• Title/Summary/Keyword: Causality assessment

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Childhood Arsenic Exposure and Health Risk Assessment from Rice Cultivated Near the Mining Areas in Korea

  • Paik, Min-Kyoung;Kim, Won-Il;Im, Geon-Jae;Hong, Moo-Ki
    • Journal of Food Hygiene and Safety
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    • v.25 no.2
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    • pp.148-152
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    • 2010
  • Domestic studies for identification of causality between children exposure to toxic chemicals, such as arsenic (As) and resulted hazardous effects were not implemented. This study was conducted to probabilistically estimate dietary As intake and health risk assessment for young children and all age-specific populations from the consumption of As-contaminated rice of Korea. Arsenic intakes for young children (1 to 6 years old) from As-contaminated rice were higher than other age-specific groups, based on a dose-per-body weight basis. Based on the current EPA cancer slope factor for As, estimated cancer risks (to the skin cancer) associated with dietary intake of As-contaminated rice for 1 to 2 years old group and 3 to years old group are 1.76 per 10,000 and 3.16 per 10,000, respectively, at the 50th percentile. Based on possible reference levels (0.005 mg/kg/day) for children, mean and $95^{th}$ percentile value of HQ from rice for young children are very below 1.0, which is a regulatory limit of non-carcinogenic risks for human.

Hepatotoxic Events Associated with Herbal Medicinal Products, Folk Remedies and Food Supplements in Korea (국내에서 보고된 한약 및 민간요법, 건강식품 관련 약인성간손상에 대한 체계적 고찰)

  • Park, Hae-Mo;Jang, In-Soo;Lee, Sun-Dong
    • The Journal of Korean Medicine
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    • v.26 no.2 s.62
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    • pp.152-165
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    • 2005
  • Background: The use of herbal preparations as remedies for various medical conditions has continuously increased in Korea Large proportions of Korean patients use herbal medicinal products, folk remedies, and food supplements. However, studies on the safety of herbal products arc conducted on a less than sufficient basis even in the countries like Korea where herbal medicine is being used extensively. Some of the reports on the safety of herbs were done by the doctors of western medicine but lack of knowledge and misclassification led to misunderstandings. Objecitves: This study aims to review the recent evidences on hepatotoxic events associated with the use of herbal medicinal products, folk remedy, and food supplements. In the process, this review will grasp trends in this field of studies and will direct further researches into the right direction. Methods: Systematic literature searches were performed on MedRic and MEDLIS in Korea. Screening and selection of the articles and the extraction of data were performed independently by two of authors. There were no restrictions regarding the published date. In order to avoid bias, the articles written by medical doctors, not by oriental doctors were selected. 43 journals were chosen for the review. Results: Analyzing the number of journals, studies on the drug-induced liver injury were increased after the year 2000. The proportion of herbal and folk remedy associated hepatotoxic injuries in all drug-induced liver injury was $21.0\%-30.0\%$. But criterion for herbal medicine is rather vague and limited objective data hindered objectiveness. Few of single medicinal herbs and combination preparations were associated with hepatotoxic injuries. But because of lack of objectivity, further researches must be conducted to yield more concrete results. Conclusions: yield more concrete results. Incidence figures are largely unknown, and in most cases a causal attribution is not established. The challenge for the future is to systematically research this area, educate all parties involved, and minimize patient risks.

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Chemical Risk Factors for Children's Health and Research Strategy (어린이 건강관련 유해물질 연구방향)

