BACKGROUND: Evidence on associations between occupational diesel exhaust and gasoline exposure and colorectal cancer is limited. We aimed to assess the effect of workplace exposure to diesel exhaust and gasoline on the risk of colorectal cancer. METHODS: This caseecontrol study included 181,709 colon cancer and 109,227 rectal cancer cases diagnosed between 1961 and 2005 in Finland, Iceland, Norway, and Sweden. Cases and controls were identified from the Nordic Occupational Cancer Study cohort and matched for country, birth year, and sex. Diesel exhaust and gasoline exposure values were assigned by country-specific job-exposure matrices. Odds ratios and 95% confidence intervals were calculated by using conditional logistic regression models. The results were adjusted for physical strain at work and occupational exposure to benzene, formaldehyde, ionizing radiation, chlorinated hydrocarbons, chromium, and wood dust. RESULTS: Diesel exhaust exposure was associated with a small increase in the risk of rectal cancer (odds ratio 1/4 1.05, 95% confidence interval 1.02–1.08). Gasoline exposure was not associated with colorectal cancer risk. CONCLUSION: This study showed a small risk increase for rectal cancer after workplace diesel exhaust exposure. However, this finding could be due to chance, given the limitations of the study.
Benzene ; Case-Control Studies ; Chromium ; Cohort Studies ; Colonic Neoplasms ; Colorectal Neoplasms ; Dust ; Finland ; Formaldehyde ; Gasoline ; Hydrocarbons, Chlorinated ; Iceland ; Logistic Models ; Norway ; Occupational Exposure ; Odds Ratio ; Parturition ; Radiation, Ionizing ; Rectal Neoplasms ; Scandinavian and Nordic Countries ; Sweden ; Vehicle Emissions ; Wood

BACKGROUND: Accumulating data indicates that pholcodine (PHO)-consuming countries have higher sero-prevalences of immunoglobulin E (IgE)-antibodies to PHO and suxamethonium (SUX) and increased frequencies of IgE-mediated anaphylaxis to neuromuscular blocking agents (NMBAs) than nonconsuming. Withdrawing PHO-containing cough syrups resulted in a significant decrease of cases with anaphylaxis in Scandinavia. Nevertheless, the European Medicines Agency in 2011 advised to continue the unrestricted use throughout the European Union. OBJECTIVE: To extend studies on PHO consumption and prevalence of IgE-sensitization to morphine (MOR), PHO, and SUX to countries representing high (Australia), and low (Korea and Japan), consumers, respectively. METHODS: IgE-antibodies to SUX, MOR, and PHO in atopic subjects were determined by immunoassay and compared with official figures for PHO consumption and reported anaphylaxis to NMBA. RESULTS: The prevalences of IgE-antibodies to PHO, MOR, and SUX were 10%, 8.6%, and 4.3%, respectively, in Australia. The corresponding figures for Japan were 0.8%, 0.8%, and 1.5%, and for Korea 1.0% to PHO and 0.5% to MOR and SUX. Of the SUX-positive sera, 100% were positive to PHO or MOR in Australia and 0% in Japan and Korea. CONCLUSION: The study supports previous findings; exposure to PHO may induce IgE-antibodies to the substituted ammonium ion epitope of NMBAs, thus increasing risk of NMBA-induced anaphylaxis considerably. However, other, still unknown factors occasionally might induce IgE-antibodies to SUX.
Ammonium Compounds ; Anaphylaxis ; Australia ; Cough ; European Union ; Immunoassay ; Immunoglobulin E ; Immunoglobulins ; Japan ; Korea ; Morphine ; Neuromuscular Blocking Agents ; Prevalence ; Scandinavian and Nordic Countries ; Succinylcholine

