PURPOSE: This study was done to estimate supply and demand for nursing workforce to provide community-based primary healthcare in the North Korean region to cost-efficiently narrow the health gap between the two Koreas in case of a Korean reunification. METHODS: To understand the nursing education system and current state of nursing workforce in North Korea, the authors interviewed six North Korean defectors who had worked as nurses in North Korea. Based on the interview results and literature review, the supply and demand for the primary healthcare nursing workforce that would be needed after Korean reunification were estimated RESULTS: Currently, a total of 2,100 to 2,700 North Korean nurses were estimated to have graduated from nursing schools with a 2 year curriculum or completed 6-month military nurse training courses every year. The projected number of nurses in demand to provide primary health care ranged from 84,160 to 105,200 and the shortage would be between 31,586 and 52,626. CONCLUSION: An active utilization of the North Korean nursing workforce to improve the health of North Koreans after reunification will be the best way to reduce the reunification cost which will be inflicted mainly on South Korea.
Curriculum ; Democratic People's Republic of Korea ; Education, Nursing ; Humans ; Korea ; Military Personnel ; Nursing ; Primary Health Care ; Schools, Nursing

The present study aimed to investigate the distribution of total serum immunoglobulin E (IgE) levels in Korean schoolchildren and to evaluate its utility in the prediction of atopy and allergic diseases. A nationwide, cross-sectional survey was conducted in first grade students from randomly selected elementary and middle schools. Total IgE levels were measured by ImmunoCAP. Skin prick tests were performed for 18 common inhalant allergens to determine the presence of atopy. Children aged 12–13 years and parents of children aged 6–7 years were asked to complete questionnaire assessing allergic diseases. The cut-off levels of total IgE were determined by analyzing receiver operating characteristic curves. The median total IgE level was 86.7 kU/L (range: 1.5–4,523.1) in 3,753 children aged 6–7 years and 94.7 kU/L (range: 1.5–3,000.0) in 3,930 children aged 12–13 years. Total IgE concentrations were higher in children with atopy or allergic diseases than in those without (all P < 0.001). At the cut-off value of 127.7 kU/L, sensitivity, specificity, and positive and negative predictive values (PPV and NPV) were 67.1%, 75.4%, 65.4%, and 76.7%, respectively, in elementary schoolchildren. At the cut-off value of 63.0 kU/L, sensitivity, specificity, PPV, and NPV were 81.9%, 66.6%, 75.0%, and 75.1%, respectively, in middle schoolchildren. PPV and NPV were ≥ 70% when cut-offs of 258.8 kU/L and 38.4 kU/L were used for the diagnosis of atopy in 6–7 year-olds and 12–13 year-olds, respectively. This nationwide population-based study provided the first normal reference ranges of total IgE in Korean schoolchildren.
Allergens ; Child ; Cross-Sectional Studies ; Diagnosis ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Immunoglobulins* ; Korea ; Parents ; Reference Values* ; ROC Curve ; Sensitivity and Specificity ; Skin

PURPOSE: This study aimed to analyze the prevalence of allergic diseases in Korean schoolchildren according to their residential areas in 2010. METHODS: A nationwide, cross-sectional study was conducted in children aged 6-7 years (n=4,003) and adolescents aged 12-13 years (n=4,112) who were randomly selected. Demographic and disease-related information was obtained through a Korean version of ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire, and skin prick tests for 18 inhalant allergens were performed. RESULTS: There was statistically significant regional difference in the prevalence of allergic rhinitis (AR) (P<0.05). The regions with highest and lowest prevalence in 12- to 13-year-old children were as follows: Chungcheong and Honam in "Diagnosis of AR, ever" (33.7% vs. 24.5%), Jeju and Yeongnam in "Treatment of AR, last 12 months" (25.5% vs. 18.0%), Chungcheong and Yeongnam in "Rhinitis with sensitization" (31.6% vs. 23.6%). The regions with highest and lowest prevalence in 6-7 years old children were as follows: Yeongnam and Seoul in "Diagnosis of AR, ever" (42.1% vs. 31.0%), Yeongnam and Jeju in "Treatment of AR, last 12 months" (31.8% vs. 21.9%), Jeju and Seoul in "Rhinitis with sensitization" (26.0% vs. 18.4%). We also found a regional difference in inhalant allergens among the children with "rhinitis with sensitization" CONCLUSION: The prevalence of AR in children differs according to residential areas in a nationwide survey in 2010 while there is no significant regional difference in the prevalence of asthma and AD.
Adolescent ; Allergens ; Asthma ; Child* ; Cross-Sectional Studies ; Dermatitis, Atopic ; Humans ; Hypersensitivity ; Prevalence* ; Rhinitis ; Seoul ; Skin ; Surveys and Questionnaires