  • Lee, Hyo-Min;Jung, Ki-Hwa
    • Journal of Food Hygiene and Safety
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    • v.23 no.3
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    • pp.276-283
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    • 2008
  • To provide the research strategy for protection of children's health from hazardous chemical, we reviewed the hazardous chemicals can be exposed through maternity, children's life style and living environment. Recently, diseases related with children's living condition were focused as asthma, atopy, childhood developmental disability, congenital malformations and obesity. Children can be exposed to hazardous chemicals through an ambient air, water, soil, food, toys and other factors such as floor dust. Also children's health was deeply related with a wrong life style and neglectful caring by a lack of knowledge and information of harmful ones at parents and child care center's nursers. According to the previous study, the chemical risk factor of children's health were identified as inorganic arsenic, bisphenol A, 2,4-D, dichlorvos, methylmercury, PCBs, pesticide, phthalates, PFOA/PFOS, vinyl chloride, et al. Domestic studies for identification of causality between children exposure to chemicals and resulted hazardous effects were not implemented. The confirmation of chemical risk factors through simultaneously performing toxicological analysis, human effect study, environmental/human monitoring, and risk assessment is needed for good risk management. And also, inter-agency collaboration and sharing information can support confirming scientific evidence and good decision making.

A Clinical Case of Liver Injury with Administration of Yeoldahanso-tang plus Rheum rhabarbarum (열다한소탕가대황(熱多寒少湯加大黃) 복용 후 간 손상 수치가 상승된 1례)

  • Kwon, Eun-Mi;Jung, Yee-Hong;Kim, Eun-Hee;Seo, Young-Kwang;Lee, Soo-Kyung;Kim, Dal-Rae;Kim, Sun-Hyung
    • Journal of Sasang Constitutional Medicine
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    • v.21 no.3
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    • pp.209-215
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    • 2009
  • 1. Objects: This case study reports a liver injury in treatment of constipation with Yeoldahanso-tang plus Rheum rhabarbarum. 2. Methods: The patient's subjective symptoms and the laboratory data including aspartate transaminase(AST), alanine transaminase(ALT), alkaline phosphatase(ALP), and gamma($\gamma$)-glutamyl transpeptidase(GGT) were observed before and after liver injury. We used the Roussel Uclaf Causality Assessment Method(RUCAM) scale in order to find out whether if Yeoldahanso-tang plus Rheum rhabarbarum was related with the liver injury. 3. Results: The patient's AST and ALT were elevated more than twice after a 3week administration period of herbal medicine. After discontinuation of the herbal medicine and administration of hepatic protective medication, AST and ALT decreased. The patient's general condition improved during hospitalization. The RUCAM score was estimated at 8. 4. Conclusions: This case is presented to bring more attention to the toxicity of herbal medicine.

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Influence of Cheongsimyeonja-tang on the Liver Function of Inpatients at the Korean Medicine Hospital (청심연자탕 복용이 한방병원 입원환자의 간 기능에 미치는 영향)

  • Han, Yun-hee;Seo, Hee-jeong;Lee, In
    • The Journal of Internal Korean Medicine
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    • v.40 no.6
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    • pp.1035-1042
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    • 2019
  • Background: Herbal medication is widely used in the Korean Medicine Hospital, and drug-induced liver injury (DILI) in Korea has increased proportionally. Herb-induced liver injury now accounts for approximately 40% of cases of hepatotoxicity in Korea, according to research data. Currently, however, the component responsible for the toxicity is usually unknown or can only be suspected. Objective: To study the hepatotoxicity of Cheongsimyeonja-tang in DILI. Methods: A retrospective review was conducted of 82 inpatients between April 2010 and March 2017 with suspected drug-induced liver injury (n=5). The standard criteria (RUCAM scale) for drug-induced liver injury (DILI) were applied. The electronic medical records (EMRs) were retrospectively reviewed to identify the relevant database. Aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and total bilirubin (T. Bili) were analyzed in blood samples before and after the administration of Cheongsimyeonja-tang. Results: Five cases out of 82 patients had a criterion-referenced probable (RUCAM) score ranging from 6 to 8 points DILI. However, statistical analysis of the liver function parameters results of the 82 patients did not show a statistically meaningful elevation after taking Cheongsimyeonja-tang. Conclusions: These data suggest a relationship between Cheongsimyeonja-tang and DILI. More studies are needed to validate these observations and to explore their implications.

