• Journal of Preventive Medicine and Public Health
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• 제47권6호
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• pp.336-342
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• 2014

Objectives: Child mortality remains a critical problem even in developed countries due to low fertility. To plan effective interventions, investigation into the trends and causes of child mortality is necessary. Therefore, we analyzed these trends and causes of child deaths over the last 30 years in Korea. Methods: Causes of death data were obtained from a nationwide vital registration managed by the Korean Statistical Information Service. The mortality rate among all children aged between one and four years and the causes of deaths were reviewed. Data from 1983-2012 and 1993-2012 were analyzed separately because the proportion of unspecified causes of death during 1983-1992 varied substantially from that during 1993-2012. Results: The child (1-4 years) mortality rates substantially decreased during the past three decades. The trend analysis revealed that all the five major causes of death (infectious, neoplastic, neurologic, congenital, and external origins) have decreased significantly. However, the sex ratio of child mortality (boys to girls) slightly increased during the last 30 years. External causes of death remain the most frequent origin of child mortality, and the proportion of mortality due to child assault has significantly increased (from 1.02 in 1983 to 1.38 in 2012). Conclusions: In Korea, the major causes and rate of child mortality have changed and the sex ratio of child mortality has slightly increased since the early 1980s. Child mortality, especially due to preventable causes, requires public health intervention.

• Journal of Preventive Medicine and Public Health
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• 제20권1호
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• pp.10-39
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• 1987

Mortality rate and causes of death are regarded as an index of strength as well as level of development of a country. However, there is no accurate data for the causes of death in Korea due to lack of systematic vital data collection system. The objective of this study was to define the causes of death of the school teachers, its changing pattern, cause-specific mortality rate, and geographic variation. The study population included all of the teachers in primary school, middle and high schools, and college who joined in Korean Teachers' Union between 1968 and 1985 that provided a total of 1,972, 069 person-years to observe (1,384,911 man-years, 587,158 woman-years). There were 3,678 deaths in this period (3,377 males, 301 females). The most common cause of death was neoplasm which was followed by the diseases of circulatory system. The proportion of death of neoplasm was 1.5 times higher than that of the general population. Causes of death were classified into 5 major groups (neoplasm, diseases of circulatory system, accidents and poisoning, diseases of liver, and all others). The mortality rates of diseases of circulatory system and all others for general population were 4 to S times higher than those for the teachers. However, mortality rates of neoplasm and diseases of liver were only about 2 times higher than those for teachers. Mortality rate of liver cancer for teachers was higher than gastric cancer mortality rate which is the reverse in general population. The crude death rate was 2.12 per 1,000 person-years for male and 1.00 for female which is one-third of the crude death rate of general population. Crude death rate of study population was higher in rural area than in urban area. However, mortality rate of neoplasm for male was higher in urban area than in rural area while mortality rates of all other causes were higher in rural area. For female, mortality rates of neoplasm and diseases of circulatory system were higher in urban area and the rates for all other causes were higher in rural area. Crude death rate was lowest in Gyeongin area and highest in Yeongnam area. The mortality of neoplasm for male accounted the highest proportion of all death in Gyeongin, Chungcheong and Yeoungnam areas while the mortality of neoplasm and mortality of circulatory system accounted the same proportion in Jeonra area. For female, the mortality of disease of circulatory system accounted the highest proportion in Gyeongin and Yeoungnam and Jeonra areas. Proportion of death due to accidents and poisoning was high in Chungcheong area and death due to all other causes was high in Yeoungnam area. The most common cause of death for male by city and province was neoplasm in Seoul, Busan, Daegu, Gyeonggi, Chungnam, Chungbuk, Gyeongnam and Gyeongbuk. Diseases of circulatory system was the leading cause of death in the rest of city and provinces. The leading cause of death for female was diseases of circulatory system in Seoul, Incheon, Chungbuk, Chungnam, and Gyeongbuk, neoplasm in Busan, and accident and poisons in all other cities and provinces. The mortality rates of male were above 2 per 1,000 person-years in Jeju, Gyeongbuk, Gyeongnam, Daegu, and Chungbuk, and it was below 1.5/l,000 in Seoul, Incheon and Gyeonggi. The mortality rate of female was above 1.2/1,000 person-years in Gyeongnam and Incheon while it was below 0.5/l,000 in Daegu, Geonggi Chungbuk and Jeju. The leading cause for male by school of employment was neoplasm in all levels of school with a remarkably higher rate in the professors of college. Leading cause of death for female was disease of circulatory system in primary schools, high schools and college but neoplasm in middle schools. There was no death due to liver diseases in middle and high school teachers and college professors and no death due to all other category in high school teachers and college professors, in females. High school teachers and the highest mortality rate and college professors showed the lowest mortality rate. Temporal trend of mortality was examined in three periods; period I ($1968{\sim}1974$), period II ($1975{\sim}1979$), and period III ($1980{\sim}1985$). The leading cause of death for male was diseases of circulatory system in period I and II but neoplasm in period III. Such trend of decreasing diseases of circulatory system and increasing neoplasm was observed in female. Overall mortality rate was decreased over the 3 periods. The mortality rates of diseases of circulatory system, liver disease and all others were decreased in male but the mortality rates of neoplasm and accident and posions was increased. Female showed a similar trend to male but the mortality rate of liver diseases was increased. Mortality rates of diseases of circulatory system, neoplasm and liver diseases increased with age of teachers up to 50 years of age but decreased in 60 years of age. Mean age at death due to each cause was higher in male than female by $4{\sim}10$ years. However, the mean age at death of the teachers was $2{\sim}5$ years lower than that of the general population in all causes of death and the sex difference in the mean a2e at death was smaller ($2{\sim}3$ years) in general population. In sex ratio of mortality, male was higher than female in almost all diseases except suicide and maintained a high ratio. The general population showed universally high ratio in male like teachers, and more or less did regular patterns in mortality with ratio smaller.

