A Study on Prevalence and Risk Factors for Varicose Veins in Nurses at a University Hospital.

BACKGROUND: Lower-limb varicose veins (VVs) are common and known to have a higher prevalence among people who work in occupations requiring prolonged standing. In the Republic of Korea, however, VV-related occupational factors have seldom been examined. This study was conducted to assess the prevalence of VVs among nurses, an occupational group considered to be at high risk of VVs, and determine the occupational risk factors of prolonged standing. METHODS: Between March and August 2014, a questionnaire survey coupled with Doppler ultrasonography was conducted on the nurses working at a university hospital. RESULTS: A total of 414 nurses participated in the survey and diagnostic testing. From the survey analysis and test results, the prevalence of VVs in nurses was estimated to be 16.18%. Significant factors for venous reflux were age [odds ratio (OR) = 1.06, 95% confidence interval (CI) = 1.03-1.10], pregnancy (OR = 2.15, 95% CI = 1.17-3.94), and delivery (OR = 2.02, 95% CI = 1.08-3.78). The statistical significance of these factors was verified after risk adjustment for sociodemographic factors (OR = 3.40, 95% CI = 1.27-9.09). CONCLUSION: Factors significantly associated with venous reflux were increasing age and prolonged working hours (≥ 4 hours) in a standing position (OR = 2.80, 95% CI = 1.08-7.25), even after risk adjustment for sociodemographic factors. This study is significant in that an objective diagnosis of VVs preceded the analysis of the risk factors for VV incidence, thus verifying objectively that VVs are associated with occupations requiring prolonged hours of working in a standing position.

Association between shift work and obesity according to body fat percentage in Korean wage workers: data from the fourth and the fifth Korea National Health and Nutrition Examination Survey (KNHANES 2008-2011).

BACKGROUND: Health problems in shift workers vary including obesity acting as a risk factor in cerebrovascular diseases. Recent studies have commonly determined the prevalence of obesity in shift workers on the basis of body mass index. The accuracy of BMI for diagnosing obesity are still limited apparently. Consequently, this study aimed to determine the relationship between shift work and obesity according to the total body fat percentage in Korean wage workers. METHODS: From the Fourth and the Fifth Korea National Health and Nutrition Examination Survey (2008-2011), after military personnel were excluded, a total of 2952 wage workers (20 ≤ age ≤ 65) whose current jobs were their longest jobs were selected as subjects of the study. The total body fat percentage was used to determine the obesity standards (≥25.7 % in males and ≥36.0 % in females). The subjects were divided into groups by gender and work type (manual vs non-manual), and chi-squared test was used to evaluate the relationship between socio-economic, health behavior, and work-related factors, on the one hand, and obesity, on the other. In addition, multivariate logistic regression analysis was performed to examine the effects of shift work on obesity. RESULTS: When other factors were controlled for, the risk of obesity in shift work showed a statistically significant increase (odds ratio = 1.779, 95 % confidence interval = 1.050-3.015) in the male manual worker group. However, there were no significant results in the male non-manual and female worker groups. CONCLUSION: Shift work was related to a higher risk of obesity in the Korean male manual worker group.

A case of complicated silicosis with a complex clinical course in a glass manufacturing worker.

We reported a case of complicated silicosis that occurred in a glass manufacturing plant worker who had presumably been exposed to low-concentration free silica for almost 20 years. To the best of our knowledge this report is the first in the Republic of Korea. The physician's first impression was cancer since the enlargement of neck and supraclavicuar lymph nodes had clearly progressed and metastasis was suspected in ultrasonography. However, it turned out to be reactive hyperplasia and anthracosis. Although lung cancer was suspected and tests were performed in 2 hospitals due to repetitive cough and dyspnea, along with weight loss of approximately 10% over the course of 7 months, the patient was eventually diagnosed with complicated silicosis and pneumothorax occurred after 1 year. Herein, we report this case with a literature review.

