Competency oriented construction of "Extreme Environment Medicine" Course / 中华医学教育探索杂志

Objective:To construct the curriculum content system of Extreme Environmental medicine based on the trainees' competency.Methods:After analysis of Chinese doctors' post competency demand, and the characteristics of military students, qualitative and quantitative methods were used to construct the curriculum system. The consistency of expert opinions was represented by Kendall's W coefficient, using chi-square test. The hierarchy and weights of all items were analyzed by the analytic hierarchy process, using consistency ratio ( CR) , which was incorporated into this system after passing the test ( CR<0.1) . Results:The selective experts were all authoritative and positivity, the assessments were consistency. Finally, it formed 5 primary items, 15 secondary items, and 54 third items of educational materials and 13 knowledge modules and 1 comprehensive seminar.Conclusions:Based on the demand of Chinese doctors' post competency, a curriculum system of extreme environment medicine has been constructed, through combined application of qualitative and quantitative research methods.

Cultivating public health youth talents with illustrious virtue and lofty aspirations to undertake glorious tasks of a new era: Minutes of the Sixteenth National Postgraduates Symposium on Environmental and Occupational Medicine / 环境与职业医学

　　From October 22 to 23, 2021, the 16th National Postgraduates Symposium on Environmental and Occupational Medicine was successfully held in Central South University, sponsored by the Editorial Board of Journal of Environmental and Occupational Medicine and Xiangya School of Public Health of Central South University, and co-organized by School of Public Health of South China University and Shanghai Preventive Medicine Association. Keeping in view the outbreak of COVID-19, the symposium was held in the form of "offline+online". More than 100 teachers and students from more than 30 universities and research institutions across China attended the conference. A total of 114 excellent papers were submitted to this conference. Focusing on the theme of "Research and practice: Healing the schism", young scholars' forum as well as postgraduates' academic exchanges at the main venue and four parallel sessions were launched. This conference not only provided an excellent platform for postgraduate students in the field of environmental and occupational medicine nationwide to share academic trends and exchange academic research, but also expanded the influence of the Journal of Environmental and Occupational Medicine.

La cultura médico ambiental en el desarrollo local de la comunidad

Se realizó un estudio con el objetivo de centrar la atención en reflexionar en la importancia de la formación de la cultura ambiental en la carrera de medicina, de relevancia en la comunidad médica y en la sociedad. Se utilizaron métodos como: análisis y síntesis, inductivo-deductivo, modelación, análisis documental, hermenéutico dialéctico. La aplicación de los métodos experimentales permitió la elaboración de un modelo para la formación de la cultura ambiental en los profesionales de la carrera de medicina con un basamento holístico-configuracional al revelar la lógica de la formación de esta cultura contextualizada se proyecta como una solución de impacto a las insuficiencias encontradas con significación, transformación y sistematización, en la práctica médica. La formación de los profesionales de la carrera de medicina en la Facultad de Ciencias Médicas de Bayamo no está acorde a las nuevas exigencias al currículo, que demanda nuestra sociedad debido a las insuficiencias en el proceso de formación de la cultura ambiental en la carrera de medicina.

A study was conducted with the objective of focusing attention on reflecting on the importance of the formation of environmental culture in the medical career, of relevance in the medical community and in society. Methods such as: analysis and synthesis, inductive-deductive, modeling, documentary analysis, dialectical hermeneutics were used. The application of the experimental methods allowed the elaboration of a model for the formation of the environmental culture in the professionals of the medical career with a holistic-configurational base when revealing the logic of the formation of this contextualized culture is projected as a solution of impact on the insufficiencies found with significance, transformation and systematization, in medical practice. The training of medical career professionals at the Faculty of Medical Sciences of Bayamo is not in line with the new requirements of the curriculum, which our society demands due to the inadequacies in the process of formation of environmental culture in the medical career.