The issue exerting the greatest influence in Korea is the low birth rate. It is important, therefore, to examine the countermeasures taken, and their effectiveness, by other countries suffering a declining birth rate and consequent aging population before Korea. Such countries can be categorized according to their cultural background: the UK, Continental Europe, Scandinavia, and Asia. In Continental European countries, such as Germany and France, the employment rate of women is relatively low, whereas it is relatively high in the UK and Scandinavian countries. In Asian countries, such as Japan and Singapore, despite many policies instituting the work-family balance, a childcare infrastructure, and child allowance, little is being achieved, due to the specific culture of Asia and the social rejection of various family forms. However, it should not be forgotten that those countries succeeding in increasing the birth rate have implemented continuous policies for decades.
Aging ; Asia ; Asian Continental Ancestry Group ; Birth Rate ; Child ; Employment ; Europe ; Female ; France ; Germany ; Humans ; Japan ; Korea ; Parturition ; Scandinavian and Nordic Countries ; Singapore ; Social Distance

This review aimed to identify risk factors for occupational accidents and illnesses among young workers in the Nordic countries and to attain knowledge on specific vulnerable groups within the young working force that may need special attention. We conducted a systematic review from 1994 to 2014 using five online databases. Of the 12,528 retrieved articles, 54 met the review criteria and were quality assessed, in which data were extracted focusing on identifying occupational safety, health risk factors, and vulnerable groups among the young workers. The review shows that mechanical factors such as heavy lifting, psychosocial factors such as low control over work pace, and organizational factors such as safety climate are all associated with increased injury risk for young Nordic workers. Results show that exposures to chemical substances were associated with skin reactions, e.g., hand eczema. Heavy lifting and awkward postures were risk factors for low back pain, and high job demands were risk factors for mental health outcomes. The review identified young unskilled workers including school drop-out workers as particularly vulnerable groups when it comes to occupational accidents. In addition, apprentices and young skilled workers were found to be vulnerable to work-related illnesses. It is essential to avoid stereotyping young Nordic workers into one group using only age as a factor, as young workers are a heterogeneous group and their vulnerabilities to occupational safety and health risks are contextual. Politicians, researchers, and practitioners should account for this complexity in the education, training and organization of work, and workplace health and safety culture.
Accidents, Occupational ; Adolescent ; Climate ; Eczema ; Education ; Hand ; Humans ; Lifting ; Low Back Pain ; Mental Health ; Occupational Health ; Posture ; Psychology ; Risk Factors ; Safety Management ; Scandinavian and Nordic Countries ; Skin ; Stereotyping

In 2008, Korea has enacted new ordinances about the role of estheticians, but this law can be interpreted ambiguously, restricting hiring of estheticians in medical clinics. The purpose of the study is to obtain information about medical-esthetic systems in other countries. We have taken a survey of this object from 30 OECD & Asian countries, and the questionnaires returned from a total of 22 countries (Australia, Austria, Canada, Denmark, Finland, France, Germany, Hungary, Japan, Netherlands, New Zealand, Norway, Portugal, Slovak Republic, Spain, Switzerland, Turkey, United Kingdom, United States, Singapore, Israel, and Thailand), were used for the final analysis. The results are summarized as follows. In most countries, estheticians working independently deal with only healthy, normal skin. In most countries, estheticians working independently have no right to operate any medical instruments. In all 17 countries that returned the questionnaires medical clinics can employ estheticians, and only theses estheticians who belong to the medical clinics can handle the non-invasive medical instruments under the supervision of doctors. In 17 countries that have related legal regulations, nurses, under the control of doctors, can perform wider range of duties in various settings than estheticians. The survey concludes that the duties of estheticians are closely related with medical skin care services and estheticians can perform various non-invasive medical procedures only under the control of doctors. From consulting a variety of medical-esthetic systems in other countries, we propose that the estheticians be allowed to work in medical clinics to provide better medical services for the patients and to make more chances of employment for themselves.
Asian Continental Ancestry Group ; Austria ; Canada ; Denmark ; Employment ; Finland ; France ; Germany ; Great Britain ; Humans ; Hungary ; Israel ; Japan ; Jurisprudence ; Korea ; Netherlands ; New Zealand ; Norway ; Organization and Administration ; Portugal ; Questionnaires ; Singapore ; Skin ; Skin Care ; Slovakia ; Social Control, Formal ; Spain ; Switzerland ; Turkey ; United States