Malignant fibrous histiocytoma of the maxillary sinus in a spray painter from an automobile repair shop.

BACKGROUND: We report a case of a spray painter who developed malignant fibrous histiocytoma (MFH) of the maxillary sinus following long-term exposure to chromium, nickel, and formaldehyde, implying that these agents are probable causal agents of MFH. CASE REPORT: The patient developed right-sided prosopalgia that began twenty months ago. The symptom persisted despite medical treatment. After two months, he was diagnosed with MFH through imaging studies, surgery, and pathological microscopic findings at a university hospital in Seoul. His social, medical, and family history was unremarkable.The patient had worked for about 18 years at an automobile repair shop as a spray painter. During this period, he had been exposed to various occupational agents, such as hexavalent chromium, nickel, and formaldehyde, without appropriate personal protective equipment. He painted 6 days a week and worked for about 8 hours a day.Investigation of the patient's work environment detected hexavalent chromium, chromate, nickel, and formaldehyde. CONCLUSIONS: The study revealed that the patient had been exposed to hexavalent chromium, formaldehyde, and nickel compounds through sanding and spray painting. The association between paranasal cancer and exposure to the aforementioned occupational human carcinogens has been established. We suggest, in this case, the possibility that the paint spraying acted as a causal agent for paranasal cancer.

Sexual activity and hepatitis B and C virus infection among young adults after introduction of a vaccination program in an area of high endemicity.

BACKGROUND: In areas where hepatitis is endemic, little is known about the sexual transmission of HBV after introduction of an HBV vaccination program. METHODS: We used a self-administered questionnaire and serological tests for HBsAg, anti-HBs, anti-HBc, and anti-HCV to examine the role of sexual activity, as well as sociodemographic status, lifestyle habits, and a history of vaccinations, transfusions, and surgery, in the transmission of HBV and HCV in Korea. The subjects were 865 female and 541 male university students (median age, 19 years; age range, 16-25). RESULTS: Overall seropositivity was 8.1% for HBsAg, 69.3% for anti-HBs, 21.3% for anti-HBc, and 0.4% for anti-HCV. Regarding HBV, 8% of the subjects were chronic carriers or had recently been infected, 22.8% were never exposed and nonvaccinated, 16.6% were exposed noncarriers, and 52.7% had most likely been vaccinated. We found a significant association between HBsAg seropositivity and history of sexual intercourse (Odds Ratio, 1.8; 95% CI, 1.1-2.8). Students without serologic evidence of immunization against HBV were more likely to have become HBsAg-positive after becoming sexually active. CONCLUSIONS: Our findings suggest that sexual transmission does occur among adolescents and young adults who have not been vaccinated, whereas vaccination protects individuals from becoming an HBV carrier after becoming sexually active.

[The relationship between ACE I/D polymorphism and HDL cholesterol].

OBJECTIVES: The purpose of this study is to evaluate the association of the angiotensin converting enzyme (ACE) insertion/deletion (I/D) polymorphism with cardiovascular disease risk factors. METHODS: Out of a total of 608 middle-aged adults who visited local health centers, 424 subjects (104 male, 320 female) who had not been diagnosed with hypertension, diabetes mellitus, or hyperlipidemia were included in this study. ACE genotypes were determined in all subjects by polymerase chain reaction methods. RESULTS: Statistical differences in high-density lipoprotein (HDL) cholesterol levels according to ACE genotype were observed using ANOVA (p<0.05), but no differences were found in other cardiovascular risk factors. Specifically, men with the DD and DI genotypes had significantly lower HDL cholesterol levels than those with the II genotype based on the LSD multi-comparison test (p<0.05). CONCLUSIONS: In men, the D-allele of the ACE I/D polymorphism was significantly associated with reduced HDL cholesterol levels. In the future, larger studies are needed to confirm this relationship between ACE I/D polymorphism and HDL cholesterol.

[The relationship between regional material deprivation and the standardized mortality ratio of the community residents aged 15-64 in Korea].