Foi realizado um estudo com o objetivo de focalizar a atenção na reflexão sobre a importância da formação da cultura ambiental na carreira médica, de relevância na comunidade médica e na sociedade. Foram utilizados métodos como: análise e síntese, indutivo-dedutivo, modelagem, análise documental, hermenêutica dialética. A aplicação dos métodos experimentais permitiu a elaboração de um modelo para a formação da cultura ambiental nos profissionais da carreira médica com base holístico-configuracional ao revelar a lógica da formação dessa cultura contextualizada como uma solução de impacto nas insuficiências encontradas com significado, transformação e sistematização, na prática médica. A formação de profissionais da carreira médica na Faculdade de Ciências Médicas de Bayamo não está de acordo com os novos requisitos do currículo exigidos por nossa sociedade devido às inadequações no processo de formação da cultura ambiental na carreira médica.

Current State of Research on the Risk of Morbidity and Mortality Associated with Air Pollution in Korea

PURPOSE: The effects of air pollution on health can vary regionally. Our goal was to comprehensively review previous epidemiological studies on air pollution and health conducted in Korea to identify future areas of potential study. MATERIALS AND METHODS: We systematically searched all published epidemiologic studies examining the association between air pollution and occurrence of death, diseases, or symptoms in Korea. After classifying health outcomes into mortality, morbidity, and health impact, we summarized the relationship between individual air pollutants and health outcomes. RESULTS: We analyzed a total of 27 studies that provided 104 estimates of the quantitative association between risk of mortality and exposure to air pollutants, including particulate matter with aerodynamic diameter less than 10 µm, particulate matter with aerodynamic diameter less than 2.5 µm, sulfur dioxide, nitrogen dioxide, ozone, and carbon monoxide in Korea between January 1999 and July 2018. Regarding the association with morbidity, there were 38 studies, with 98 estimates, conducted during the same period. Most studies examined the short-term effects of air pollution using a time series or case-crossover study design; only three cohort studies that examined long-term effects were found. There were four health impact studies that calculated the attributable number of deaths or disability-adjusted life years due to air pollution. CONCLUSION: There have been many epidemiologic studies in Korea regarding air pollution and health. However, the present review shows that additional studies, especially cohort and experimental studies, are needed to provide more robust and accurate evidence that can be used to promote evidence-based policymaking.

Health effects of particulate matter

Particulate matter is an air pollutant emitted from both natural and anthropogenic sources, and its adverse health effects have been well documented in time-series analyses and cohort studies. The effect size of particulate matter exposure—a roughly 0.5% increase in mortality for each 10 µg/m³ increment of short-term exposure to particulate matter with aerodynamic diameter ≤10 µm and approximately a 10% increase for each 10 µg/m³ increment of long-term exposure to particulate matter with aerodynamic diameter ≤2.5 µm—is small compared to other risk factors, but the exposure is involuntary and affects the entire population, which makes particulate matter pollution an important public health issue. The World Health Organization and Korean government have both established guidelines for particulate matter concentrations, but the Korean guideline is less stringent than that of the World Health Organization. The annual mean concentration of particulate matter in Korea is decreasing, but the trend seems to be slowing. In addition to policy efforts to reduce particulate matter emission, personal approaches such as the use of face masks and air purifiers have been recommended. Personal approaches may not solve the fundamental problem, but can provide temporary mitigation until efforts to reduce emission make progress.

Expert clinician's perspectives on environmental medicine and toxicant assessment in clinical practice

