Burden of disease attributable to the Hebei Spirit oil spill in Taean, Korea.

OBJECTIVES: We aimed to assess the burden of disease (BOD) of the residents living in contaminated coastal area with oil spill and also analysed the BOD attributable to the oil spill by disease, age, sex and subregion. DESIGN: Health impact assessment by measuring years lived with disability (YLD) due to an oil spill. SETTING: A whole population of a community affected by an anthropogenic environmental disaster and secondary health outcome data. PARTICIPANTS: Based on the health outcome survey including 10 171 individuals (male 4354; female 5817), BOD of 66 473 populations (male 33 441; female 33 032) was measured. INTERVENTIONS: None. Observational study on the effect of a specific environmental health hazard. PRIMARY AND SECONDARY OUTCOME MEASURES: Using disability adjusted life year (DALY) method, BOD including physical and mental diseases was measured. For the BOD measurement, excess incidences of illnesses related to oil spill were estimated from the comparison of prevalence of the health outcomes between contaminated areas and reference area without contamination. RESULTS: YLD attributable to the oil spill were estimated to be 14 724 DALYs (male 7425 DALYs; female 7299 DALYs) for the year 2008. The YLD of mental diseases including post-traumatic stress disorder (PTSD) and depression for men were higher than that for women. The YLD for women was higher in asthma and allergies (rhinitis, dermatitis, conjunctivitis) than that for men. The effects of asthma and allergies were the greatest for people in their 40s, with the burden of mental illness being the greatest for those in their 20s. Proximity to the spill site was associated with increased BOD. CONCLUSIONS: An oil spill near a coastline can cause substantial adverse health effects. As the health effects of hazardous pollutants from oil spills are long-lasting, close follow-up studies are required to identify chronic health effects.

What is different about medical students interested in non-clinical careers?

BACKGROUND: The proportion of medical school graduates who pursue careers other than full-time clinical practice has increased in some countries as the physician's role has evolved and diversified with the changing landscape of clinical practice and the advancement of biomedicine. Still, past studies of medical students' career choices have focused on clinical specialties and little is known about their choice of non-clinical careers. The present study examined backgrounds, motivation and perceptions of medical students who intended non-clinical careers. METHODS: A questionnaire was administered to students at six Korean medical schools distributed across all provinces in the nation. The questionnaire comprised 40 items on respondents' backgrounds, their motivation for and interest in the study of medicine, their perceptions of medical professions, and their career intentions. Data was analyzed using various descriptive and inferential statistics. RESULTS: In total, 1,388 students returned the questionnaire (60% response rate), 12.3% of whom intended non-clinical careers (i.e., basic sciences, non-clinical medical fields, and non-medical fields). Those who planned non-clinical careers were comparable with their peers in their motivation for studying medicine and in their views of medical professions, but they were less interested in the study of medicine (P < 0.01). The two groups also differed significantly on their perceptions of what was uninteresting about the study of medicine (P < 0.01). The two groups were comparable in gender and entry-level ratios but their distributions across ages and years of study differed significantly (P < 0.01). A majority of respondents agreed with the statements that "it is necessary for medical school graduates to pursue non-clinical careers" and that "medical schools need to offer programs that provide information on such careers." Still, our finding indicates that medical school curricula do not address such needs sufficiently. CONCLUSIONS: Our study found some differences in backgrounds and perceptions of the study of medicine in medical students interested in non-clinical careers from their peers. Future studies are suggested to enhance our understanding of medical students" choice of non-clinical careers.

Burden of cancer in Korea during 2000-2020.