OBJECTIVES: This study was performed to investigate the relationship between regional material deprivation and the standardized mortality ratios(SMRs) of community residents aged 15-64 in Korea. METHODS: SMRs were investigated using the registered death data from 1995 to 2000 that was obtained from the Korean National Statistics Office with the denominators being drawn from the 1995 to 2000 census. Material deprivation was measured using the Townsend score that was calculated from the 1995 to 2000 census. The relationship between the regional material deprivation and the SMRs of the community residents aged 15-64 was investigated by using ANOVA, Spearman's rank correlation analysis and Pearson's correlation analysis. The trends in mortality inequality were investigated using the concentration index. RESULTS: On the ANOVA, the SMRs of the men and women residents in the least deprived areas were the smallest and those in the most deprived areas were the largest. Spearman's rank correlation analysis, Pearson's correlation analysis and the concentration index revealed that significant positive relationships exist between the regional material deprivation and the SMRs of the community residents aged 15-64. CONCLUSIONS: This study suggests that there are mortality inequalities among the communities in Korea and part of this difference is due to the material deprivation of the community. Strategies aimed at reducing mortality inequalities among the communities will be needed to address economic inequalities. Further studies are needed to explore the mechanisms of how the regional deprivation influences on health and how the other factors of the community influence on the health of the community residents.

[Epidemiologic study of Clonorchis sinensis infestation in a rural area of Kyongsangnam-do, South Korea].

OBJECTIVES: To investigate the prevalence of Clonorchis sinensis infestation and to determine the associated risk factors among a population in a part of the rural area of Gyeongsangnam-do, Korea, which is an area known to have a high mortality from liver cancer and a high infection of C. sinensis. METHODS: The study population consisted of those people who have lived in rural areas and who were over 40 years old. This study was performed in 5 areas during the period from 1999 to 2003. Informed consents were obtained from the 2,381 study participants, and these people were interviewed about their life style habits with using the structured questionnaire that was administered by trained staff members. The subjects underwent blood sampling and their stool specimens were examined by using the Formalin-ether sedimentation technique. RESULTS: Among the study subjects (N=2,381), the positivity for C. sinensis in the stool was 34.4% (95% CI= 36.3-42.5); it was 39.4% (95% CI=36.3-42.5) in the males and 30.9% (95% CI=28.5-33.3) in the females. The positivity for C. sinensis was associated with current alcohol drinking (odds ratio=1.8, 95% CI: 1.5-2.1) and raw fish consumption (odds ratio 1.2, 95% CI: 0.9-1.6). CONCLUSION: The present study confirmed the high prevalence of C. sinensis in the study subjects. It is necessary to establish consistent medical management and education programs for the treatment and prevention of C. sinensis infestation in the rural inhabitants of Korea.

Occupations and Parkinson's disease: a multi-center case-control study in South Korea.

OBJECTIVE: We performed a hospital based case-control study in South Korea (1) to clarify the role of occupational exposure, and especially manganese (Mn) exposure in the etiology of Parkinson's disease (PD) and (2) to discover the association between any occupations and PD. METHODS: We selected two groups, PD patient group (N1) and controls (N2). Three hundred sixty-seven consecutive outpatients with PD (177 men, 190 women) and 309 controls were interviewed about life style, past history, family history, education level, and occupational history etc. We employed a range of industrial categories as defined by section (the most broad category) and division (sub-category) of the Korea Standard Industry Code (KSIC) Manual. Along with KSIC, we also used the Korea Standard Classification of Occupations (KSCO) as proxies of occupational exposure. The odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for age, sex, smoking status, and education level are presented. RESULTS: As regarding the exposure to hazardous materials, especially Mn, more subjects in the control group than the PD patient group have worked in the occupations with potential exposure to Mn (P < 0.001). Ever having worked in 'agriculture, hunting, and forestry' section of industry was positively associated with PD (OR 1.88), and 'agriculture production crops (OR 1.96)' division of industry was positively associated with PD. On the other hand, ever having worked in the 'manufacturing (OR 0.56)', 'transportation (OR 0.28)' section of industry, and 'transporting (OR 0.20)' division of industry were negatively associated with PD. 'Drivers (OR 0.13)' division of occupation also was negatively associated with PD. CONCLUSIONS: To our knowledge, this is the first case-control studies to find an inverse relationship between 'transporting' or 'technicians like machinery engineers' as his/her longest job and PD risk. Because of this unexpected finding, our work should be replicated in various populations.