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.
Academies and Institutes ; Biological Markers ; Curriculum ; Developed Countries ; Education ; Employment ; Environmental Medicine* ; Internship and Residency* ; Korea* ; Occupational Health ; Specialization ; Toxicology

OBJECTIVES: To estimate the demand and demand-supply balances of occupational and environmental medical specialties (OEMS) in the target year of 2020. METHODS: We adopted a new OEMS demand model based on the situations of periodic workers' health examination (PHE) agencies, health management agencies (HMA), and legal enforcement for health and safety systems in Korea. 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, statistics and internal documents from the Ministry of Employment and Labor (MOEL). RESULTS: From the data and assumptions, newly demanded OEMS were 193 for workers who had received PHE, and 205 based on total workers for PHE in 2020 for PHE. But no OEMS for HMA area is demanded. Comparing with the calculated numbers of supply estimates, the demand was slightly higher, but could be balanced if MOEL kept consistent and unchanging policies. CONCLUSIONS: The study results suggest that the demand-supply balance of OEMS is mainly influenced by the policy of MOEL. Further studies are needed examining more detailed data and statistics about PHE agencies, HMA and considering MOEL policies are needed to configuring more sophisticated and need-included estimation.
Employment ; Environmental Medicine ; Health Manpower ; Health Services Needs and Demand ; Korea ; Occupational Medicine ; Public Policy

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.
Accreditation ; Employment ; Environmental Medicine ; Forecasting ; Korea

To investigate the prevalence of asthma, allergic rhinitis, and eczema, we did a cross-sectional survey of 4,003 children aged 6-7 years (students in the 1st year of elementary school) and 4,112 students aged 13-14 years (students in the 1st year of middle school), chosen from a random sample of 45 primary and 40 middle schools across the nation. The Korean-translated modified version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was used in this survey. The weighted 12-month prevalence of asthma symptoms from the questionnaires was 10.3% (95% confidence interval [CI], 9.2 to 11.4) for children aged 6-7 years and 8.3% (95% CI, 7.4 to 9.2) for children aged 13-14 years. The weighted 12-month prevalence of allergic rhinoconjuctivitis symptoms was 18.9% (95% CI, 17.5 to 20.4) for children aged 6-7 years and 19.2% (95% CI, 17.9 to 20.6) for children aged 13-14 years. The weighted 12-month prevalence of eczema symptoms was 17.9% (95% CI, 16.6 to 19.3) for children aged 6-7 years and 11.2% (95% CI, 10.1 to 12.3) for children aged 13-14 years. Compared with results from a 2000 ISAAC study, the 12-month prevalence of asthma increased from 5.8% to 10.3% in children aged 6-7 years, but there was little change (from 8.7% to 8.3%) in children aged 13-14 years. The prevalence of allergic rhinoconjunctivitis and eczema has increased considerably in both age groups.
Aged ; Asthma ; Child ; Cross-Sectional Studies ; Eczema ; Humans ; Hypersensitivity ; Prevalence ; Surveys and Questionnaires ; Rhinitis ; Rhinitis, Allergic, Perennial

