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Psychological Distress and Occupational Injury: Findings from the National Health Interview Survey 2000-2003.

Journal of Preventive Medicine and Public Health.2008;41(3):200-207. doi:10.3961/jpmph.2008.41.3.200

OBJECTIVES: This study examined whether serious psychological distress (SPD) is associated with occupational injury among US employees. METHODS: The employed population aged 18-64 years was examined (n=101,855) using data from the National Health Interview Survey (NHIS) 2000-2003. SPD was measured using the Kessler 6-item Psychological Distress Scale (K-6), a screening scale designed to identify persons with serious mental illness. The predicted marginal prevalence of psychological distress and occupational injury with the adjusted odds ratio were estimated using multiple logistic regression analyses. RESULTS: The age-adjusted 3-month prevalence of occupational injury was 0.80+/-0.12% in workers with SPD, which was 37% greater than in workers without SPD (0.58+/-0.03%). The odds of occupational injury in workers with SPD were higher compared to workers without SPD (OR=1.34, 95% CI=0.93-1.92), after controlling for sex, age, race, education, occupation, and activity limitation by at least one medical condition. Male, service and blue collar occupation, and activity limiation by co-morbidity showed significantly higher odds of occupational injury for workers with SPD. CONCLUSIONS: The findings suggest that SPD accounts for an increased likelihood of occupational injury among US employees. A further longitudinal study is needed to differentiate the mechanism or causal pathways linking individual injury risk at the workplace, SPD, and socioeconomic factors.
Accidents, Occupational/*psychology/statistics & numerical data ; Adolescent ; Adult ; Female ; Health Surveys ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Prevalence ; Stress, Psychological/*epidemiology ; United States ; Wounds and Injuries/*psychology

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Stability and Intra-Individual Variation of Urinary Malondialdehyde and 2-Naphthol.

Kyoung Ho LEE ; Daehee KANG

Journal of Preventive Medicine and Public Health.2008;41(3):195-199. doi:10.3961/jpmph.2008.41.3.195

OBJECTIVES: Malondialdehyde (MDA), a lipid peroxidation by-product, has been widely used as an indicator of oxidative stress. Urinary 2-naphthol, a urinary PAH metabolite, is used as a marker of ambient particulate exposure and is associated with lung cancer and chronic obstructive pulmonary disease. However, the stability and intra-individual variation associated with urinary MDA and 2-naphthol have not been thoroughly addressed. The objective of this study was to assess the stability and intraindividual variation associated with urinary MDA and 2-naphthol. METHODS: Urine samples were collected from 10 healthy volunteers (mean age 34, range 27~42 years old). Each sample was divided into three aliquots and stored under three different conditions. The levels of urinary MDA and 2-naphthol were analyzed 1) just after sampling, 2) after storage at room temperature (21degrees C) for 16 hours, and 3) after storage in a -20degrees C freezer for 16 hours. In addition, an epidemiological study was conducted in 44 Chinese subjects over a period of 3 weeks. The urinary MDA and 2-naphthol were measured by HPLC three times. RESULTS: There was no difference in the levels of urinary MDA and 2-naphthol between the triplicate measurements (n=10, p=0.84 and p=0.83, respectively). The intra-class correlation coefficients (ICC) for urinary MDA and 2-naphthol were 0.74 and 0.42, respectively. However, the levels of PM2.5 in the air were well correlated with the levels of both MDA and 2-naphthol in the epidemiological study. CONCLUSIONS: These results suggest that urinary MDA and 2-naphthol remain stable under variable storage conditions, even at room temperature for 16 hours, and indicate that these markers can be used in epidemiological studies involving various sample storage conditions. The intra-CC of urinary 2-naphthol and MDA were acceptable for application to epidemiological studies.
Adult ; Biological Markers ; Female ; Humans ; Male ; Malondialdehyde/*metabolism/*urine ; Middle Aged ; Naphthols/*metabolism/*urine ; Oxidative Stress/physiology ; Reproducibility of Results

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Socioeconomic Disparities in Breast Cancer Screening among US Women: Trends from 2000 to 2005.