Occupations and Parkinson's disease: a case-control study in South Korea.

We performed a hospital based case-control study in the southeast region of Korea to clarify the role of occupational exposure, especially manganese (Mn), in the etiology of Parkinson's disease (PD) and to discover the association between any occupation and PD. 105 outpatients with PD and 129 neurological disease controls and 101 healthy controls were interviewed. We employed occupational and industrial categories as defined by Section (the most broad category) and Division (sub-category) of the Korea Standard Industry Code and the Korea Standard Classification of Occupations. There was not a significant association between exposure to hazardous materials, especially Mn and PD. There were not any occupations listed under the Section of Industry Classification as a significant risk factor or protective factor for PD. However, the 'clerk' occupation [Section] was positively associated with PD. There is a decreased risk for PD with a subject ever having worked in the 'agriculture, forestry and fishery' occupational group. Ever having worked in 'sales' also was negatively associated with PD. There were not any Divisions of Industry found as a significant risk factor or protective factor for PD. However, ever having worked in an 'agriculture' Division of Occupation was negatively associated with PD.

Prevalence and determinants of genital infection with papillomavirus, in female and male university students in Busan, South Korea.

BACKGROUND: Little is known about the prevalence of human papillomavirus (HPV) infection in young adults in Asia. METHODS: We invited female and male students in Busan, South Korea, to participate in a survey that included, for females, self-collection of vaginal cells and, for males, physician-performed collection of exfoliated genital cells. The prevalences of 25 HPV types were evaluated, by a polymerase chain reaction-based assay, in 672 female students (median age, 19 years) and in 381 male students (median age, 22 years). RESULTS: HPV DNA was detected more frequently in female students (15.2%) than in male students (8.7%); in both sexes, high-risk HPV types were predominant. Among sexually active students, HPV prevalence was 38.8% in females and 10.6% in males. In female students, currently smoking cigarettes and having multiple lifetime sex partners were the strongest risk factors for HPV infection; in male students, associations between HPV prevalence and sexual habits were similar to those in female students but never attained statistical significance. CONCLUSIONS: Young women in South Korea start having penetrative sexual intercourse relatively late (median age, 18 years), but, once they begin, HPV prevalence quickly rises to levels comparable with those found in university students in the United States and in northern Europe. The high rate of participation in our study suggests that trials of new vaccines against HPV may be feasible among university students in South Korea.

A seroepidemiological Study of Hepatitis B and C Virus (HBV and HCV) Infections in the Young Population in parts of Busan, Korea.

OBJECTIVES: To investigate the prevalence of hepatitis B and C virus infections and determine the associated risk factors among young adults in Busan, Korea, which is known to have a high incidence of liver cancer. METHODS: The study population consisted of volunteer participants in a health survey during 2002, which included 1, 350 students (515 males and 835 females) aged between 16 and 24 years, from three different schools in Busan. The participating students were asked to fill in a selfadministered questionnaire which included lifestyle habits and risk factors of hepatitis. Sera obtained from the participants were studied for HBsAg, anti-HBs, and Anti- HCV by enzyme immunoassay (EIA) method and for liver function tests. RESULTS: Among the study subjects (N=1, 350), the seropositivities of HBsAg 7.9% (95% CI=7.8-8.0), 7.6% (95% CI=7.6-7.7) in male and 8.1% (95% CI=8.0-8.2) in female. And the seropositivity of Anti-HBs was 69.7% (95% CI=69.0- 70.4), 70.5% (95% CI=69.8-71.2) in male and 69.2% (95% CI=68.5-69.9) in female. The seropositivity of Anti-HCV was 0.4%, 0.2% in male and 0.5% in female. The seropositivity for HBsAg in the subjects not having a hepatitis B vaccination history was twice (95% CI=1.0-4.4) that of those that did. Also, the seropositivity for HBsAg in subjects having experienced sexual intercourse was 1.7 times (95% CI=0.9-3.0) that of the subjects who had not. CONCLUSIONS: The present study confirmed the high prevalence of HBsAg seropositivity and sexual transmission of HBV among adolescents and young adults may occur. Further studies to evaluate the relationship between HBV vaccination and sexual transmission are required for the young population in Korea.