Case of Suspected Drug-Induced Liver Injury after Intravenous Wild Ginseng Pharmacopuncture (산삼약침 시술 후 발생한 것으로 의심되는 약인성 간손상 : 증례 보고)

  • Jo, Hee Guen;Jung, Pil Sun;Kim, Hee Young;Bae, So Yeon;Jo, Mi Jin;Shin, Jun Huk;Han, Sae Huk;Na, Jae Il;Sul, Jae Uk;Lee, Sang Young
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.28 no.1
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    • pp.102-106
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    • 2014
  • Wild ginseng pharmacopuncture is a partly used Traditional Korean Medicine's therapy with no previously well documented hepatotoxicity. We report the the first case of suspected drug-induced liver injury (DILI) after intravenous Wild ginseng Pharmacopuncture therapy. Our clinical observation based on patient's laboratory studies, medical history, detailed drug history and ruling out other possible causes. Our patient's suspected diagnosis was wild ginseng pharmacopuncture-induced liver injury with correlation between detailed drug history and laboratory studies. This diagnosis was supported by the Council for International Organizations of Medical Sciences-Roussel Uclaf Causality Assessment Method(RUCAM). This report represents the first documented cases of suspected DILI after intravenous wild ginseng pharmacopuncture therapy, highlighting the need for future research regarding potential hepatotoxicity of Wild ginseng Pharmacopuncture.

A survey on the impact of a pharmacovigilance practice training course for future doctors of Korean medicine on their knowledge, attitudes, and perception

  • Kim, Mikyung;Han, Chang-ho
    • The Journal of Korean Medicine
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    • v.42 no.4
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    • pp.40-60
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    • 2021
  • Objectives: This study aimed to evaluate the impact of a training course on pharmacovigilance for future doctors of Korean medicine (DKM). Methods: In 2020, a pharmacovigilance training course was conducted for 57 senior students of a Korean medicine (KM) college, and its impact to the students were assessed in terms of the knowledge, attitudes, and perceptions of these students at three-time points: pre-training, post-training, and 4-6 months after the end of the training. Results: A total of 38 students completed the survey. The average score from the knowledge test increased significantly after training compared to prior to the training (5.47±2.140, 6.61±1.001, respectively, p<0.001) and was maintained until the final survey (6.61±1.220). The rate of correct answers to most of the knowledge test questions increased after the training but decreased in the final survey. In terms of attitudes, self-confidence in causality assessment (2.63±1.025, 4.58±0.826, p<0.001) and spontaneous reporting (2.08±1.050, 4.74±0.446, p<0.001) significantly increased after the training and then slightly decreased (3.92±1.171, 4.40±0.755). The perception level was high prior to the training, and this pattern was maintained throughout the study period. Students responded that pharmacovigilance education was necessary for DKM after training, and for the undergraduates of KM colleges. Conclusions: This study shows that this pharmacovigilance training course is effective for students majoring in KM but that retraining is required at least 6 months after the initial training. Further follow-up studies are needed to ensure that students actively participate in spontaneous reporting after graduation, and continuous education should be provided to graduates.

Current Research Status of National Health Insurance Database Studies in Korea Related to Parkinson's Disease and Future Research Proposals for Integrative Therapies (국민건강보험공단 청구자료를 활용한 파킨슨병과 관련된 코호트 연구 디자인 분석 및 향후 한의중재 관련 파킨슨 후향적 코호트 연구를 위한 제언)