Jaeyoung KIM ; Soong Nang JANG

Journal of Preventive Medicine and Public Health.2008;41(3):186-194. doi:10.3961/jpmph.2008.41.3.186

OBJECTIVES: This study describes trends in the socioeconomic disparities in breast cancer screening among US women aged 40 or over, from 2000 to 2005. We assessed 1) the disparities in each socioeconomic dimension; 2) the changes in screening mammography rates over time according to income, education, and race; and 3) the sizes and trends of the disparities over time. METHODS: Using data from the Behavioral Risk Factor Surveillance System (BRFSS) from 2000 to 2005, we calculated the age-adjusted screening rate according to relative household income, education level, health insurance, and race. Odds ratios and the relative inequality index (RII) were also calculated, controlling for age. RESULTS: Women in their 40s and those with lower relative incomes were less likely to undergo screening mammography. The disparity based on relative income was greater than that based on education or race (the RII among low-income women across the survey years was 3.00 to 3.48). The overall participation rate and absolute differences among socioeconomic groups changed little or decreased slightly across the survey years. However, the degree of each socioeconomic disparity and the relative inequality among socioeconomic positions remained quite consistent. CONCLUSIONS: These findings suggest that the trend of the disparity in breast cancer screening varied by socioeconomic dimension. ontinued differences in breast cancer screening rates related to income level should be considered in future efforts to decrease the disparities in breast cancer among socioeconomic groups. More focused interventions, as well as the monitoring of trends in cancer screening participation by income and education, are needed in different social settings.
Adult ; Age Factors ; Aged ; Behavioral Risk Factor Surveillance System ; Breast Neoplasms/*radiography ; Female ; *Healthcare Disparities ; Humans ; Mammography/*utilization ; Mass Screening/*trends ; Middle Aged ; *Social Class ; Socioeconomic Factors ; United States

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Reliability of a Questionnaire for Women's Reproductive History.

Kwang Pil KO ; Sue Kyung PARK ; Yeonju KIM ; Jisuk BAE ; Jae kwan JUN ; Jin GWACK ; Keun Young YOO

Journal of Preventive Medicine and Public Health.2008;41(3):181-185. doi:10.3961/jpmph.2008.41.3.181

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.
Adult ; Aged ; Cohort Studies ; Female ; Humans ; Korea ; Middle Aged ; *Questionnaires ; Reproducibility of Results ; *Reproductive Medicine

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Mi Ah HAN ; So Yeon RYU ; Jong PARK ; Myung Geun KANG ; Jong Ku PARK ; Ki Soon KIM

Journal of Preventive Medicine and Public Health.2008;41(3):173-180. doi:10.3961/jpmph.2008.41.3.173

OBJECTIVES: The purposes of this study were to examine the health-related quality of life(HRQoL) and to identify its related factors for a group of rural adults. METHODS: The study subjects were 1,901 adults who were aged 40-70 years and who were living in Naju City, Jeollanamdo. The sociodemographic characteristics, health-related behavior, health status and global self-rated health were collected for statistical analysis. The healthrelated quality of life was measured by the Euroqol EQ-5D instrument. The differences on the EQ-5D index between the groups were assessed with t-test, ANOVA and hierarchical multiple regression analysis. RESULTS: Overall, the mean value of the EQ-5D index was 0.884+/-0.140 and this score was significantly different according to the socioeconomic characteristics, the healthrelated behavior, the health status and the global self-rated health. According to the results from the hierarchical multiple regression analysis, the HRQoL was significantly reduced for females, older subjects, and other subjects with no spouse and the subjects with osteoporosis, obesity, mental distress or poorer global self-rated health. CONCLUSIONS: The HRQoL for rural adults was related to the socioeconomic characteristics, the health status and the global self-rated health. A better understanding of the factors related to the HRQoL would help to improve the rural adults' quality of life.
Aged ; Female ; Health Behavior ; *Health Status ; Humans ; Korea ; Male ; Middle Aged ; *Quality of Life ; Questionnaires ; Risk Factors ; *Rural Population ; Social Class

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Health Inequality Measurement in Korea Using EuroQol-5 Dimension Valuation Weights.