• 한국환경보건학회지
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• 제40권5호
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• pp.346-354
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• 2014

Objectives: Although a number of epidemiologic studies have examined the association between air pollution and mortality, data limitations have resulted in fewer studies of particulate matter with an aerodynamic diameter of ${\leq}2.5{\mu}m$ ($PM_{2.5}$). We conducted a time-series study of the acute effects of particulate matter with an aerodynamic diameter of ${\leq}10{\mu}m$($PM_{10}$) and $PM_{2.5}$ on the increased risk of death for all causes and cardiovascular mortality in Seoul, Korea from 2006 to 2010. Methods: We applied the generalized additive model (GAM) with penalized splines, adjusting for time, day of week, holiday, temperature, and relative humidity in order to investigate the association between risk of mortality and particulate matter. Results: We found that $PM_{10}$ and $PM_{2.5}$ were associated with an increased risk of mortality for all causes and of cardiovascular mortality in Seoul. A $10{\mu}g/m^3$ increase in the concentration of $PM_{10}$ corresponded to 0.44% (95% Confidence Interval [CI]: 0.25-0.63%), and 0.95% (95% CI: 0.16-1.73%) increase of all causes and of cardiovascular mortality. A $10{\mu}g/m^3$ increase in the concentration of $PM_{2.5}$ corresponded to 0.76% (95% CI: 0.40-1.12%), and 1.63% (95% CI: 0.89-2.37%) increase of all causes and cardiovascular mortality. Conclusion: We conclude that $PM_{10}$ and $PM_{2.5}$ have an adverse effect on population health and that this strengthens the rationale for further limiting levels of $PM_{10}$ and $PM_{2.5}$ in Seoul.

• Journal of Preventive Medicine and Public Health
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• 제44권6호
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• pp.249-259
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• 2011

Objectives: This study aimed to analyze long-term trends in the contribution of each cause of death to socioeconomic inequalities in all-cause mortality among Korean adults. Methods: Data were collected from death certificates between 1990 and 2004 and from censuses in 1990, 1995, and 2000. Age-standardized death rates by gender were produced according to education as the socioeconomic position indicator, and the slope index of inequality was calculated to evaluate the contribution of each cause of death to socioeconomic inequalities in all-cause mortality. Results: Among adults aged 25-44, accidental injuries with transport accidents, suicide, liver disease and cerebrovascular disease made relatively large contributions to socioeconomic inequalities in all-cause mortality, while, among adults aged 45-64, liver disease, cerebrovascular disease, transport accidents, liver cancer, and lung cancer did so. Ischemic heart disease, a very important contributor to socioeconomic mortality inequality in North America and Western Europe, showed a very low contribution (less than 3%) in both genders of Koreans. Conclusions: Considering the contributions of different causes of death to absolute mortality inequalities, establishing effective strategies to reduce socioeconomic inequalities in mortality is warranted.