  • Ye-Chae Hwang;Jungtae Leem
    • Journal of Society of Preventive Korean Medicine
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    • v.28 no.1
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    • pp.69-87
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    • 2024
  • Objectives : This study is to investigate the current National Health Insurance Database cohort studies related to complications of Parkinson's Disease (PD) and suggest the design of Korean medical epidemiological studies of PD. Methods : Nationwide longitudinal studies of PD patients in South Korea were collected through Pubmed and the Korea Citation Index (KCI). We selected cohort studies that used the National Health Insurance Database in Korea and targeted Parkinson's disease patients. Studies published before February 2024 were categorized according to study designs. We examined variables and covariates, enroll dates and matching methods. Results : Of a total of 536 studies, 18 studies met the inclusion criteria. All studies used the National Health Insurance (NHI) Research Database and among them, 5 used sample data and one senior database. Studies can be classified into two types. 11 cohort studies were comparing PD patients and non-PD patients. Another type was 4 PD patients cohort studies. Most studies used two diagnostic codes (G20 and V124) for inclusion criteria. Enroll periods were from 2002 to 2017, and follow-up periods were from 7 to 14 years. 16 studies considered age and sex as covariates. 15 studies used the propensity score matching method to increase the level of causality. There was only one study related to the Korean medical treatment. Conclusion : In future cohort studies on Korean medical treatment, more attempts should be made to reveal the effect of the treatments on PD patients by defining inclusion criteria for patient groups, covariates, exposure variables, and assessment indicators more operatively.

Identifying Characteristics of Incidents at Hazardous Material Facilities

  • Kim, Geun-Young;Kim, Sang-Won;Won, Jai-Mu
    • Journal of the Korean Society of Hazard Mitigation
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    • v.9 no.6
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    • pp.51-56
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    • 2009
  • Safety and quality assessment systems are very important in manufacture, storage, transportation, and handling of hazardous materials(hazmat) to prevent hazmat disasters. At present, hazardous materials exist everywhere in our daily lives with various forms of plastics, household products of cleaning and washing detergents, fertilizers or petroleum-related products. However, hazardous materials are dangerous substances when they are released to human or environment. Hazardous materials become very widely used substances in the age of oil-based industrial economy. The Korean Ministry of Environment (KMOE) describes about one hundred thousand types of chemicals are produced and used worldwide. Over four hundred new chemicals are introduced in every year. A crucial question for the Korean hazardous material management may have been raised: Will you be safe from hazardous material incidents? The gas leak disaster at Union Carbide's Bhopal, India in 1984 that made over 6,400 people killed and 30,000 to 40,000 people seriously injured is the representative case for the safety of hazmat. Korea becomes vulnerable to hazmat disaster due to the development of high-tech industry. Thus, the risk assessment system is required to Korea for transferring abandoned hazmat management systems to self-correcting safety systems. This research analyzed characteristics of various hazmat incidents applying statistical analysis methods including frequency analysis or analysis of category data to hazmat incidents for ten years. All of three analyses of category data indicate the significance of causality between hazmat incident site groups and seasons, regional groups, and incident casualty groups.

Trends of Life-Space Mobility in Community-dwelling Elderly (지역사회 거주 노인 대상의 생활공간 이동성(Life-space mobility) 연구 동향)

  • Jeong, Eun-Hwa
    • Therapeutic Science for Rehabilitation
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    • v.10 no.1
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    • pp.19-35
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    • 2021
  • Objective : This study aimed to systematically examine studies on the life-space mobility in community-dwelling elderly and analyze and summarize the research trends. Methods : The Embase and PubMed databases were searched for articles on the life-space mobility of community-dwelling elderly published between January 2010 and January 2020. Based on the selection and exclusion criteria of the 335 articles, a total of 27 articles were finally selected and analyzed. Results : As a results, 11 (40.7%) cohort studies had evidence level II. This study showed that the participants in the studies were healthy elderly (81.5%), and the University of Alabama Life-Space Assessment (UAB-LSA) used the most participants (88.9%). Of the foci of the 27 finally selected studies, 8 (29.6%) were physical, 8 (29.6%) were psychosocial, 6 (22.2%) were cognitive, and 2 (7.4%) were social, and 3 (11.1%) were others. The life-space mobility of the elderly needs to be analyzed from a multidimensional point of view, and not based on a single factor such as the physical, cognitive, psychosocial, or social. Conclusion : The results of this study are expected to verify causality through the study of life-space mobility for the elderly staying in various communities and provide future directions for the study on the mobility of the elderly's and the development of community-based intervention programs.