BACKGROUND@#Most clinicians feel ill-equipped to assess or educate patients about toxicant exposures, and it is unclear how expert environmental medicine clinicians assess these exposures or treat exposure-related conditions. We aimed to explore expert clinicians' perspectives on their practice of environmental medicine to determine the populations and toxicants that receive the most attention, identify how they deal with toxicant exposures and identify the challenges they face and where they obtain their knowledge.@*METHODS@#A qualitative study involving semi-structured interviews with expert environmental clinicians in Australia and New Zealand was conducted. Interviews were recorded and transcribed, and themes were identified and collated until no new themes emerged.@*RESULTS@#Five dominant themes emerged from 16 interviews: (1) environmental medicine is a divided profession based on type of practice, patient cohort seen and attitudes towards nutrition and exposure sources; (2) clinical assessment of toxicant exposures is challenging; (3) the environmental exposure history is the most important clinical tool; (4) patients with environmental sensitivities are increasing, have unique phenotypes, are complex to treat and rarely regain full health; and (5) educational and clinical resources on environmental medicine are lacking.@*CONCLUSIONS@#Environmental medicine is divided between integrative clinicians and occupational and environmental physicians based on their practice dynamics. All clinicians face challenges in assessing toxicant loads, and an exposure history is seen as the most useful tool. Standardised exposure assessment tools have the potential to significantly advance the clinical practice of environmental medicine and expand its reach across other clinical disciplines.

Environmental parasitology: soil analysis for geohelminth larvae contamination in Ilhéus, Bahia

The study of parasitic soil contamination is important for monitoring biohazards in densely populated areas or those with high anthropic activities. The present study quantified geohelminth larvae in two estuaries in the urban area of Ilhéus, Bahia; one to the north, formed by the Almada River and another to the south, in the Pontal Bay. The collections were performed following standard methodology considering climactic conditions and local tide tables; the Rugai method with modifications was used to analyze soil sediments. Morphological results showed a significantly higher number of Strongyloides stercoralis larvae in the estuary of the Almada River from September to December, coinciding with higher temperatures and lower rainfall and humidity. However, there was significant variation in climatic conditions and in the classification of anthropic activity interfering in the frequency and diversity of soiltransmitted helminth larvae, which justifies its monitoring to ensure environmental health in areas frequented by residents and tourists in Ilhéus, Bahia.

Revisão sistemática sobre a epidemiologia das doenças cardiovasculares e respiratórias e suas associações com a poluição do ar em Vitória/ES / Epidemiology of cardiovascular and respiratory diseases and its associations with air pollution in Vitória, Brazil: a systematic review

Introdução: A poluição do ar é um importante fator ambiental relacionado a doenças crônicas não transmissíveis, como doenças cardiovasculares e respiratórias. Essa relação torna-se importante em cidades com alta atividade industrial, como Vitória/ES. Esta pesquisa utilizou três revisões sistemáticas (RSs) distintas para avaliar a epidemiologia das doenças cardiovasculares (RS1), a epidemiologia das doenças respiratórias (RS2) e a associação entre poluição do ar e doenças cardiorrespiratórias (RS3) na cidade de Vitória. Métodos: A busca bibliográfica considerou três bases de dados (PubMed, Scopus e LILACS). Foi estabelecida uma quantidade mínima de três estudos para a condução de metanálises. A heterogeneidade de cada análise foi calculada pelo índice I2. Resultados: A busca bibliográfica resultou em 1.205 registros, dos quais 27 foram incluídos ­ 17 na RS1, cinco na RS2 e cinco na RS3. Apenas dois desfechos puderam ser avaliados por meio de metanálises: prevalência de hipertensão e prevalência de asma em crianças. Estima-se uma prevalência de 34% (IC95%: 24-45) de hipertensão e de 12% (IC95%: 1-32) de asma em crianças. Os poluentes mais avaliados foram MP10 e SO2, para os quais não se pôde realizar metanálises. Todas as análises apresentaram baixo número de registros incluídos e alta heterogeneidade. Conclusão: Há poucos dados disponíveis sobre a associação de doenças cardiorrespiratórias e poluição ambiental em Vitória. A heterogeneidade, a diversidade de desfechos e a baixa quantidade de estudos impediram a condução de análises mais profundas e limitaram o poder de síntese e conclusão dessas revisões, impossibilitando uma avaliação adequada dos objetivos propostos. São necessários mais estudos epidemiológicos com amostras de grande porte e representativas para que se tenha resultados conclusivos sobre a relação entre poluição ambiental e doenças cardiorrespiratórias em Vitória (AU)

