smoking and Gastric Cancer Risk in a Community-based Cohort Study in Korea / 예방의학회지

OBJECTIVES: Gastric cancer is the most common incident cancer in Korea. Although Helicobacter pylori infection is the most important risk factor for the development of gastric cancer, cigarette smoking has also been suggested to play an important role in the development of gastric cancer. The objective of this study is to evaluate the relationship between cigarette smoking and gastric cancer risk in a Korean population. METHODS: The study population consisted of 13,785 subjects who had been enrolled in the Korean Multi-Center Cancer Cohort between 1993 and 2002. As of December 2002, 139 incident gastric cancer cases were ascertained through the Korea Central Cancer Registry and the National Death Certificate Database. Relative risks (RR) and 95% confidence intervals (CI) for gastric cancer were estimated using CoxZs proportional hazard model adjusted for age, education, alcohol drinking status and history of gastritis or ulcer. RESULTS: Significant dose-response relationships were observed between the duration of smoking and the risk of gastric cancer among the male subjects in comparison to non-smokers: men who smoked for 20-39 years had a 2.09- fold (95% CI 1.00-4.38) increase, and those who smoked for more than 40 years had a 3.13-fold (95% CI 1.59-6.17) increase in the risk of gastric cancer (Ptrend<0.01). CONCLUSIONS: This study suggests that a longer duration of cigarette smoking may increase the risk of gastric cancer development in a dose-response manner in Korean men. The association between smoking and gastric cancer risk in women should be verified in future studies with a larger number of cases.

Long Term Trends and the Future Gastric Cancer Mortality in Korea : 1983~2013 / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: In spite of gastric cancer's decreasing incidence and mortality rates, it is still the most common cancer in Korea. In the present study, we examined the temporal trends of gastric cancer mortality during the past 20 years in Korea by using an age-period-cohort model, and we predicted the mortality rates for the next 10 years. MATERIALS AND METHODS: Data on the annual number of deaths due to gastric cancer and data on population statistics from 1984 to 2003 were obtained from the Korean National Statistical Office. A log-linear Poisson ageperiod-cohort model was used to estimate age, period and birth cohort effects. To project two periods (10 years) into the future, the new cohort values were estimated by performing linear regression that was applied to a chosen number of the most recent cohort values. RESULTS: The trends of gastric cancer mortality were predominantly explained by the cohort effect; the risk of gastric cancer death decreased since the 1919 birth cohort for both genders. The predicted, expected age-adjusted mortality rates per 100,000 for males and females are 45.72 and 23.75, respectively, during 2004~2008, and 34.62 and 17.93 respectively, during 2009~2013. During 2004~2008 and 2009~2013, the predicted numbers of deaths due to gastric cancer in males are 36,922 and 27,959, respectively, whereas those in females are 19,698 and 14,869, respectively. CONCLUSIONS: Not only the mortality, but also the incidence of gastric cancer in Korea is expected to further decrease in both men and women if the trends of the past 20 years continue.

A Cotwin Control Study of Smoking and Risk Factors of Metabolic Syndrome

BACKGROUND: Smoking effects are relatively well-documented, especially on cancers and cardiovascular diseases. However, the direction and magnitude of association between smoking and obesity remain unclear. Conflicting results so far are thought to stem from the multiple confounding structure of smoking and other obesogenic life style characteristics. METHODS: Cotwin control study is a genomic epidemiology design, in which the other twin (=cotwin) serves as a control of the twin. Cotwin control study, discordant for smoking habits can provide powerful evidence of association between smoking and obesity by completely matching genomic information, intrauterine environment, and almost all environmental factors. We selected 3,697 like-sex twin pairs (2,762 male and 935 female pairs) out of 63,666 pairs of adult twins in the existing Korea Twin and Family Register, whose smoking habits are discordant. We used the information of obesity as body mass index (BMI, kg/m2), blood pressure, and blood cholesterol level at the time or later than the smoking information. Paired t-test was done to compare the smoking effects. RESULTS: Lifetime smoking rate was 80.1% (47.9 current smoker) for men and 10% (1.7% current smoker) for women. Among 2,762 and 935 male and female like-sex twin pairs, 363 male pairs and 20 female pairs correspond to the definition of smoker-nonsmoker pair. The male smokers demonstrated increase in BMI by 0.47, while female smokers show slight decrease (by 0.13), which were not statistically significant. Diastolic and systolic blood pressure, and cholesterol level were slightly increased among smokers by 1.85 mmHg,0.62 mmHg, and 1.28 mg/dl for men. For women, the results show increase in diastolic blood pressure (3.42mmHg) and cholesterol level (1.25 mg/dl), and systolic pressure (8.17 mmHg). CONCLUSION: The results refute the possibility that smoking can reduce BMI. Considering the direct adverse effect of smoking, it should be emphasized that smoking do not decrease obesity and thus increase overall metabolic syndrome.