We performed this study to assess the prevalence of sensitization to aeroallergens and to analyze the difference between prevalence rates according to children's ages and residential areas. In this nationwide cross-sectional study, first grade students of 45 elementary schools and 40 middle schools were randomly selected, and skin prick tests were performed for 18 inhalant allergens between October and November 2010. Of 7,829 analyzed subjects, 3,753 (47.9%) were sensitized to at least one aeroallergen. Sensitization to Dermatophagoides farinae was found to be the most prevalent in elementary schoolchildren (32.4%), followed by Dermatophagoides pteronyssinus, Tyrophagus putrescentiae, Japanese hop, and oak. In middle schoolchildren, D. pteronyssinus yielded the highest prevalence (42.7%), followed by D. farinae, T. putrescentiae, Japanese hop, and cat. In middle schoolchildren, the sensitization rate to aeroallergens in metropolitan, urban, and rural areas was 57.2%, 54.3%, and 49.8%, respectively (P = 0.019). In this age group, the sensitization rate in low, middle, high, and very high income groups was 53.8%, 51.8%, 59.0%, and 59.6%, respectively (P = 0.002). In conclusion, the sensitization rate is 47.9% and house dust mite is the most prevalent allergen in the pediatric population in Korea. The rate is higher in metropolitan areas and the highest income group than in rural areas and low income groups.
Adolescent ; Age Factors ; Air Pollutants/*immunology ; Allergens/*immunology ; Animals ; Child ; Cross-Sectional Studies ; Demography ; Female ; Humans ; Hypersensitivity/*diagnosis/epidemiology/immunology ; Male ; Pyroglyphidae/immunology ; Republic of Korea ; Rural Population ; Sex Factors ; Skin Tests ; Socioeconomic Factors ; Urban Population

OBJECTIVE: We investigated the differences among the patients who were diagnosed with carpal tunnel syndrome according to the frequency of exposure to wrist-burdening work by using carpal tunnel syndrome surveillance system. METHODS: The study subjects were a total of 855 patients from 1,017 patients who were diagnosed with carpal tunnel syndrome in 9 university hospitals from May, 2001 to October, 2004, and we excluded 161 patients who had no clear information for their occupational status. The subjects were classified into three groups according to four types of wrist-burdening work: 1) repetitive use of wrists, 2) inappropriate posture of the hand, 3) use of vibrating tools, and 4) overpressure work on the hand or palm, - as defined in the operational definition by the National Institute for Occupational Safety and Health (NIOSH). The subjects with two or more types of wrist-burdening work were classified as 'high risk group', the subjects with one type of wrist-burdening work were classified as 'intermediate risk group', and the subjects with none of the types of wrist-burdening work were classified as 'low risk group'. We used chi-square test, Fisher's exact test and ANOVA for comparing the characteristics according to the 3 subgroup. RESULTS: The mean age in the high risk group was the lowest(53 years), and there was a significant difference among the groups for the mean age(p<0.05). The high risk group included the most males with 39(22.0%). The subjects in the high risk group had significantly more jobs in agriculture.forestry.fisheries, factory work, and simple labor and less comorbidities, including diabetes and rheumatoid arthritis(p<0.05). The subjects in the intermediate risk group had a higher proportion of service workers. There were significant differences for the symptoms of carpal tunnel syndrome according to the frequency of exposure to wrist-burdening work. The subjects in the high risk group showed the highest proportion of work-related aggravation of symptoms with 88(76.5%) and the highest mean number of days absent from work(6 days) as related to carpal tunnel syndrome. CONCLUSION: Worker in agriculture.forestry.fisheries, factory work, and simple labor showed significantly more frequent carpal tunnel syndrome, and so management strategies are needed to prevent them from developing carpal tunnel syndrome.
Carpal Tunnel Syndrome ; Comorbidity ; Employment ; Hand ; Hospitals, University ; Humans ; Male ; National Institute for Occupational Safety and Health (U.S.) ; Occupations ; Posture ; Wrist

OBJECTIVE: The purpose of this study was to develop a quality assessment domain and to determine its priority in Korea's Occupational Health Services. METHODS: We designed the study in a 3 phase approach. The first phase of the process encompasses making a list of measures for quality assessments by a thorough review of the literature. The second phase emcompassed the development of inclusion and priority criteria. The third phase of survey development was conducted during August 2008 and a questionnaire was administered to occupational health physicians covering 58 subjects. RESULTS: Finally we investigated 40 quality assessment measures, including 2 for structural domain, 17 for process domain, 21 for result domain in occupational health service. The 40 quality assessment measures divided into 2 parts. The early quality assessment part was 14 measures that including 8 measures for process domains and 5 measures for result domains. CONCLUSION: We investigate a quality assessment domain and determined the priorities of the occupational health service in Korea.
Humans ; Korea ; Occupational Health ; Occupational Health Physicians ; Occupational Health Services ; Questionnaires