• Journal of Environmental Health Sciences
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• v.47 no.3
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• pp.245-258
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• 2021

Objectives: In many previous studies, endocrine disruptors (EDCs) have been found to affect delays in puberty. Various EDCs have been reported on, but there have been only limited epidemiologic studies on the effects of exposure to environmental heavy metals and pyrethroid pesticides on puberty delay. Therefore, the aim of this study was to investigate the association of exposure to environmental mercury, cadmium, and pyrethroid pesticides with delayed puberty in children based on national survey data that represents Korean children. Methods: We selected 450 children at the ages of 9-11 years old from the third Korean National Environmental Health Survey (3rd KoNEHS). The relations of urinary Hg, Cd, and 3-PBA with pubertal development were evaluated using multiple logistic regression analyses. Results: Urinary Hg levels were significantly associated with delayed puberty in boys [testicle development: OR=0.41 (95% CI: 0.20, 0.84); genitalia development: OR=0.35 (95% CI: 0.15, 0.81)]. Girls with higher Hg levels were more likely to experience delayed menarche [OR=0.23 (95% CI: 0.06, 0.90)]. We observed a significant 49% reduction in odds for menarche per increasing unit of urinary cadmium levels [OR=0.51 (95% CI: 0.24, 1.01)]. In addition, urinary 3-PBA showed a negative association with genitalia development in boys and menarche in girls [genitalia development: OR=0.73 (95% CI: 0.55, 0.96); menarche: OR=0.56 (95% CI: 0.32, 1.00)]. Conclusions: The results of this study support the hypothesis that exposure to environmental mercury, cadmium and pyrethroid pesticides may affect puberty delays. Additional evidence needs to be obtained through further prospective studies.

• Health Policy and Management
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• v.34 no.1
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• pp.87-93
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• 2024

Background: In recent years, studies have shown conflicting results regarding the benefits of dietary supplements in reducing healthcare expenditures. This study aimed to address this inconsistency by examining the association between supplement consumption and health expenditures using nationally representative data from the Korea Health Panel Survey (2019-2020). Methods: A 1:1 matched case-control dataset was established using propensity score matching technique based on supplement consumption. Then, total annual healthcare expenditures were compared between the two groups. In addition, a multivariate regression analysis (Proc Surveyreg) was performed to determine the association between the supplement consumption and medical costs. Results: The supplement user group spent about 1.72 million Korean won, while the non-user group spent about 1.43 million Korean won on medical services (p=0.0186). The results of multivariate regression showed that the costs were approximately 26.15% higher in the user group than in the non-user group (p=0.0004). Conclusion: Contrary to the previous studies that have shown the benefits of supplement use in reducing healthcare costs, this study showed that those who consistently consumed supplements spent more on medical services. This can be interpreted in the same context as previous studies suggesting that dietary supplement intake is a healthy behavior for managing one's health. However, we caution against drawing firm conclusions due to data limitations. Further analysis using patient-level epidemiologic data is needed.

• Journal of the Korean Home Economics Association
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• v.46 no.8
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• pp.97-107
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• 2008

This study was conducted in order to identify the relationship between psychological factors, such as depression and self-esteem, and nutritional status, such as nutritional risk index and nutrient intake, among the elderly in Chunnam Province. The participants were 119 elderly individuals over the age of 65 years who visited the Senior Welfare Center in Chunnam province between January 29 and February 2, 2007. This study was conducted using a structured questionnaire that included, the Center for Epidemiologic Studies Depression Scale (CES-D), General Self Efficacy Scale (GSES), Nutritional Screening Initiative Checklist (NSI checklist), questions pertaining to the general characteristics of the participants and an estimation of nutrient intake using the 24-hour recall method. Data were analyzed by the SPSS program. Analysis of the participant's CES-D scores revealed that 43.7% of the subjects were normal and 56.3% had more than mild depression. The mean GSES score was 45.9 for the entire group of subjects (51.9 for men, 43.6 for women). The mean nutritional risk index value was 4.30 (5.03 for men, 4.01 for women). Analysis of the participant's scores on the NSI checklist revealed that 69.7% of the subjects were normal and 30.3% exhibited a moderate nutritional risk. The CES-D was positively correlated with the NSI checklist (p < 0.05) but negatively correlated with nutrient intake. However, the GSES was negatively correlated with the NSI checklist (p < 0.05), but positively correlated with nutrient intake (P < 0.01 for protein, calcium, phosphorus, zinc etc.). The results of this study indicate that it is necessary to manage psychological factors, including depression and self-esteem, in the elderly in order to decrease their nutritional risk and increase their nutrient intake.