Introduction: Air pollution is an important environmental factor related to chronic non-transmittable diseases, including cardiovascular and respiratory diseases. This relationship is especially relevant in cities with high industrial activity, such as Vitória, Brazil. This research used three systematic reviews (SRs) to evaluate the epidemiology of cardiovascular diseases (SR1), the epidemiology of respiratory diseases (RS2), and the association between air pollution and cardiorespiratory diseases (RS3) in Vitória, Brazil. Methods: A bibliographic search was conducted in three independent databases (PubMed, Scopus and LILACS). A minimum amount of three studies was established to perform meta-analyses. Heterogeneity was calculated using the I2 index. Results: The bibliographic search retrieved 1205 references, of which 27 were included ­ 17 in SR1, five in SR2, and five in SR3. Only two outcomes could be evaluated through meta-analysis: prevalence of hypertension and prevalence of asthma in children. The most frequently evaluated pollutants were PM10 and SO2. The estimated prevalence of hypertension was 34% (CI95%: 24-45) and of asthma in children was 12% (CI95%: 1-32). All analyses had a limited number of included references and showed high heterogeneity. Conclusions: There are limited data available regarding the association of cardiorespiratory diseases and air pollution in Vitória, Brazil. The heterogeneity, the diversity of outcomes, and the limited number of studies hampered the performance of a more detailed analysis and limited the conclusions of these reviews, preventing a proper appraisal of the proposed aims. Further epidemiological studies with bigger and more representative sample sizes are needed to generate conclusive data about the relationship between air pollution and cardiorespiratory diseases in Vitória, Brazil (AU)

Residency programs and the outlook for occupational and environmental medicine in Korea

OBJECTIVES: This study investigated the implementation of training courses and the overall outlook for occupational and environmental medicine (OEM) in Korea. We described the problems facing OEM residency programs in Korea, and reviewed studies dealing with the specialty of occupational health in developed countries in order to suggest directions of improvement for the OEM training courses. METHODS: We surveyed 125 OEM residents using a questionnaire in August 2012. A total of 23 questions about the training environment, residency programs, preferred institutions for post-licensure employment, and the outlook for OEM specialists were included in the questionnaire and analyzed according to the type of training institution and residency year. Responses from 88 residents (70.4 %) were analyzed. RESULTS: The major responsibilities of OEM residents were found to vary depending on whether they were trained in research institutes or in hospitals. OEM residents had a lower level of satisfaction with the following training programs: toxicology practice (measurements of biological markers, metabolites, and working environments), and OEM practice (environmental diseases and clinical training involving surgery). When asked about their eventual place of employment, OEM residents preferred institutions providing special health examinations or health management services. OEM residents reported a positive outlook for OEM over the next 5 years, but a negative outlook for the next 10 years. CONCLUSIONS: Although a standardized training curriculum for OEM residents exists, this study found differences in the actual training courses depending on the training institution. We plan to standardize OEM training by holding a regional conference and introducing open training methods, such as an open hospital system. Use of Korean-language OEM textbook may also reduce differences in the educational programs of each training institution. Toxicology practice, environmental diseases, and clinical training in surgery are areas that particularly need improvement in OEM residency training programs.

Fatores ambientais e risco de quedas em idosos: revisão sistemática / Environmental hazards and risk of fall in the elderly: systematic review

A queda em idosos é resultado de uma interação complexa entre fatores intrínsecos e extrínsecos. Embora seja difícil separar esses fatores, estudos apontam que fatores de risco ambientais estão presentes em aproximadamente 40% das quedas. O objetivo deste estudo foi realizar uma revisão sistemática da literatura sobre o envolvimento de fatores ambientais nas quedas em idosos vivendo na comunidade. Para tanto, foram selecionados estudos publicados no período de janeiro de 2000 a maio de 2014 nas bases de dados eletrônicas MEDLINE, LILACS e SciELO. Apenas artigos disponíveis na íntegra e em inglês, português e espanhol foram considerados para esta revisão. Após a análise do título, do resumo e do texto na íntegra, dez artigos foram incluídos na revisão. Nos estudos analisados, aproximadamente metade das quedas ocorreu durante a locomoção e envolveu tropeços e escorregões. Os fatores de risco ambientais estão muito presentes nas quedas (20-58%), sendo que superfícies irregulares, superfícies molhadas/escorregadias, objetos/tapetes soltos e desníveis no chão/problemas com degraus foram os mais prevalentes. Observou-se tendência de aumento na ocorrência de quedas em ambientes externos, as quais são frequentemente precipitadas por fatores extrínsecos. Mais estudos são necessários na caracterização e no desenvolvimento de estratégias de prevenção de quedas em ambientes externos.