Hosung SHIN ; Dongjin KIM

Journal of Preventive Medicine and Public Health.2008;41(3):165-172. doi:10.3961/jpmph.2008.41.3.165

OBJECTIVES: Despite various government initiatives, including the expansion of national health insurance coverage, health inequality has been a key health policy issue in South Korea during the past decade. This study describes and compares the extent of the total health inequality and the income-related health inequality over time among Korean adults. METHODS: This study employs the 1998, 2001 and 2005 Korean National Health and Nutrition Examination Surveys (KNHANESs). The self-assessed health (SAH) ordinal responses, measured on a five-point scale, rescaled to cardinal values to measure the health inequalities with using interval regression. The boundaries of each threshold for the interval regression analysis were obtained from the empirical distribution of the EuroQol-5 Dimension (EQ-5D) valuation weights estimated from the 2005 KNHANES. The final model predicting the individuals' health status included age, gender, educational attainment, occupation, income, and the regional prosperity index. The concentration index was used to measure and analyze the health inequality. RESULTS: The KNHANES data showed an unequal distribution of the total health inequality in favor of the higher income groups, and this is getting worse over time (0.0327 in 1998, 0.0393 in 2001 and 0.0924 in 2005). The income-related health inequality in 2005 was 0.0278, indicating that 30.1% of the total health inequality can be attributed to income. CONCLUSIONS: The findings indicate there are health inequalities across the sociodemographic and income groups despite the recent government's efforts. Further research is warranted to investigate what potential policy actions are necessary to decrease the health inequality in Korea.
Adult ; Aged ; Female ; *Health Status Disparities ; Humans ; Income ; Korea ; Male ; Middle Aged ; *Quality of Life ; Questionnaires

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Citrus Fruits Intake and Prostate Cancer Risk: A Quantitative Systematic Review.

Jong Myon BAE ; Eun Ja LEE ; Gordon GUYATT

Journal of Preventive Medicine and Public Health.2008;41(3):159-164. doi:10.3961/jpmph.2008.41.3.159

OBJECTIVES: The purpose of this systematic review was to investigate the association between dietary intake of citrus fruits and prostate cancer risk. METHODS: Authors searched electronic databases and the reference lists of publications of diet and prostate cancer studies until August 2007. All of the epidemiological studies that obtained individual data on dietary intake of citrus fruits and presented risk estimates of the association between intake of citrus fruits and risk of prostate cancer were identified and included. Using general variance-based methods, study-specific odds ratios (OR)/ relative risk (RR) and associated confidence interval (CI)/ standard error (SE) for highest versus lowest intake of citrus fruits level were extracted from each paper. RESULTS: Eleven articles including six case-control studies, one nested case-control study and four cohort studies, proved eligible. Overall summary OR using random effect model did not show an association in risk of prostate caner with intake of citrus fruits (summary OR=1.03, 95% CI=0.89-1.19) with large heterogeneity across studies that we were unable to explain (I(2)=67.88%). The summary ORs in case-control studies and cohort studies were 1.10 (95% CI=0.97-1.22) and 1.05 (95% CI=0.96-1.14), respectively. CONCLUSIONS: Pooled results from observational studies did not show an association between intake of citrus fruits and the risk of prostate cancer, although results vary substantially across studies.
Case-Control Studies ; *Citrus ; Cohort Studies ; *Diet ; Humans ; Male ; Prostatic Neoplasms/*epidemiology ; Risk Factors

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Epidemiological Investigation of a Measles Outbreak in a Preschool in Incheon, Korea, 2006.

Jae Sung SO ; Un Yeong GO ; Dong Han LEE ; Koang Suk PARK ; Jong Koo LEE

Journal of Preventive Medicine and Public Health.2008;41(3):153-158. doi:10.3961/jpmph.2008.41.3.153

OBJECTIVES: This study describes a plan that was designed to prevent a measles outbreak that showed a changed outbreak pattern. This study is based on the epidemiological investigation of a measles outbreak in a preschool in Incheon, Korea, 2006. METHODS: The subjects were 152 students at a preschool where a measles outbreak occurred. A questionnaire survey was conducted and serological testing for measlesspecific IgM was preformed. RESULTS: Of the fifteen confirmed, identified cases, eleven patients had been vaccinated with one dose, one patient had received two doses and three patients were unvaccinated. The three unvaccinated cases consisted of one 5-year-old child, one 3-year-old child and one 16-month-old infant. For the cases with one dose of the vaccination, there were 11 cases, which consisted of six 5-year-old children, two 4-year-old children, two 3-year-old children and one 2-year-old child. The case with two doses of the vaccination was one 4-year-old child. The attack rate of measles was 100% in the 0-dose group, 11.2% in the 1-dose group and 2.0% in the 2-dose group. The vaccine's efficacy was 88.8% in the 1-dose group and 98.0% in the 2-dose group. The vaccine effectiveness for the 2-dose group was higher than that of the 1-dose group. CONCLUSIONS: High coverage with a 2-dose vaccination should be maintained, and the vaccination should be given at the suitable time to prevent a measles outbreak with a changed outbreak pattern.
Child, Preschool ; *Disease Outbreaks/prevention & control ; Humans ; Immunization Programs ; Korea ; Measles/*epidemiology/immunology/*prevention & control/virology ; Measles Vaccine/*administration & dosage ; Preventive Medicine ; Questionnaires

