• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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• pp.2431-2440
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• 2015

Background: Registry data from four major public hospitals indicate trends in clinical care and survival from colorectal cancer over three decades, from 1980 to 2010. Materials and Methods: Kaplan-Meier productlimit estimates and Cox proportional hazards models were used to investigate disease-specific survival and multiple logistic regression analyses to explore first-round treatment trends. Results: Five-year survivals increased from 48% for 1980-1986 to 63% for 2005-2010 diagnoses. Survival increases applied to each ACPS stage (Australian Clinico-Pathological Stage), and particularly stage C (an increase from 38% to 68%). Risk of death from colorectal cancer halved (hazards ratio: 0.50 (0.45, 0.56)) over the study period after adjusting for age, sex, stage, differentiation, primary sub-site, health administrative region, and measures of socioeconomic status and geographic remoteness. Decreases in stage were not observed. Survivals did not vary by sex or place of residence, suggesting reasonable equity in service access and outcomes. Of staged cases, 91% were treated surgically with lower surgical rates for older ages and more advanced stage. Proportions of surgical cases having adjuvant therapy during primary courses of treatment increased for all stages and were highest for stage C (an increase from 5% in 1980-1986 to 63% for 2005-2010). Radiotherapy was more common for rectal than colonic cases. Proportions of rectal cases receiving radiotherapy increased, particularly for stage C where the increase was from 8% in 1980-1986 to 60% in 2005-2010. The percentage of stage C colorectal cases less than 70 years of age having systemic therapy as part of their first treatment round increased from 3% in 1980-1986 to 81% by 1995-2010. Based on survey data on uptake of adjuvant therapy among those offered this care, it is likely that all these younger patients were offered systemic treatment. Conclusions: We conclude that pronounced increases in survivals from colorectal cancer have occurred at major public hospitals in South Australia due to increases in stage-specific survivals. Use of adjuvant therapies has increased and the patterns of change accord with clinical guideline recommendations. Reasons for sub-optimal use of radiotherapy for rectal cases warrant further investigation, including the potential for limited rural access to impede uptake of treatments at metropolitan-based radiotherapy centres.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5923-5931
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• 2015

Background: Registry data from four major public hospitals indicate trends over three decades from 1980 to 2010 in treatment and survival from colorectal cancer with distant metastases at diagnosis (TNM stage IV). Materials and Methods: Kaplan-Meier product-limit estimates and Cox proportional hazards models for investigating disease-specific survival and multiple logistic regression analyses for indicating first-round treatment trends. Results: Two-year survivals increased from 10% for 1980-84 to 35% for 2005-10 diagnoses. Corresponding increases in five-year survivals were from 3% to 16%. Time-to-event risk of colorectal cancer death approximately halved (hazards ratio: 0.48 (0.40, 0.59) after adjusting for demographic factors, tumour differentiation, and primary sub-site. Survivals were not found to differ by place of residence, suggesting reasonable equity in service provision. About 74% of cases were treated surgically and this proportion increased over time. Proportions having systemic therapy and/or radiotherapy increased from 12% in 1980-84 to 61% for 2005-10. Radiotherapy was more common for rectal than colonic cases (39% vs 7% in 2005-10). Of the cases diagnosed in 2005-10 when less than 70 years of age, the percentage having radiotherapy and/or systemic therapy was 79% for colorectal, 74% for colon and 86% for rectum (&RS)) cancers. Corresponding proportions having: systemic therapies were 75%, 71% and 81% respectively; radiotherapy were 24%, 10% and 46% respectively; and surgery were 75%, 78% and 71% respectively. Based on survey data on uptake of offered therapies, it is likely that of these younger cases, 85% would have been offered systemic treatment and among rectum (&RS) cases, about 63% would have been offered radiotherapy. Conclusions: Pronounced increases in survivals from metastatic colorectal cancer have occurred, in keeping with improved systemic therapies and surgical interventions. Use of radiotherapy and/or systemic therapy has increased markedly and patterns of change accord with clinical guideline recommendations.

• Health Policy and Management
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• v.28 no.2
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• pp.168-177
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• 2018

Background: This study investigates the potential volume and outcome association of coronary heart disease (CHD) patients who have undergone percutaneous coronary intervention (PCI) using a large and representative sample. Methods: We used a National Health Insurance Service-Cohort Sample Database from 2002 to 2013 released by the Korean National Health Insurance Service. A total of 8,908 subjects were analyzed. The primary analysis was based on Cox proportional hazards models to examine our hypothesis. Results: After adjusting for confounders, the hazard ratio of thirty-day and 1-year mortality in hospitals with a low volume of CHD patients with PCI was 2.8 and 2.2 times higher (p=0.00) compared to hospitals with a high volume of CHD patients with PCI, respectively. Thirty-day and 1-year mortality of CHD patients with PCI in low-volume hospitals admitted through the emergency room were 3.101 (p=0.00) and 2.8 times higher (p=0.01) than those in high-volume hospitals, respectively. Only 30-day mortality in low-volume hospitals of angina pectoris and myocardial infarction patients with PCI was 5.3 and 2.4 times those in high-volume hospitals with PCI, respectively. Conclusion: Mortality was significantly lower when PCI was performed in a high-volume hospital than in a low-volume hospital. Among patients admitted through the emergency room and diagnosed with angina pectoris, total PCI volume (low vs. high) was associated with significantly greater cardiac mortality risk of CHD patients. Thus, There is a need for better strategic approaches from both clinical and health policy standpoints for treatment of CHD patients.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.27 no.2
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• pp.105-114
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• 2017