Paget bone disease(PBD) is usually focal, but can be wide spread disorder of the skeletal remodeling characterized by greatly increased osteoclast size and activity. It has extremely variable prevalence worldwide, being common in England and northern European countries and areas populated by their descendants, but strikingly uncommon in Asia, the middle east, Africa and Scandinavia. It's occurrence also shows familial clustering, some postulates autosomal dominant inheritance. Many studies have shown that paramyxoviruses may play a critical role in the etiology of this disorder. However, the precise etiology of PBD remains unknown.We describe a kindred with PBD in 3 successive generations. The propositus, a 55-year-old man, has panostotic PBD and giant cell reparative granuloma of pagets disease involving his head, mandible, abdomen and ileum, rare tumorous complication of Paget's disease. Bowed limbs were first noticed at age 25 years, and progressed for 20 years. Giant cell reparative granuloma began manifesting at age 45 years, and responded dramatically to high-dose dexamethasone therapy. His pretreatment biochemical finding were remarkable for elevated serum ALP, 765(normal 66-220 u/L) and osteocalcin, 154(normal 6.3-30.7 mg/ml), but normal serum calcium, phosphorous, 250HD and PTH. A nondecalcified iliac crest specimen demonstrated classic histopathologic 25OHD and PTH. A nondecalcified iliac crest specimen demonstrated classic histopathologic changes of PBD on light microscopy. His decreased father had a similar degree of bony deformities beginning at age 20 years, but had not been examined. His two asymptomatic daughters, 20 and 24-year-old, were both found to be affected with widespread PBD by bone scan, radiographic study, and their serum ALP levels, 939 and 435U/L, respectively. This is the first report of familial occurance of PBD and a case of giant cell reparative granuloma of Paget's disease in Korea, where PBD is very rare.
Abdomen ; Africa ; Asia ; Bone Diseases ; Calcium ; Congenital Abnormalities ; Dexamethasone ; England ; Extremities ; Family Characteristics ; Fathers ; Giant Cells ; Granuloma ; Head ; Humans ; Ileum ; Korea ; Mandible ; Microscopy ; Middle Aged ; Middle East ; Nuclear Family ; Osteocalcin ; Osteoclasts ; Pedigree ; Prevalence ; Scandinavian and Nordic Countries ; Wills ; Young Adult

The first comprehensive clinical description of exfoliation syndrome was published by Vogt. The appearance is described as a deposition of white granular fluffy material on the anterior lens surface, pupil margin, zonule, ciliary body and anterior chamber angle, and floating free in the aqueous. At past, this syndrome was thought to be rare outside of the Scandinavian countries, but the relatively high prevalence has been noted in many other countries outside of Scandinavia. The clinical significance of this syndrome is high frequency of glaucoma. Six cases in this report illustrate some of typical clinical features of exfoliation syndrome. The purpose of this study is to concentrate our attention upon the presence of this syndrome in Korea.
Anterior Chamber ; Ciliary Body ; Exfoliation Syndrome* ; Glaucoma ; Korea ; Prevalence ; Pupil ; Scandinavia

In recent years there has been increased media scrutiny and criticism about the use of selective serotonin reuptake inhibitors (SSRIs) and their possible association with suicidal behavior. In clinical practice, these may confuse many patients with depressive disorder and some doctors. Since early 1990s some authors reported that antidepressants could be related with increased suicidality. However, considering the limitation of study design, there is no evidence that suicide is precipitated by SSRIs or older antidepressants. There were merely some reports of weak correlation between non-fatal self harm and SSRIs, with the number needed to treat for self-harm being approximately 1 in 700-1,000. It is also informative that the correlation between self-harm and tricyclic antidepressants(TCAs) is not different with SSRIs and that psychotherapy unto adolescents with depressive disorder has been reported to have similar correlation with suicidal thoughts as that with antidepressants. These suggest that the suicidal risks is not specifically due to the use of SSRIs, but broadly related with all other treatment for depression. We should consider the benefits and risks when choosing a specific treatment. The efficacy of SSRIs has been verified for the treatment of depressive symptoms and for relieving suicidal thoughts in most patients. Compared to the minuscule possibility of suicidal risks (NNT : 700~1,000), the efficacy of SSRIs improving depression is much more powerful and important (NNT : 4~7). Some assumed that SSRIs alleviate depressive symptoms and suicidal thoughts in most population and there may be small population vulnerable to self-harm with SSRIs. Considering the researches of Scandinavia reporting that many adolescents commit suicide with no history of antidepressants medication, there are also suicidal risks associated with non-treatment, and they have not had the potential benefit of antidepressants. It is a matter of course that clinicians should have a close monitoring of suicidal risk when treating depressed patients and prescribing SSRIs, especially early 2 weeks in the treatment. There is a risk that media reports will result in discouraging compliance with effective treatment for depression and potential relief from suicide.
Adolescent ; Antidepressive Agents ; Compliance ; Depression ; Depressive Disorder ; Humans ; Psychotherapy ; Risk Assessment ; Scandinavia ; Serotonin Uptake Inhibitors ; Suicide

