• Journal of Preventive Medicine and Public Health
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• 제30권2호
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• pp.293-307
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• 1997

In Korea, sudden deaths of middle-aged and older male workers who are the responsible persons at home as well as workplace, have aroused social concern. Besides, U. N. has reported recently that mortality of Korea male in 40-50's was one of the highest among newly developed countries in 1992. Not much is, however, known about the nature of the work contributing to the mortality of different groups of workers. Therefore, this study was done to examine mortality of public servants, comprising about 5% of all the employed in Korea, according to their job titles and grades. The datas of 1753 official deaths, comprised 323 (only disease-oriented deaths) applicants of survivors' compensation, were used to examine age-adjusted Standardized Mortality Ratios(SMRs) according to their job titles, grades, tenures and cause of deaths. Controlling age and sex difference was conducted using 26,950,481 general population, 95,340 general deaths and 864,560 working public servants. All the groups were aged 20-64, who were being observed January - December in 1993, at the same time. Results and discussions are as follows. 1. SMRs standardized by general population was significantly low (SMR 44.9 CI 42.8-52.7) for all job titlses. Of public servants, 90.0% was graduated from high school, although 17.5% in general population. The distinction of social status such a education may produce a strong healthy worker effect. Besides, SMRs for different tenure groups showed a steady increase as tenure increases. This suggests that the magnitude of healthy-worker effect may be greater with increasing tenures. 2. SMRs standardized by own public servants was significantly elevated for work-men(SMR 121.0, CI 110.2-132.6) in solitue. When SMRs for different grade, of work-men was examined, 9th(SMR 124.2, CI 104.4-146.7) and 10th(SMR 137.9 CI 120.8-156.8)grade, lower grade in workmen, showed significantly elevated SMRs. Of workmen, 57.0% were graduated from high school and 50.1% in 9th grade, as well. These mean that low economic states made up social class, education may increase mortality rate. 3. Of SMRs according to all causes of death, only policemen on 'cause of death related hypertensive disease'(SMR 282.5, CI 121.6-556.7) was significantly high except for' cause of death related other signs, symptoms and ill-defined conditions'. 4. When SMRs on cause of death related hypertensive disease for different grade of policemen was examined, senior policemen(SMR 241.9), in charge of the front service, showed elevated SMR, in spite of statistical no significance. Especially, the working hour of senior policemen is quite long and also the work schedule is even more irregular for policemen. The results of this study showed that mortality for different jobs differed, and it differed also for different grades in the same job. This difference in mortality may reflect the difference in the nature of job contents, and further studies are warranted to elucidate which job characteristics are responsible.

• Journal of Preventive Medicine and Public Health
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• 제25권2호
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• pp.148-156
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• 1992

혈중 카드뮴, 아연 및 아연에 대한 카드뮴의 비와 혈압 간의 관련성을 보기 위하여 울산 및 그 인근지역에서 직업적으로 카드뮴에 폭로된 경력이 없는 근로자중 고혈압군 83명과 대조군 77명을 성과 연령에 대해 빈도수 짝짓기로 선택하여 얻은 결과는 다음과 같다. 평균 혈중 카드뮴치는 고혈압군이 $2.90{\eta}g/ml$로, 대조군의 $1.99{\eta}g/ml$보다 유의하게 높았으며(P<0.01), 흡연 정도와 연령에 대해 층화분석을 한 후에도 모든 층에서 고혈압군이 유의하게 놀았다. 혈중 아연에 대한 카드뮴의 비도 고혈압군이 2.46. 대조군의 1.65로 유의하게 높았으며(P<0.01), 흡연정도와 연령에 대해 층화분석을 한 후에도 모든 층에서 고혈압군이 유의하게 높았다. 혈중 아연치는 두 군 사이에 유의한 차이를 볼 수 없었다. 홉연, 연령, 음주, 크레아티닌 및 ${\beta}2$-마이크로글로블린 등의 혼란변수를 고려한 다변량 분적상 혈중 아연에 대한 카드뮴의 비가 가장 유의한 변수로 나타났다. 본 연구를 통하여 볼 때 정상치 범위 이내의 혈중 카드뮴치도 고혈압과 관련성이 있을 것으로 생각되며, 특히 아연치에 대한 상대적인 카드뮴치의 상승이 카드뮴의 절대치보다 더욱 중요한 인자일 것으로 생각된다. 그러나 명확한 인과관계를 밝히기 위하여서는 코호트 연구가 필요할 것으로 생각된다.