• Korean Journal of Psychosomatic Medicine
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• v.23 no.1
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• pp.26-35
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• 2015

Objectives:The purpose of this study was to evaluate reliability and validity of the Korean version of the Postconcussional Syndrome Questionnaire(KPCSQ) which was originally developed in 1992 by Lees-Haley. Methods:Patients with traumatic brain injury were recruited from April 2009 to December 2011 from the Korean University Ansan Hospital. We selected patients that met the ICD-10 diagnostic criteria of postconcussional syndrome and organic mental disorder including organic mood disorder, organic emotionally labile disorder, organic anxiety disorder and organic personality disorder. The KPCSQ, Trait and State Anxiety Inventory(STAI-I, II), and Center for Epidemiologic Studies Depression Scale(CESD) were administered to all subjects. Factor analysis of the items were performed and test-retest correlation were evaluated. Internal consistency of the KPCSQ and its subscales was assessed with Cronbach's alpha. External validity of the KPCSQ were examined by correlation coefficient with the STAI-I, II, and CESD. Results:The Cronbach's alpha coefficient of the total PCSQ was 0.956. The test-retest reliability coefficient was 0.845. The PCSQ showed significant correlation with STAI-I, II and CESD. The factor analysis of the PCSQ yielded 4 factors model. Factor 1 represented 'affective and cognitive symptoms', factor 2 represented 'somatic symptoms', factor 3 represented 'infrequent symptoms' and factor 4 represented 'exaggeration or inattentive response'. There was no significant difference between the PCS group and the organic mental disorder group in the score on each measure. The scores on KPCSQ and its subscales in the subjects that had scored 5 or more in 'exaggeration or inattentive response' are significantly higher than those in the subjects had scored 4 in 'exaggeration or inattentive response'. Conclusions:This study suggests that the Korean version of PCSQ is a valid and reliable tool for assessing psychiatric symptomatology of patients with traumatic brain injury. Further investigations with greater numbers of subjects are necessary to assess the clinical usefulness of the KPCSQ.

• Journal of Korean Society for Atmospheric Environment
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• v.28 no.5
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• pp.571-580
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• 2012

Epidemiologic studies of air pollution need accurate exposure assessments at unmonitored locations. A land use regression (LUR) model has been used successfully for predicting traffic-related pollutants, although its application has been limited to Europe, North America, and a few Asian region. Therefore, we modeled traffic-related pollutants by LUR then examined whether LUR models could be constructed using a regulatory monitoring network in Metropolitan area in Korea. We used the annual-mean nitrogen dioxide ($NO_2$) in 2010 in the study area. Geographic variables that are considered to predict traffic-related pollutants were classified into four groups: road type, traffic intensity, land use, and elevation. Using geographical variables, we then constructed a model to predict the monitored levels of $NO_2$. The mean concentration of $NO_2$ was 30.71 ppb (standard deviation of 5.95) respectively. The final regression model for the $NO_2$ concentration included five independent variables. The LUR models resulted in $R^2$ of 0.59. The mean concentration of $NO_2$ of elementary schools was 34.04 ppb (standard deviation of 5.22) respectively. The present study showed that even if we used regulatory monitoring air quality data, we could estimate $NO_2$ moderately well. These analyses confirm the validity of land use regression modeling to assign exposures in epidemiological studies, and these models may be useful tools for assessing health effects of long-term exposure to traffic related pollution.