Factors associated with cervical cancer screening in busan, Korea.

OBJECTIVE: Cervical cancer is the second most frequent cancer among women in Busan. The Pap smear test could have a significant effect on detecting cervical cancer, and enhancing their rate of use is an important strategy for reducing the incidence and mortality of cervical cancer. This study aimed to evaluate the factors associated with the past use of the Pap smear test in Korean women. METHODS: A population-based survey was carried out in Busan between November 1999 and March 2000. 1, 673 participants were randomly selected from 2, 684 women in Busan, using a 2-stage cluster sampling method, and interviewed in their homes. Their socio-demographic characteristics, smoking, drinking, familial cancer history, Pap smear screening history, reproductive and menstrual factors, sexual habits and use of contraceptive methods data were collected by a trained interviewer using a questionnaire. The use of the screening test was defined by a self-report from the participants on how many times they had had a Pap smear test in their lifetime, and when they had received their latest examination. RESULTS: Of the 1, 673 respondents (62.3% response rate), 57.6% had had a Pap smear test during her life (mean number, 2.3). Among the health examination participants (1, 064), 961 (90.3%) reported having sexual experience and 70.9% of these had had a Pap smear test. In a multiple logistic regression analysis, statistically significant relationships were observed for age groups and the Pap smear test rate (odds ratio, OR for 35-44 years=2.45; OR for 45-54 years=3.41; OR for 55 years=2.60; reference, under 34 years). The married or cohabiting women were more likely to have used the Pap smear test than those separated or widowed (OR=1.73). Among the reproductive behavioral measures, the number of births (OR for 3 births=4.22; OR for 2 births=3.95; OR for 1 births=3.38; reference, 0 births) and husband's extra-marital affairs (OR=1.50) were associated with the rates of use of Pap smear tests. CONCLUSIONS: It appears that the most important contributing factors to cervical cancer screening were age, marital status and number of births. A positive association was also observed for the husband's extra-marital affairs. This study enabled us to systematically assess the relationship between Pap smear rates and risk factors for cervical cancer. It is hoped that this study will make a significant contribution to the accumulating scientific evidence on the identification of factors associated with cervical cancer screening in Korea.

Prevalence of metabolic syndrome and waist circumference estimation in some korean adults.