Objectives: The Ministry of Employment and Labor's enforcement programs, such as workplace monitoring inspection, are one of the major public efforts to protect worker's health. Therefore, a more effective inspection method is required for workplace monitoring, which is helpful for controlling health hazards in the workplace. Methods: For this study, we investigated the related safety and health laws, regulations, and inspection guidelines from the USA, Japan, and Korea. We also analyzed the provisions of industrial safety and health acts, which are related to enhancing the reliability of workplace monitoring. We applied the process of opinion convergence through an experts meeting for our research. Results: We proposed an efficient inspection scheme for workplace monitoring that includes how to select companies(mainly randomized inspections by using a workplace measurement database and workers' compensation insurance database), how to proceed with the inspection process(mainly unannounced visits), and who should carry out this project. Conclusions: We conclude that our proposal for the inspection of workplace monitoring could be a very effective tool for reducing the numbers of companies that do not undertake workplace monitoring and could produce reliable monitoring results.

• The Korean Society of Law and Medicine
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• v.10 no.2
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• pp.287-307
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• 2009

A person is injured in car accident caused by his/her slight negligence except he / she causes accident by his / her willfulness or gross negligence. Because the National Health Insurance Corporation (hereinafter called "Corporation") shall not provide any insurance benefit "when he has intentionally or through gross negligence caused a criminal conduct or intentionally contributed to the occurrence of an accident" referred to in Article 48 (1) 1 of the National Health Insurance Act. So, if he / she is insured by his / her own bodily injury coverage, he / she can be compensated for his / her medical expenses. The injured have the rights to file either National Health Insurance claim and Automobile Insurance claim but there is no clear and definite adjustment clause. The claim disputes between National Health Insurance (hereinafter called "NHI") and Automobile Insurance (hereinafter called "AI") in the own bodily injury coverage makes some problems. Firstly, there are some differences in co-payments which he / she chooses between NHI and AI. Profit per a patient is higher in the NHI than in the AI. Secondly, it can provoke criticism that people shall unnecessarily pay double contributions. Lastly, it can raise moral hazards. For example, if he / she can cover the compensations when the insured receives the compensations from his / her insurer, the Corporation can be claimed by medical care institution payment of the health care benefit costs. In conclusion, first of all, to improve the national health and preserve the insured's rights the Corporation shall keep notice these facts.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.28 no.2
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• pp.175-189
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• 2018

Objectives: In this study, we analyze statistics on industrial accidents caused by chemical skin contact and provide skin toxicity hazard information on the related domestic system and circulation volumes. Methods and Results: We analyzed occupational fatalities and skin diseases caused by chemical leaks and contact from 2007 to 2016(10 years) and surveyed data on occupational skin diseases using the 2014 work environment survey data. The NIOSH Skin Notation Profiles for 57 chemical substances, which are provided to prevent occupational skin diseases, were searched and hazard information on skin contact with chemical substances was classified. In order to identify skin toxicity information among domestically distributed and legally regulated substances and to investigate skin-toxic substances, MSDS basic data on 19,740 chemical substances provided on the homepage of Korea Occupational Safety & Health Agency were searched. Acute toxicity(dermal) category 1-4 substances totaled 1,020, and the number of chemical substances classified as category 1 and 2 substances were 135 and 137, respectively. In the chemical substances prescribed by the Ministry of Employment and Labor, 173 substances were classified into acute toxicity(dermal) categories 1-4, 58 of which correspond to category 1 or 2. Conclusions: Within the present range of industrial accidents, the proportion of skin diseases due to contact with chemicals is not high. However, there is always a risk of occupational skin diseases due to increasing chemicals and due to the use of new chemicals. It is hoped that this information will be used by workplace safety and health officials and health and safety experts to prevent acute toxity(dermal) due to chemical skin contact.