Daylight Saving Time (DST) is used worldwide and affects millions of people annually. In the most countries, DST begins turning clocks forward by an hour in the spring and backward by an hour in the fall. transition out of DST in the fall increases the available daylight in the morning by one hour. Springtime transition into DST leads to an increase of the available daylight in the evening. During World War I, in an effort to reduce fuel consumption, Germany and England began to practice DST in 1916. Currently, 77 countries and most of OECD adopted DST except Korea, Japan, Iceland. The rationale for Daylight Saving Time (DST) is bolstered by the fact that it increases daylight hours within which the activity a population reaches its peak. Therefore, the effects of transitions into DST to the public health should be further explored, as DST affects millions of people annually and its impacts are still largely unknown. A general perception is that Turning clock forwards (on spring) or backwards (on fall) by one hour would affect our health. In This study, the association between Daylight Saving Time (DST) and health in population was investigated through theoretical and systemic review studies. Since the study was conducted solely on theoretical grounds, further research is needed to assess additional health-related impacts of Daylight Saving Time (DST) and to carry out more specific analysis on population health in Korea. In conclusion, population health is more strongly affected during spring transition into DST than during fall transition out of DST.
England ; Germany ; Iceland ; Japan ; Korea ; Public Health ; World War I

Hereditary breast carcinomas associated with BRCA1/2 mutations have unique clinicopathological and epidemiological characteristics. The objective of this study is to outline the prevalence, founder effect and clinicopathological characteristics of BRCA1/2 mutations for hereditary breast cancers from an analysis of reports recently published regarding Korean subjects. The prevalence of BRCA1 and/or BRCA2 mutations is 2.5-3.1% for sporadic breast cancers, 19.4-42.9% for familiar breast cancer patients with two or more affected first- and second- degree relatives with breast or ovarian cancers and 9.6-18.3% for early breast cancers. Common mutations for the Korean subjects were 2552delC, 3476insA, 4184del4, 5589del8, and 5615del111insA for BRCA1; and 7708C>T for BRCA2. These mutations were not found in Ashkenazi Jewish or Icelandic subjects. The proportion of estrogen or progesterone receptor (ER/PR) or ER/PR/HER2 triple negative status, basal-like phenotype as detected by immunohistochemical staining, and undifferentiated histological grade in Korean BRCA mutation subjects were higher than in subjects lacking BRCA1/2 mutations. Our review found that previous studies describing BRCA mutations among Korean subjects were limited. Since the clinicopathological, phenotypic and epidemiological characteristics of the BRCA1/2 mutations among Korean subjects are different from those among subjects from the Americas and Europe, more studies of hereditary or familial breast cancer including BRCA mutations must be conducted. A largescale prospective study called Korean Hereditary Breast Cancer Study (KOHBRA) was started from May 2007, and future information provided by the KOHBRA study will make a substantial contribution to solving the basic questions in etiology, individual susceptibility and clinicopathological characteristics for hereditary breast cancer among Korean subjects.
Americas ; Breast ; Breast Neoplasms ; Estrogens ; Europe ; Founder Effect ; Humans ; Iceland ; Ovarian Neoplasms ; Phenotype ; Prevalence ; Receptors, Progesterone