• Journal of Environmental Health Sciences
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• v.34 no.3
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• pp.188-198
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• 2008

Since 2003, the National Institute of Environmental Research (NIER) of Korea has been conducting "The monitoring study on exposure level and biomarkers of environmental pollutants" in the Ulsan industrial complex with the goals to establish a surveillance system for residents, to evaluate the health effects associated with chronic exposure to environmental pollutants and to develop the environmental health indicators in Ulsan industrial complex. This program consists of three phases an initial or foundation phase in which the program is developed, made operational and extended to the community, followed by an evaluation and accountability assessment of the surveillance system and finally an improvement in the quality of life and the maintenance of good health for Ulsan residents. In the period 2003 to 2008, the study program developed the surveillance system which will be used for the full-length survey. All participants in this study were contacted at a presentation meeting for residents, introduced to the objectives and protocols of the survey, and asked to participate. Informed consent was obtained from each participant. The study is now underway and includes questionnaires, health examinations and the analysis/collection/banking of bio-sample such as blood and urine. To date 828 subjects have participated and already 588 subjects have been followed up. We are committed to complete health examinations and to arrange storage of biosample for all participants. During the current year, we will analyze metals (Pb in blood and Cd, inorganic As and Hg in urine) in 1,972 samples and VOCs (11 species) and PARs (18 species) in 300 samples (blood sample). Moreover, the summary of the first step and the further preparation of the second step are currently underway. In this article, we introduce the study and its protocols and the distribution and size of the study participants. In conclusion, this survey will be continuously conducted on the established cohort and will enable the identification of relationship between environmental pollutant exposures and the health status of residents in Ulsan industrial complex.

• Safety and Health at Work
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• v.11 no.4
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• pp.443-449
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• 2020

Background: The study tries to show the effect of Occupational Health and Safety (OHS) legislation implemented via plan-do-check-act methodology on accident and sickness absenteeism. Methods: The data for the study gathered via a questionnaire from a large-sized organization operates in production and maintenance of passenger coaches in February-March 2019 in Turkey. The data analyzed via structural equation model analysis. Results: The results showed that there are statistically meaningful relationships between OHS protective measures, training and informing of employees, and employee participation and accident and sickness absenteeism. In addition, a meaningful relationship between internal control and accident and sickness absenteeism was determined. Statistically meaningful relationships between emergency measures, and health surveillance and internal control, and accident and sickness absenteeism could not be determined. Conclusion: It is concluded that the actions implemented by organizations to reduce absenteeism should be as per OHS legislation.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8993-9004
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• 2014

Background: The incidence rate and the treatment costs of hepatocellular carcinoma (HCC) are high, especially in Thailand. Previous studies indicated that early detection by a surveillance program could help by down-staging. This study aimed to compare the costs and health outcomes associated with the introduction of a HCC surveillance program with no program and to estimate the budget impact if the HCC surveillance program were implemented. Materials and Methods: A cost utility analysis using a decision tree and Markov models was used to compare costs and outcomes during the lifetime period based on a societal perspective between alternative HCC surveillance strategies with no program. Costs included direct medical, direct non-medical, and indirect costs. Health outcomes were measured as life years (LYs), and quality adjusted life years (QALYs). The results were presented in terms of the incremental cost-effectiveness ratio (ICER) in Thai THB per QALY gained. One-way and probabilistic sensitivity analyses were applied to investigate parameter uncertainties. Budget impact analysis (BIA) was performed based on the governmental perspective. Results: Semi-annual ultrasonography (US) and semi-annual ultrasonography plus alpha-fetoprotein (US plus AFP) as the first screening for HCC surveillance would be cost-effective options at the willingness to pay (WTP) threshold of 160,000 THB per QALY gained compared with no surveillance program (ICER=118,796 and ICER=123,451 THB/QALY), respectively. The semi-annual US plus AFP yielded more net monetary benefit, but caused a substantially higher budget (237 to 502 million THB) than semi-annual US (81 to 201 million THB) during the next ten fiscal years. Conclusions: Our results suggested that a semi-annual US program should be used as the first screening for HCC surveillance and included in the benefit package of Thai health insurance schemes for both chronic hepatitis B males and females aged between 40-50 years. In addition, policy makers considered the program could be feasible, but additional evidence is needed to support the whole prevention system before the implementation of a strategic plan.

• Health Policy and Management
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• v.7 no.2
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• pp.19-45
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• 1997

This study was performed to evaluate the appropriateness of resource allocation based on the ranking of health center function. Through the Delphi processes, health center functions were ranked in order of importance as follows; planning and research, followed by health education, health promotion, management of chronic diseases, health screening tests, welfare activities, mental health services, medical personnel management, medical services, prevention of communicable diseases, maternal and infant health services, housekeeping, management of oral hygiene, nutrition services, surveillance for community health services, family planning, and administration of the health center. In relation to the above priorities, the allocation of manpower was not appropriate. Even though the expert groups emphasized on functions such as planning and research, health education, and health promotion, they inputted more personnel for administration of a health center, maternal and infant health services, and medical services which were evaluated with lower importance. The budget allocation showed the same trends as the above. Although the functions such as planning and research, health education, and health promotion, and management of chronic diseases were evaluated highly, the budget was allocated accordingo to the the results of the former fiscal year rather than on the importance of function. However the budget for nutrition services, surveillance for the community health services, family planning, and administration of a health center was allocated according to priority. Based upon the above findings, community health center should be given the opportunity to make their own ranking of health center function and to allocate their resources including personnel and budget in order to improve the responsibilities and roles of the community health center.