• Safety and Health at Work
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• v.13 no.3
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• pp.364-371
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• 2022

Background: Respiratory masks can provide healthcare workers with protection from biological hazards when they have good performance. There is a direct relationship between the visual specifications of a mask and its efficacy; thus, the aim of this study was to develop tools for qualitative assessment of the performance of masks used by healthcare workers. Methods: A mixed-methods design was used to develop a qualitative assessment tool for medical face masks (MFM) and particle filtering half masks (PFHM). The development of domains and items was undertaken using observation and interviews, the opinions of an expert panel, and a review of texts and international standards. The second phase evaluated the psychometric properties of tools. Finally, the validated Mask Qualitative Assessment Tools (MQAT) were used to assess six samples from 10 brands of the two types of masks. Results: MQAT-MFM and MQAT-PHFM shared 42 items across seven domains: "cleanliness," "design," "marking, labeling and packaging," "mask layers," "mask strap," "materials and construction," and "nose clip." MQAT-MFM included one additional item. MQAT-PHFM included another nine items associated with an eighth "Practical Performance" domain, and the valve version had another additional "Exhalation Valve" domain and six items. The evaluation indicated 80% compliance for MFM and 71% compliance for PFHM. "Marking, labeling and packaging" and "Layers" were associated with the least compliance in both types of masks and should be checked carefully for defining mask quality. Conclusion: MQAT can be used for immediate screening and initial assessment of MFM and PHFM through appearance, simple tools, and visual inspection.

• Journal of Food Hygiene and Safety
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• v.26 no.3
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• pp.273-282
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• 2011

This study established hazards which may cause risk to human at farm during cultivation stage of paprika. Samples of plants (paprika, leaf, stem), cultivation environments (water, soil), personal hygiene (hand, glove, clothes), work utensils (carpet, basket, box) and airborne bacteria were collected from three paprika farms (A, B, C) located in Western Gyeongnam, Korea. The collected samples were assessed for biological (sanitary indications and major foodborne pathogens), chemical (heavy metals, pesticide residues) and physical hazards. In biological hazards, total bacteria and coliform were detected at the levels of 1.9~6.6 and 0.0~4.610g CFU/g, leaf, mL, hand or 100 $cm^2$, while Escherichia coli was not detected in all samples. In major pathogens, only Bacillus cereus were detected at levels of ${\leq}$ 1.5 log CFU/g, mL, hand or 100 $cm^2$, while Staphylococuus aureus, Listeria monocytogenes, E. coli O157 and Salmonella spp. were not detected in all samples. Heavy metal and pesticide residue as chemical hazards were detected at levels below the regulation limit, physical hazard factors, such as insects, pieces of metal and glasses, were also found in paprika farms. Proper management is needed to prevent biological hazards due to cross-contamination while physical and chemical hazards were appropriate GAP criteria.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.11 no.2
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• pp.169-178
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• 2001

Numerous regulations have been introduced and a various kinds of institutional intervention have been made by government against the occupational safety and health problems. However, it was serious issue to the workers that what can be claimed by those who meet with apparently harmful and risky working conditions in their social systems. In the view point of employees, their right to be free from unacceptable risk and hazards has not been clearly defined. Therefore, workers have very limited rights to take any actions unless employer or government do their actions. It is believed that this undesirable conditions resulted from Jack of legal definition of workers' right to work in the safe and healthy environment. It has been found increased social pressure to make intervention to the industry to protect workers' health. Also, increased pressure has been kept for deregulation. This conflict lay the current situation in dilemma. The concept of the working environmental right has been developed and discussed in this study to overcome this trade-off confliction. It should be clearly separated between legal aspects and administrative and Policy area to make the regulations effective. Strong enforcement to the industry based on the law should be minimum, however, it should be practically effective in the aspect of workers' right. Administration and policy should be focused on supportive and leading activities to achieve the ultimate goal, safe and healthy working environment. It is concluded that establishment of working environmental right would satisfy workers and industry and it would result in improvement workers' environment and conditions.

• Transactions of the Korean Society for Noise and Vibration Engineering
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• v.23 no.9
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• pp.841-849
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• 2013

Workers engaged in construction works have been exposed to high levels of noise during their work in tunnels. Noise is one of the major health hazards for employees working in construction sites. The aim of this study is to evaluate the noise levels generating from tunneling equipments such as jumbo drills, backhoes, payloaders, shotcrete machines and service cars. Explosion and turbo fan noises were also monitored. A high precision sound level meter was introduced for measuring LAeq, LAFmax, LAFmin and LCpeak noises in 5 tunneling work sites that were located in Seoul, Kyunggi-do and Kangwon-do areas with NATM and shield methods. The highest noise was recorded by explosion(151.9 dB LCpeak) followed by jumbo drills of higher than 110 dB(A) LAeq. Backhoe normally generated 90~110 dB(A) LAeq while breaking work of rock showed additional around 5~15 dB(A). Noise exposure levels for payloader and shotcrete machine scored more than 90 dB(A) which might be a source of noise-induced hearing loss. Additional research in revealing noise levels from construction equipments operating in tunneling works may enhance the protection of workers who exposed to noise primarily at the sites.