Falls in the elderly is the result of a complex interplay between intrinsic and extrinsic factors. Although it is difficult to separate these factors, studies indicate that environmental hazards are involved in approximately 40% of the falls. This study aimed to conduct a systematic review about the contribution of environmental hazards for falls in community-dwelling elderly. Studies published from January 2000 to May 2014 in the electronic databases MEDLINE, LILACS and SciELO were selected. Only free full-text articles written in English, Portuguese and Spanish were considered for this research. After title, abstract and full text analysis, ten articles were included in this review. In the studies analyzed, approximately half of the falls occurred during walk and involved tripping and slipping. The environmental risk factors are present in falls (20-58%), in which irregular surfaces, wet/slippery floors, objects/loose rugs and uneven floor/steps were the most prevalent hazards among the studies. There was tendency of increase in the occurrence of outdoor falls, which are often caused by extrinsic factors. More studies are needed to characterize and develop strategies to prevent outdoor falls among community-dwelling older adults.

El Estado y la educación Ambiental Comunitaria en el Perú / The State and community Environmental Education in Peru

La salud ambiental, según la organizacòn Mundial de la Salud es "una disciplina que comprende aquellos aspectos de la Salud_humana, incluìda la calidad de vida, el bienestar social,entre otros, que son determinados por factores ambientales físicos; químicos, biológicos, sociales y psicosociales. También se refiere a la teoría y práctica de evaluar, corregir, controlar y prevenir aquellos factores en el medio ambiente que pueden potencialmente afectar adversamente la salud de presentes y futuras generaciones". En este contesto la cultura ambiental es fundamental en una sociedad para establecer conductas y corrientes de opiniòn tendientes al cuidado del ambiente asociado a la salud.

Environmental health, according to the World Organizacon of Health is "a discipline that comprises those Salud_humana aspects, including quality of life, social welfare, etc., which are Physical determined by environmental factors; chemical, biological, social and psychosocial. It also refers to the theory and practice of assessing, correcting, controlling and preventing those factors in the environment that can potentially affect adversely the health of present and future generations". This answer is critical environmental culture in a society to establish behaviors and current opinion aimed at caring for the environment associated health.

Underwater and Hyperbaric Medicine as a Branch of Occupational and Environmental Medicine

Exposure to the underwater environment for occupational or recreational purposes is increasing. As estimated, there are around 7 million divers active worldwide and 300,000 more divers in Korea. The underwater and hyperbaric environment presents a number of risks to the diver. Injuries from these hazards include barotrauma, decompression sickness, toxic effects of hyperbaric gases, drowning, hypothermia, and dangerous marine animals. For these reasons, primary care physicians should understand diving related injuries and assessment of fitness to dive. However, most Korean physicians are unfamiliar with underwater and hyperbaric medicine (UHM) in spite of scientific and practical values. From occupational and environmental medicine (OEM) specialist's perspective, we believe that UHM should be a branch of OEM because OEM is an area of medicine that deals with injuries caused by physical and biological hazards, clinical toxicology, occupational diseases, and assessment of fitness to work. To extend our knowledge about UHM, this article will review and update on UHM including barotrauma, decompression illness, toxicity of diving gases and fitness for diving.

A pragmatic & translational approach of human biomonitoring to methyl isocyanate exposure in Bhopal.