• Korean Journal of Community Nutrition
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• v.25 no.1
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• pp.48-60
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• 2020

Objectives: Most cohort studies used food frequency questionnaires (FFQ) to evaluate coffee consumption as it assesses habitual dietary patterns, whereas some studies have used the 24-hour recalls (24HR) as it elicits in-depth description of foods and the amount eaten. The aim of this study was to compare FFQs and 24HR to assess the consumption of various types of coffee. Methods: We included 25,904 participants aged 40 years or older from the Health Examinees (HEXA) Study of the Korean Genome and Epidemiologic Study (KoGES). Each participant completed one FFQ and one-day (n=11,280) or two-day 24HR (n=14,624). We classified coffee types into: black coffee, coffee with sugar and cream, and coffee with sugar alone or cream alone. We compared the proportions of nondrinkers, black coffee, and coffee with sugar and cream through FFQ and 24HR. Results: Among those who completed one FFQ and one-day 24HR, 39.4% of "nondrinkers" on one-day 24HR reported that they did not drink coffee on their FFQs. Whereas among those who complete two-day 24HR, 71.2% of "nondrinkers" on two-day 24HR said that they did not drink coffee on their FFQs. Among those who completed one FFQ and oneday 24HR, 58.3% marked "black coffee" on one-day 24HR said that they drank black coffee on their FFQs. Among those who complete two-day 24HR, 58.8% marked "black coffee" on two-day 24HR said that they drank black coffee on their FFQs. The kappa coefficients and percent agreements were 0.4 and 59.6%, respectively, for the comparison of coffee intake between FFQ and one-day 24HR, and 0.6 and 72.8%, respectively, for the comparison of coffee intake between FFQ and two-day 24HR. Conclusions: We found discrepancies between FFQs and 24HR in the types of coffee consumed. Such limitations should be considered when using the 24HR data to examine the effect of coffee consumption on disease development.

• Journal of Preventive Medicine and Public Health
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• v.28 no.3 s.51
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• pp.609-622
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• 1995

Until now there are few available epidemiologic data of osteoporosis in Korea, and the severity of osteoporosis-related health problem has not been widely recognized yet. But the numbers of the old people are increasing in Korea, and in 2000, the proportion of people over 65 will be up to about 6.8% of total population. Therefore, osteoporosis, one of the most common metabolic bone disease among the old people, will be one of the most important public health problem. On this background this study was performed to find out risk factors of the development of osteoporosis in Korean women through case-control approach. The subject of this study were selected among the women who visited menopause clinic in one general hospital in Seoul and were checked bone density from Sep. 1988 to Sep. 1993. Those who were diagnosed to have hypertension, diabetes mellitus, thyroid disease, breast disease, or liver disease, which are thought to influnce bone density, were excluded. Also excluded those who are age-unknown. Finally the subjects were 2,139 women aged between 18 and 79. We operatively defined patient group as those whose bone density is below $1.039/cm^2$, 90% of average bone density of women of 4th decade who visited the same hospital. And we defined control group as whose bone dendity is above $1.15g/cm^2$. We randomly selected 201 women from the patient group and 202 from the control. As independent variables we chose age, menarche age, menopause age, menopause type, the number of siblings, the number of pregnancies, body mass index, taking oral pill or not, feeding type, and educational state. Multiple logistic regression analysis was done to see the influence of these variables on the risk of osteoporosis. Results are as follows; 1. menopausal status was statistically significant risk factor to all women irrespective of her age, while obesity and later menopause age were found to be statistically significant protective factors. 2. The more siblings and pregnancies, the greater tile risk of osteoporosis, but these factors were not statistically significant. This result is not consistent with other studies. Further studies are strongly needed.

• Journal of Nutrition and Health
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• v.45 no.3
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• pp.229-239
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• 2012