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Effects of Long-term Fluoride in Drinking Water on Risks of Hip Fracture of the Elderly: An Ecologic Study Based on Database of Hospitalization Episodes.

Eun Young PARK ; Seung Sik HWANG ; Jai Yong KIM ; Soo Hun CHO

Journal of Preventive Medicine and Public Health.2008;41(3):147-152. doi:10.3961/jpmph.2008.41.3.147

OBJECTIVES: Fluoridation of drinking water is known to decrease dental caries, particularly in children. However, the effects of fluoridated water on bone over several decades are still in controversy. To assess the risk of hip fracture related to water fluoridation, we evaluated the hip fracture-related hospitalizations of the elderly between a fluoridated city and non-fluoridated cities in Korea. METHODS: Cheongju as a fluoridated area and Chungju, Chuncheon, Suwon, Wonju as non-fluoridated areas were chosen for the study. We established a database of hip fracture hospitalization episode based on the claims data submitted to the Health Insurance Review Agency from January 1995 to December 2002. The hip fracture hospitalization episodes that satisfied the conditions were those that occurred in patients over 65 years old, the injuries had a hip fracture code (ICD-9 820, ICD-10 S72) and the patients were hospitalized for at least 7days. A total of 80,558 cases of hip fracture hospitalization episodes were analyzed. RESULTS: The admission rates for hip fracture increased with the age of the men and women in both a fluoridated city and the non-fluoridated cities (p<0.01). The relative risk of hip fracture increased significantly both for men and women as their age increased. However, any difference in the hip fracture admission rates was not consistently observed between the fluoridated city and the nonfluoridated cities. CONCLUSIONS: We cannot conclude that fluoridation of drinking water increases the risk of hip fracture in the elderly.
Aged ; Aged, 80 and over ; Cities ; Female ; Fluoridation/*adverse effects ; Hip Fractures/*epidemiology ; Hospitalization/*statistics & numerical data ; Humans ; Korea ; Male ; Retrospective Studies ; Risk Assessment

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Analysis of Willingness-to-Quit Cigarette Price among Korean Male Adults.

Woojin CHUNG ; Sunmi LEE ; Kayoung SHIN ; Seungji LIM ; Kyungsook CHO

Journal of Preventive Medicine and Public Health.2008;41(3):136-146. doi:10.3961/jpmph.2008.41.3.136

OBJECTIVES: The purpose of this study was to estimate the willingness to quit cigarette price among Korean male adults, and to examine he factors affecting the willingness to quit cigarette price. METHODS: The data was collected by a random digit dial telephone survey. 702 samples were analyzed by using ttests, ANOVA and OLS regression analysis. To estimate the willingness to quit cigarette price, smokers were asked dichotomous questions with open-ended follow-up and the starting point of the price was randomized by one of 5 bid prices elicited from a pilot study. RESULTS: The mean of the willingness to quit cigarette price was 4,287 Won per package, which was about 2,000 Won higher than the mean of the actual price the smokers now paid. About 41% of respondents were willing to quit smoking if the price of cigarette would be increased by 3,000 Won, and if the price would be increased by 20,000 Won, all respondents were willing to quit smoking. The factors associated with the willingness to quit cigarette price were the place of residence, the amount of smoking and the degree of exposure to smoking through the mass media. CONCLUSIONS: The results showed that to get people to quit smoking, increasing the cigarette price would obviously be effective and much higher prices have a greater effect. Furthermore, to enlarge the effect of increased cigarette prices, providing more cessation programs to small towns, reducing the amount of smoking and decreasing or prohibiting advertisements of cigarettes and smoking in the mass media will be efficient.
Adult ; *Commerce ; Humans ; Interviews as Topic ; Korea ; Male ; Middle Aged ; *Motivation ; Smoking/*economics/ethnology ; Smoking Cessation/*ethnology

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