• Proceedings of the Korea Inteligent Information System Society Conference
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• 2001.01a
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• pp.330-335
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• 2001

The occurrences of occupational illness and injury have been seriously underestimated in Korea. Surveillance systems for occupational diseases have recently emerged as important strategies for the control of occupational hazards and the implementation of intervention programs to protect workers. However, health service providers do not actively diagnose occupational diseases and are unwilling to report occupational diseases. With the rapid growth of Internet usage in Korea, the computer network has become the predominant means of communicating and sharing information. Therefore, we developed a web-based updated information and education network to assist the health services providers in reporting occupational diseases. Information systems for occupational disease surveillance were also designed to support occupational disease reporting. Commonly available database systems, such as web databases, are useful to manage occupational diseases data efficiently. Standardized case definitions and report guidelines were also established, which included cumulative trauma disorder, occupational asthma, occupational contact dermatitis, and occupational cancer. This system may provide the basis of an efficient and continuously updated source of educational information and provide specific information concerning the occurrence of occupational diseases in specific areas. Background information on occupational diseases obtained in this way will be invaluable for preventing hazards and enforcing occupational disease prevention programs. Moreover, our experiences in establishing these information systems will be of great use in other countries and settings.

• Health Policy and Management
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• v.28 no.4
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• pp.402-410
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• 2018

Background: Monitoring appropriate medication categories can provide early warning of certain disease outbreaks. This study aimed to present a methodology for selecting and monitoring medications relevant to the surveillance of acute respiratory tract infections, such as influenza. Methods: To estimate correlations between acute febrile respiratory tract infection and some medication categories, the cross-correlation coefficient (CCC) was used and established. Two databases were used: real-time prescription trend of antivirals, anti-inflammatory drugs, antibiotics using Drug Utilization Review Program between 2012 and 2015 and physicians' number of encounters with acute febrile respiratory tract infections such as influenza outbreaks using the national level health insurance claims data. The seasonality was also evaluated using the CCC. Results: After selecting six candidate diseases that require extensive monitoring, influenza with highly specific medical treatment according to the health insurance claims data and its medications were chosen as final candidates based on a data-driven approach. Antiviral medications and influenza were significantly correlated. Conclusion: An annual correlation was observed between influenza and antiviral medications, anti-inflammatory drugs. Suitable models should be established for syndromic surveillance of influenza.

• Korean Journal of Veterinary Research
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• v.50 no.1
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• pp.43-48
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• 2010

Animal disease surveillance system, defined as the continuous investigation of a given population to detect the occurrence of disease or infection for control purposes, has been key roles to assess the health status of an animal population and, more recently, in international trade of animal and animal products with regard to risk assessment. Especially, for a system aiming to determine whether or not a disease is present in a population sensitivity of the system should be maintained high enough not to miss an infected animal. Therefore, when planning the implementation of surveillance system a number of factors that affecting surveillance sensitivity should be taken into account. Of these parameters sample size is of important, and different approaches are used to calculate sample size, usually depending on the objective of surveillance systems. The purpose of this study was to evaluate the sensitivity of the current national serological surveillance programs for four selected bovine diseases assuming a specified sampling plan, to examine factors affecting the probability of detection, and to provide sample sizes required for achieving surveillance goal of detecting at least an infection in a given population. Our results showed that, for example, detecting low level of prevalence (0.2% for bovine tuberculosis) requires selection of all animals per typical Korean cattle farm (n = 17), and thus risk-based target surveillance for high risk groups can be an alternative strategy to increase sensitivity while not increasing overall sampling efforts. The minimum sample size required for detecting at least one positive animal was sharply increased as the disease prevalence is low. More importantly, high reliability of prevalence estimation was expected with increased sampling fraction even when zero-infected animal was identified. The effect of sample size is also discussed in terms of the maximum prevalence when zero-infected animals were identified and on the probability of failure to detect an infection. We suggest that for many serological surveillance systems, diagnostic performance of the testing method, sample size, prevalence, population size, and statistical confidence need to be considered to correctly interpret results of the system.

• 대한예방의학회:학술대회논문집
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• 1999.10a
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• pp.361-362
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• 1999

• Proceedings of the Korean Society of Life Science Conference
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• 2005.04a
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• pp.129-129
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• 2005

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.32 no.3
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• pp.231-241
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• 2022

Objectives: The purpose of this study is to evaluate the input status of exposure-related information in the working environment monitoring database (WEMD) and special health examination database (SHED) for the construction of a national exposure surveillance system. Methods: The industrial and process code input status of WEMD and SHED for 21 carcinogens from 2014 to 2016 was compared. Data from workers who performed both work environment monitoring and special health examinations in 2019 and 2020 were extracted and the actual status of input of industrial and process codes was analyzed. We also investigated the cause of input errors through a focus group interview with 12 data input specialists. Results: As a result of analyzing WMED and SHED for 21 carcinogens, the five-digit industrial code matching rate was low at 53.5% and the process code matching rate was 19% or less. Among the data that simultaneously conducted work environment monitoring and special health examination in 2019 and 2020, the process code matching rate was very low at 18.1% and 5.2%, respectively. The main causes of exposure-related data input errors were the difference between the WEMD and SHED process code input systems from 2020, the number of standard process and job codes being too large, and the inefficiency of the standard code search system. Conclusions: In order to use WEMD and SHED as a national surveillance system, it is necessary to simplify the number of standard code input codes and improve the search system efficiency.