OBJECTIVE: The purpose of this study was to estimate the prevalence of metabolic syndrome, as defined by the ATP III report, in some Korean adults and use the Asian-Pacific proposed waist circumference to investigate waist circumference in some Korean adults using ROC curves. METHODS: Study subjects were seventy-five thousands and ninety one persons (47, 979 men and 27, 111 women) who were selected among the patients who visited hospital for health evaluation from January 2000 to December 2001. All subjects were measured by height, weight, waist and hip circumferences, blood pressure and blood chemistry (lipid profile). RESULTS: The mean age was 41.6+/-8.5 years in men, 41.1+/-10.4 years in women (p< 0.05). Body mass index was in the normal range in 35.3% of men, and 55.9% of women. In both men and women, blood pressure, blood sugar, total cholesterol and triglyceride were positively correlated with BMI. waist circumference, and Broca's index (p< 0.01). However HDL. choloesterol was correlated negatively (p< 0.01). Using ROC curve, the calculated waist circumferences were 84 cm in men (sensitivity 61.4% and specificity 64.1%) and 74 cm in women (sensitivity 65.0% and specificity 73.2%). The age adjusted prevalences of the metabolic syndrome as defined by NCEP ATP III were different for men (6.4%) and women (14.6%). The prevalence increased from 1.2% among participants aged 20 through 29years to 15.0% among participants aged over 60years in men (p< 0.05) and from 1.6% to 27.4% respectively, in women. The age adjusted prevalences, as defined by using the waist circumference that was recommended by WHO's regional office for the western Pacific, were 10.6% in men and 18.5% in women. The age adjusted prevalences, as defined by using the waist circumference that was calculated by the ROC curves, were 17.1% in men and 22.4% in women. And All prevalences were increased following increased BMI and Broca's index. CONCLUSIONS: The prevalence of metabolic syndrome in some Korean adults was lower than that in western adults. Nevertheless because waist circumference was differed among race and region, application of the same criteria was not proper. Morcover, a higher awareness was required in women, because the prevalence of metabolic syndrome was rapidly increased with increment of age.

The relationship between cold exposure and hypertension.

This study was performed to determine whether there was any relationship between cold exposure and hypertension, and to evaluate risk factors affecting hypertension in cold-exposed workers. In 11 refrigeration industries, 68 male workers working in cold areas more than once per day were selected as the cold-exposed group, and 68 workers not exposed to cold were selected as the control group. The questionnaire survey, clinical and laboratory tests were performed. Systolic and diastolic blood pressures were significantly higher in the cold-exposed group, and body core temperature was significantly lower in the cold-exposed group (p<0.05). In logistic regression analysis, age, cold exposure severity and milk intake were significant variables affecting hypertension in cold-exposed workers, whose odd ratios were 5.204 (95% CI 1.440-18.812), 2.674 (95% CI 1.080-6.618), and 0.364 (95% CI 0.141-0.942), respectively. Cold exposure was a risk factor for hypertension, and risk factors affecting hypertension in cold exposed workers were age, cold exposure severity, and milk intake. Therefore, cold exposed workers should minimize cold exposure time as much as possible, and ingest foods containing calcium such as milk. In particular, old workers working in cold areas should check their blood pressure and electrocardiogram periodically.

Prevalence of human papillomavirus infection in women in Busan, South Korea.

To investigate the prevalence of and the risk factors for human papillomavirus (HPV) infection in South Korea, we interviewed and examined a randomly selected sample of 863 sexually active women (age range = 20-74 years, median 44) and 103 self-reported virgins from Busan. The presence of DNA of 34 different HPV types in cervical exfoliated cells was tested among sexually active women by means of a PCR-based assay. IgG antibodies against L1 virus-like particles (anti-VLPs) of HPV types 16, 18, 31, 33 and 58 were also evaluated by means of ELISA. The overall prevalence of HPV DNA was 10.4% (95% confidence interval, CI: 8.5-12.7%). The most often found HPV DNA types were HPV 70, HPV 16 and HPV 33; 19.8% (95% CI: 17.2-22.0) of sexually active women had antibodies against one or more HPV types. The most common anti-VLPs were against HPV 18, 31 and 16. Prevalences standardized by age on the basis of the world standard population were 13.0% for HPV DNA and 17.1% for anti-VLPs. The concordance between the 2 HPV markers at an individual level was modest, but the risk factors for detection of HPV DNA and anti-VLPs were similar: number of lifetime sexual partners (odds ratio, OR for >/= 4 vs. 1 = 3.5 and 5.4, respectively), seropositivity for herpes simplex virus-2 antibodies (OR = 2.6 and 2.5, respectively) and being single or divorced. HPV DNA, but not anti-VLPs, were elevated among women whose husbands were thought by their wives to have extra-marital affairs and those who had undergone vasectomy. Among 103 virgins, 4.9% had anti-VLPs (1/73 among those aged 24 years or less).