• 보건교육건강증진학회지
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• 제20권4호
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• pp.51-65
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• 2003

Objectives： To examine the regional mortality differences in The Republic of Korea according to geographic location. Methods： All 232 administrative districts of the Republic of Korea in 1998 were studied according to their geographic locations by dividing each district into three categories； "metropolis," "urban," and "rural". Crude mortality rates for doth sexes from total deaths as well as the three major causes of death in Korea (cardiovascular disease, cancer, and external causes) were calculated with raw data from the "1998 report on the causes of death statistics" and resident registration data. Standardized mortality ratios (SMR) were calculated using the indirect standardization method. Poisson regression analyses were performed to examine the effects of geographic locations on the risk of death. To correct for the socioeconomic differences of each region, the percentage of old ($\geq$ 65 years old) population, the number of privately owned cars per 100 population, and per capita manufacturing production industries were included in the model. Results： Most SMRs were the lowest in the metropolis and the highest in the rural areas. These differences were more prominent in men and in deaths from external causes. In deaths from cancer in women, the rural region showed the lowest SMR. In Poisson regression analysis after correcting for regional socioeconomic differences, the risk of death from all causes significantly increased in both urban (OR＝1.111) and rural (OR＝1.100) regions, except for rural women, compared to the metropolis region. In men, the rural region showed higher risk (OR＝1.180) than the urban region (OR＝1.l51). For cardiovascular disease and cancer, significant differences were not found between geographic locations, except in urban women for cardiovascular disease (OR＝1.151) and in rural women for cancer (OR＝0.887), compared to metropolis women. In deaths from external causes, the risk ratios significantly increased in both urban and rural regions and an increasing tendency from the metropolis to the rural region was clearly observed in both sexes. Conclusions： Regional mortality differences according to geographic location exist in The Republic of Korea and further research and policy approaches to reduce these differences are needed. to reduce these differences are needed.

• Journal of Chest Surgery
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• 제22권1호
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• pp.32-41
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• 1989

We scrutinized the 64 cases of TGA and Taussig-Bing anomaly who underwent Senning and Mustard operations from Jan. 1981 to May 1988. The ratio of male to female was 45; 19, and the age at operation varied from 2 months to 18 years [mean 18.9*32.9 months]. The in-hospital mortality was in 24 cases [37.5%] and the major causes were myocardial failure and congestive heart failure associated with arrhythmias. The risk factors for hospital mortality were complex TGA, prolonged bypass time and high postoperative CVP. In addition, mortality increased during the first year the procedure was used. Late mortality occurred in 6 cases and the major causes was congestive heart failure, and there was not any significant risk factor noted in late mortality. Early arrhythmia developed in 37.5%, all of which were transient and self limited and 7 cases of early mortality were related to the arrhythmias. Late arrhythmias developed in 8 cases, but 7 cases were transient. One case died with junctional tachycardia. Of significance the one case that died late by arrhythmia had a similar junctional tachycardia in the early postoperative period. The survival rate in all cases disregarding initial in-hospital mortality 1YSR 89.8% and 5YSR 84.3%, but because of short duration of follow up this is not significant. We concluded that early hospital mortality could be decreased by operating at an earlier age and by adjusting the appropriate operation method.

• Journal of Preventive Medicine and Public Health
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• 제48권2호
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• pp.105-110
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• 2015

Objectives: Recently, low systolic blood pressure (SBP) was found to be associated with an increased risk of death from vascular diseases in a rural elderly population in Korea. However, evidence on the association between low SBP and vascular diseases is scarce. The aim of this study was to prospectively examine the association between low SBP and mortality from all causes and vascular diseases in older middle-aged Korean men. Methods: From 2004 to 2010, 94 085 Korean Vietnam War veterans were followed-up for deaths. The adjusted hazard ratios (aHR) were calculated using the Cox proportional hazard model. A stratified analysis was conducted by age at enrollment. SBP was self-reported by a postal survey in 2004. Results: Among the participants aged 60 and older, the lowest SBP (<90 mmHg) category had an elevated aHR for mortality from all causes (aHR, 1.9; 95% confidence interval [CI], 1.2 to 3.1) and vascular diseases (International Classification of Disease, 10th revision, I00-I99; aHR, 3.2; 95% CI, 1.2 to 8.4) compared to those with an SBP of 100 to 119 mmHg. Those with an SBP below 80 mmHg (aHR, 4.5; 95% CI, 1.1 to 18.8) and those with an SBP of 80 to 89 mmHg (aHR, 3.1; 95% CI, 0.9 to 10.2) also had an increased risk of vascular mortality, compared to those with an SBP of 90 to 119 mmHg. This association was sustained when excluding the first two years of follow-up or preexisting vascular diseases. In men younger than 60 years, the association of low SBP was weaker than that in those aged 60 years or older. Conclusions: Our findings suggest that low SBP (<90 mmHg) may increase vascular mortality in Korean men aged 60 years or older.