Human biomonitoring has evolved beyond margins to ascertain exposure-response relationship in environmental associated human diseases. As occupational ailments continue to dominate global concerns, biomonitoring strategies have evolved better in terms of evaluating health risks associated with systemic uptake from chronic (long-term) environment exposures. Even though contributions of acute toxic exposures (short-term) towards initiation of disease processes have been gradually recognized, a comprehensive approach delineating mechanistic insights of such an implication remains elusive. Molecular biomonitoring in a strictly selected defined surviving cohort of the infamous Bhopal gas tragedy “as a model”, could provide an unparallel opportunity to discern the long standing implications of acute exposures. Besides comprehending clinical significance of isocyanate toxicity, the results might provide a framework for understanding the molecular repercussions pertaining to a host of other such acute environmental exposures. The investigative strategy might also be helpful in identification of biomarkers with potential for translational research.

Pediatria ambiental: um tema emergente / Environmental pediatrics: an emerging issue

OBJETIVO: Revisar os artigos mais relevantes sobre a pediatria ambiental, seus efeitos potenciais para a saúde e, especialmente, seus avanços na prevenção. FONTES DOS DADOS: Foi realizada uma pesquisa utilizando as bases de dados MEDLINE/PubMed e SciELO. Foram revisados artigos de 1990 a 2010, além de capítulos de livros relacionados à pediatria ambiental. SÍNTESE DOS DADOS: Há uma variedade significativa de fatores que tornam as crianças altamente vulneráveis à exposição a riscos ambientais, associados principalmente ao consumo comparativamente maior de água, comida e ar por parte da criança, em relação ao seu peso corporal. De acordo com a Organização Mundial de Saúde, mais de 3 milhões de crianças menores de 5 anos morrem devido a doenças relacionadas ao meio ambiente. Aproximadamente 30-40 por cento das doenças pediátricas estão relacionadas a fatores ambientais. As crianças estão constantemente expostas a vários riscos ambientais para a saúde, dentre os quais se destacam: água contaminada, falta de condições adequadas de saneamento, poluição do ar, vetores de doenças, perigos químicos, injúrias e acidentes. CONCLUSÕES: Atualmente, os pediatras são desafiados a tratar das necessidades de saúde ligadas à pediatria ambiental. A história pediátrica deve ser mais abrangente, acrescentando-se questões pontuais que ajudem a identificar potenciais riscos ambientais. A conscientização e o entendimento sobre os efeitos nocivos das várias condições ambientais e o conhecimento sobre as medidas de prevenção relacionadas resultarão em intervenções oportunas e adequadas que melhorarão a saúde e o desenvolvimento das nossas crianças.

OBJECTIVE: To review the most relevant articles regarding environmental pediatrics, its potential effects on health, and especially its advances in prevention. SOURCES: A literature search was conducted using MEDLINE/PubMed and SciELO databases. Articles from 1990 to 2010 were reviewed, in addition to book chapters related to environmental pediatrics. SUMMARY OF THE FINDINGS: There is a significant variety of factors that make children highly vulnerable to environmental hazard exposure, which are mainly associated with children’s comparatively greater consumption of water, food, and air in relation to body weight. According to the World Health Organization, every year more than 3 million children under the age of 5 die because of environment-related conditions. Approximately 30 to 40 percent of pediatric diseases are related to environmental factors. Children are constantly exposed to various environmental health hazards, among which the following stand out: contaminated water, lack of adequate sanitation facilities, air pollution, disease vectors, chemical hazards, injuries, and accidents. CONCLUSIONS: Nowadays, pediatricians are challenged to address environmental pediatrics health care needs. The pediatric health history needs to be more comprehensive by adding pointed questions to help identify potential environmental risks. Awareness and understanding of the noxious effects of various environmental conditions and knowledge of the related prevention measures will result in timely and adequate interventions that will improve our children’s health and development.