BACKGROUND: This study estimates the burden of cancer in Korea during 2000-2020, ameliorating the Global Burden of Disease Study Group (GBD) method with the Incidence-Prevalence-Mortality (IPM) Model. METHODS: Besides using the GBD approach to calculate the Years of Life Lost in Korea during 2000-2020, this research calculates the Years Lived with Disability (YLDs) of major cancers based on the combination of the GBD method and the IPM Model. RESULTS: Colon, breast and thyroid cancers became more significant in terms of Disability Adjusted Life Years during 2000-2010 and this will continue during 2010-2020, colon cancer leading the pack instead of stomach cancer in 2020. The rise of colon cancer is more evident for the older age group and the opposite is true for breast and thyroid cancers. Indeed, stomach and liver cancers were resilient in terms of DALYs during 2000-2010 and this will continue during 2010-2020. Overall, the burden of cancer in Korea is characterized by an increasing centrality of YLDs (chronic components) as in other advanced nations. CONCLUSIONS: Korea's convergence with other advanced nations in cancer burden might reflect their convergence in living standards, the age structure, health behavior and medical technology during the past four decades. These transitions have been reflected in the Second 10-Year Plan for Cancer Control in Korea during 2006-2015, government policy consisting of four main programs, i.e., primary prevention, early detection, diagnosis/treatment and palliative care.

Prevalence of musculoskeletal symptoms related with activities of daily living and contributing factors in Korean adults.

OBJECTIVES: This study aims to investigate the prevalence of musculoskeletal symptoms and factors related to daily activities in a representative Korean population. METHODS: This study was based on the questions about musculoskeletal symptoms in the Korean General Social Survey 2010. The questionnaire about musculoskeletal symptoms was adopted from Korean Occupational Safety and Health Agency guide, and it includes general characteristics, characteristics of pain, work type, work intensity and a 12-item Short Form Health Survey (SF-12). We utilized the criteria of the National Institute for Occupational Safety and Health to define the prevalence of musculoskeletal symptoms. Demographic, behavioral and socioeconomic factors were analyzed using logistic regression. RESULTS: The prevalence of musculoskeletal symptoms was 38.3%. The prevalence was higher in females, the elderly, those without health insurance, and those with a low income, low education, and occupations with a heavy workload. The prevalence by body part was highest in the back, shoulder, and knee, in that order. The physical component summary and mental component summary of the SF-12 decreased with increasing musculoskeletal symptoms. CONCLUSIONS: Musculoskeletal symptoms are very common in the general population, and related to various socio-demographic factors. These results suggest that active prevention and management of musculoskeletal symptoms is needed at a national level.

Effects of heat wave on body temperature and blood pressure in the poor and elderly.

OBJECTIVES: We aimed to investigate the acute effects of heat stress on body temperature and blood pressure of elderly individuals living in poor housing conditions. METHODS: Repeated measurements of the indoor temperature, relative humidity, body temperature, and blood pressure were conducted for 20 elderly individuals living in low-cost dosshouses in Seoul during hot summer days in 2010. Changes in the body temperature, systolic blood pressure (SBP) and diastolic blood pressure (DBP) according to variations in the indoor and outdoor temperature and humidity were analyzed using a repeated-measures ANOVA controlling for age, sex, alcohol, and smoking. RESULTS: Average indoor and outdoor temperatures were 31.47℃ (standard deviation [SD], 0.97℃) and 28.15℃ (SD, 2.03℃), respectively. Body temperature increased by 0.21℃ (95% confidence interval [CI], 0.16 to 0.26℃) and 0.07℃ (95% CI, 0.04 to 0.10℃) with an increase in the indoor and outdoor temperature of 1℃. DBP decreased by 2.05 mmHg (95% CI, 0.05 to 4.05 mmHg), showing a statistical significance, as the indoor temperature increased by 1℃, while it increased by 0.20 mmHg (95% CI, -0.83 to 1.22 mmHg) as outdoor temperature increased by 1℃. SBP decreased by 1.75 mmHg (95% CI, -1.11 to 4.61 mmHg) and 0.35 mmHg (95% CI, -1.04 to 1.73 mmHg), as the indoor and outdoor temperature increased by 1℃, respectively. The effects of relative humidity on SBP and DBP were not statistically significant for both indoor and outdoor. CONCLUSIONS: The poor and elderly are directly exposed to heat waves, while their vital signs respond sensitively to increase in temperature. Careful adaptation strategies to climate change considering socioeconomic status are therefore necessary.