• Journal of Preventive Medicine and Public Health
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• 제38권1호
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• pp.38-44
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• 2005

Objective : To compare the mortality rate of Korean medical doctors to that of the general Korean population for the period 1992-2002. Methods : The membership records of the Korean Medical Association were linked to the 1992-2002 death certificate data of Korea s National Statistical Office using 13-digit unique personal identification numbers. The study population consisted of 61,164 medical doctors with a follow-up period of 473,932 person-years. Standardized mortality ratios(SMRs) were calculated to compare cause-specific mortality rates of medical doctors to those of the general population. Results : We confirmed 1,150 deaths at ages from 30 to 75 years from 1 January 1992 to 31 December 2002. The SMR for all-cause of death was 0.47(95% CI : $0.44{\sim}0.50$). The SMRs for smoking-related diseases such as cerebrovascular accidents and chronic obstructive pulmonary disease were smaller than the SMR of all-cause of death. However, the SMRs for colorectal and pancreatic cancers were not significantly lower than those of the general population. Transport accidents and suicides accounted for 72% (94 of 131) of external causes of death. The SMR for suicide was 0.51 (95% CI : $0.38{\sim}0.68$). Conclusions : The mortality rate of South Korean medical doctors was less than 50% that of the general population of South Korea. Cause-specific analysis showed that mortality rates in leading causes of death were lower among medical doctors although differences in mortality rates between medical doctors and the general population varied with the causes of death. These health benefits found among medical doctors may be attributable to the lower level of health damaging behaviors (e.g., lower smoking rates) and better working conditions.

• Journal of Radiation Protection and Research
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• 제47권1호
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• pp.22-29
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• 2022

Background: A comprehensive, traceable, and easy-to-understand radiation risk indicator is desired for radiological protection. The early-onset hypothesis could be used for this purpose. Materials and Methods: An indicator for early death (IED) was developed and calculated using the epidemiological dataset from the 14^th Report of the Life Span Study (LSS) of Hiroshima and Nagasaki. By clarifying the calculation process, IED for all-cause mortality was estimated. In addition, the characteristics of IED for solid cancer mortality and cardiovascular mortality as well as those of men and women, and their dependence on age at exposure were investigated for detailed analysis. Results and Discussion: The IED for all-cause mortality was estimated to be approximately 4 years for an acute radiation exposure of 1 Gy regardless of the fitting dose range. The cumulative death rate for all solid cancers also indicated the early-death tendency (approximately 7-10 years at 1 Gy). Although, there is a slight difference in the characteristics of the risk obtained from the LSS study and this study, it is considered that the IED in a unit of years can also be used to show the overall picture of risk due to radiation exposure. Conclusion: We developed and calculated the indicator for early death, IED, for the cumulative mortality rate of all causes of death, all solid cancers, and circulatory diseases. The quantitative values of IED were estimated to be 4 years for all causes of death, 7-10 years for all solid cancers. IED has an advantage for intuitively understanding the meaning of radiation risk since it can be obtained by a simple and traceable method.

• Neonatal Medicine
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• 제28권3호
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• pp.99-107
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• 2021

Purpose: Studies have been conducted on the prevalence and infant mortality rate of congenital anomalies; however, studies on child mortality are rare. Therefore, we evaluated the characteristics of deaths associated with congenital anomalies among children born in Korea who died within 5 years of age. Methods: Birth-to-death cohort linked data of children under the age of 5 years from 2010 to 2013, and statistical data on the cause of death by age from 1999 to 2019, both provided by the Korea National Statistical Office's Microdata Integrated Service, were retrospectively investigated. We investigated the trends and characteristics of mortality associated with congenital anomalies. Results: Among 1,858,945 children, 6,510 children who died were under 5 years of age, and among them, 1,229 deaths were associated with congenital anomalies, while 5,281 deaths were due to other causes. Deaths associated with congenital anomalies accounted for 18.9% of all deaths. When comparing congenital anomalies by systems, anomalies of the cardiovascular system (52.6%) were the most common. The mortality rate associated with congenital anomalies and those of other causes showed similar declining trends in 21 years. Conclusion: The mortality rate of congenital anomalies during the first 5 years of life did not increase differently from the prevalence of congenital anomalies but rather decreased. Deaths associated with congenital anomalies accounted for 20.5% of all infant deaths and 12.1% of child deaths, since the major causes of death in infants and children are slightly different, continuous and careful monitoring is required.