The purpose of this study was to investigate and examine the relationship between dietary habits, food intake patterns, and depression in Korean women with polycystic ovary syndrome (PCOS). The Center for Epidemiologic Studies Depression Scale Korean Version was used to determine whether a participant was depressed or not. The dietary habits were assessed by the Min-Dietary Assessment (MDA) method, and food intake data were collected by the 24-hour recall method on two non-consecutive days, at least 7 days apart, and the average of the two days was used to estimate the usual dietary intake. The total MDA scores of the Depression Group was significantly lower than that of the No-Depression Group ($31.5{\pm}6.4$ vs $33.4{\pm}6.0$, p = 0.027). The intake of cereals/potatoes/sugar products, milk and milk products, plant protein, and calcium for the Depression Group were significantly lower compared to the No-Depression Group. The Depression Group had a significantly higher percentage of energy intakes from protein as well as the consumption of fish and shellfish compared to the No-Depression Group. There was a significant inverse relationship between milk and milk products consumption and the prevalence of depression [OR (95% CI) for the highest tertile compared to the lowest: 0.390 (0.177-0.857); p for trend = 0.016]. There were also significant positive relationships between the prevalence of depression and the consumption of the following: fish and shellfish [OR (95% CI) for the highest tertile compared to the lowest: 2.319 (1.128-4.770); p for trend = 0.009], animal protein (p for trend = 0.049), and the percentage of energy intakes from protein [OR (95% CI) for the highest tertile compared with the lowest: 2.546(1.156-5.609); p for trend = 0.025]. Further studies are needed in order to investigate whether the intake of protein and of animal protein is indeed associated with depression in PCOS patients in Korea and the possible mechanisms thereof. The results of our study can be applicable for the development of effective nutrition counseling and education programs regarding PCOS patients with depression as part of their successful treatment regimen.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.8
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• pp.4175-4179
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• 2016

Background: Oral cavity cancer (OCC) is one of the most common cancers worldwide. No studies have reported on the prevalence and epidemiologic risk factors of oral premalignant lesions (OPLs) in Thailand. The purpose of this study was to investigate the prevalence of OPLs and associated factors in Roi Et Province, Thailand. Materials and Methods: To investigate the prevalence of OPLs, a cross-sectional descriptive study was conducted in which 2,300 subjects over 40 years of age were recruited and screened for the prevalence of OPLs. To identify factors associated with OPLs, a matched case-control study was used in which the subjects were 102 cases with OPL and 102 matched controls without OPLs. The studies were conducted in Roi Et Province during the period 1 February, 2014, to 30 April, 2014, and the data were collected by the use of a structured interview questionnaire and by extraction of information from medical records. Data analyses involved the use of descriptive statistics, McNemar's test, and conditional logistic regression. Results: The overall prevalence of OPLs was 3.8%, and no-one was diagnosed with more than one type of OPL. The factors found to be associated with a statistically significant higher risk of an OPL were betel nut chewing, smoking, and alcohol consumption. The associations with these factors were strong, especially for betel nut chewing and smoking. Conclusions: The habits of betel nut chewing, smoking, and alcohol use are confirmed as factors associated with OPLs in a population of Roi Et Province, Thailand. Campaigns to reduce such risk healthy behaviour are needed, but whether any actual decrease will prevent the eventual transformation of an OPL into an OCC remains an open question.

• Journal of Environmental Health Sciences
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• v.32 no.4 s.91
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• pp.304-315
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• 2006

This study is performed to reexamine the association between ambient air pollution and daily mortality in seven major cities of Korea using a method of meta-analysis with the data filed for the period 1998-2001. These cities account for half of the Korean population (about 23 million). The observed concentrations of carbon monoxide (CO, mean=1.08 ppm), ozone ($O_3$, mean=33.97 ppb), particulate matter less than 10 ${\mu}m$ ($PM_{10},\;mean=57.11\;{\mu}g/m^3$), nitrogen dioxide ($NO_2$, mean=25.09 ppb), and sulfur dioxide ($SO_2$, mean=9.14 ppb) during the study period were at levels below Korea's current ambient air quality standards. Generalized additive models were applied to allow for the highly flexible fitting of seasonal and long-term time trends in air pollution as well as nonlinear associations with weather variables, such as air temperature and relative humidity. Also, we calculated a weighted mean as a meta-analysis summary of the estimates and its standard error. In city-specific analyses, an increase of $41.17{\mu}g/m^3(IQR)\;of\;PM_{10}$ corresponded to $1{\sim}12%$ more deaths, given constant weather conditions. Like most of air pollution epidemiologic studies, this meta-analysis cannot avoid fleeing from measurement misclassification since no personal measurement was taken. However, we can expect that a measurement bias be reduced in district-specific estimate since a monitoring station is better representative of air quality of the matched district. Significant heterogeneity was found for the effect of all pollutants. The estimated relative risks from meta-like analysis increased compared to those relative risks from pooled analysis. The similar results to those from the previous studies indicated existence of health effect of air pollution at current levels in many industrialized countries, including Korea.