Estimation of Demand and Supply for Occupational and Environmental Medicine Specialties in Korea (I): Estimation of Supply / 대한산업의학회지

OBJECTIVES: To estimate the supply of occupational and environmental medicine specialties in the target year of 2020. METHODS: We adopted alternative projection models combined with a demographic method as a supply forecasting method. The model uses data selected primarily from the database of the Korean Society of Occupational and Environmental Medicine (KSOEM), a survey for certified members of KSOEM, audit data from the Ministry of Employment and Labor (MOEL) and Hospital Accreditation. We assumed five viable alternatives in supply forecasting. RESULTS: Depending on the assumptions, the total occupational and environmental medicine specialties supply ranged from 706 by low-level supply estimates to 754 by high-level supply estimates in 2020. Among them, approximately 81% were estimated to engage themselves in agency for health management and periodic health examinations for workers exposed to hazards. CONCLUSIONS: The study results suggest that the supply of occupational and environmental medicine specialties is related to the policy of MOEL. Further studies are needed concerning overall policy about health and safety and for the newly demanded market.

Discussion on medical biometeorological pathogenesis of respiratory tract diseases / 国际中医中药杂志

Based on the findings of the past five decades, the seasonal regularity of respiratory disease was summed leading to respiratory tract diseases were summed up.

A Clinical Review of Acute Mountain Sickness

PURPOSE: Rapid ascent from low to high altitude (above 2500 m) often causes acute mountain sickness (AMS), a symptom-complex characterized by headache and other systemic symptoms (gastrointestinal upset, weakness, dizziness, and difficulty sleeping). In this study, we observed the vital signs and AMS symptoms. 13 participants in a mountain climb in order to determine correlation between AMS and risk factors such as obesity, smoking, and a previous history of AMS. METHODS: We studied 13 participants who climbed Mt.Cholatse (6440 m), and measured their vital signs and symptoms during the trekking. Standard Lake Louise questionnaires were filled out at five times during the trek: at the sea level, 2700 m, 3440 m, 4040 m, and 4700 m. With AMS scores and severity grades, we evaluate the severity of symptoms and the physical status. RESULTS: The overall AMS score was 3.7+/-.5, and headache was the most frequent symptom. As the altitude increased, oxygen saturation decreased whereas other vital signs (blood pressure, respiratory rate, and pulse rate) increased. The average AMS scores and severity grades increased more rapidly for obese men than for non-obese men (p<0.001). Smoking and previous history of AMS were also associated with the development of AMS (p<0.001). CONCLUSION: Persons who are obese or have a history of a smoking or AMS, are more likely to develop AMS symptoms. Further understanding of the natural and evolution of AMS and of the risk factors associated with AMS will educate the general population and physicians and help in its prevention and treatment.

Residency Programs for Occupational and Environmental Medicine in Korea / 한국의학교육

PURPOSE: This study was performed to obtain baseline information about the occupational and environmental medicine(OEM) residency programs in Korea. METHODS: We surveyed 39 residents for the present training condition, satisfaction, vision of OEM, the condition and satisfaction after residency programs by self- administered questionnaire. RESULTS: Residents want to get appropriate clinical and practical training to be a medical director in a factory or specialist of the occupational medicine based at a hospital. They report, however, that current system for OEM residency training program is not appropriate. The curricula, duration of the each curriculum, level of training hospital or institute need to be reconsidered. CONCLUSIONS: We need to develop more systematic residency program with support from government and OEM society.

PAY MORE ATTENTION TO THE RESEARCH ON WAR INJURIES IN TROPICAL REGION / 解放军医学杂志

The research on war injuries in tropical areas is an important subject to be urgently dealt with at present in Chinese military medicine. Military medicine related to hot and humid environment is a significant branch of military environmental medicine. More efforts should be made in the research on care of war injuries as well as on military hygiene and military epidemiology so as to establish an integrated system involving basic and clinical science and art in military environmental medicine in hot and humid areas, which should be considered as an important task in the transition of our military strategy to win a war with improvement in the military medical support capability in a local high technicology conflict in such an area. In this paper, the significance of paying more attention to the research on the care of war injuries in hot and humid areas is emphasized, their features are highlighted, and main problems demanding further research are proposed.