• Journal of Preventive Medicine and Public Health
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• 제24권4호
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• pp.516-530
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• 1991

일상생활을 통한 연섭취로 인한 고혈압 발생 가능성 및 이때 연이 혈압에 영향을 미칠 수 있는 기전을 밝히기 위한 연구의 일환으로 환자 대조군 연구를 실시하였다. 대상자로서 울산 및 그 인근지역의 직업적 연폭로 과거력이 없는 남자 근로자 중 고혈압 환자 72명, 대조군 69명을 선택하였다. 혈중 연과 혈장레닌활성도(Plasma renin activity, PRA)를 측정하였으며 동시에 흡연유무, 음주유무, 고혈압 가족력 유무를 확인하고 body mass index(BMI), 혈청 소디움, 포타시움, 이온화 칼슘, 크레아티닌 및 총 콜레스테롤을 측정하였다. 고혈압군의 혈중 연농도는 $19.8{\pm}5.5{\mu}g/dl$로서 대조군의 $12.5{\pm}4.7{\mu}g/dl$에 비해 유의하게 높았고(p<0.01) 또한 혈중 연의 고혈압발생에 대한 교차비(odds ratio)가 1.38로서 역시 유의하였다(p<0.01). PRA나 In(PRA)가 고혈압군과 대조군 사이에 유의한 차이가 없었으나 고혈압군에서 혈중 연농도가 증가함에 따라 PRA도 어느정도 증가하는 양상을 보였고(p<0.1), In(PHA)를 종속변수로 하는 중회귀분석을 실시하였을 때 혈중 연농도(회귀계수 ; 0.037)가 10% 수준에서 유의하였다. 본 연구를 통해 볼 때, 지금까지 알려진 정상치 범위 이내의 혈중 연과 고혈압 발생간의 인과 관계에 대해 계속 연구해 볼 필요성을 느끼며 이때 PRA의 변화가 작용 기전의 일부에 관여할 가능성이 있을 것으로 추측된다.

• Journal of Preventive Medicine and Public Health
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• 제35권4호
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• pp.340-350
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• 2002

Objectives : To evaluate the annual visit days, the annual prescription days and the medical costs of hypertensive patients. Methods : The medical insurance records of 40,267 incident patients with the diagnostic code of hypertension from September 1998 through August 1999 in Daegu city were reviewed. Results : The proportion of the most proper medical care pattern group (Group VIII) who visited for 6-15 days with 240 prescription days or more a year was only 6.2%. The proper care group (Group IX) who visited for more than 16 days with 240 prescription days or more a year was 9.3%. The overall proper care group (Group VIII+IX) was therefore 15.5%. The proportion of the insufficient care group (Group I, IV) in both the number of visiting days and prescription days was 57.4%. The mean prescription day of the most proper group (Group VIII) was 29 days; the mean annual medical expenses,453,587won; the mean annual amount paid by patients, 218,013won; and mean medical expenses per prescription day, 1,483won. The proportion of the overall proper care group (Group VIII+IX) was significantly higher in adults aged 50-59, those who were enrolled in industrial workers health insurance as well as government employees and private school teachers health insurance, and those who made a higher contribution per month (p<0.01). According to the type of medical facilities, the proportion of the most proper medical care pattern group was highest in the general hospitals (9.3%) but the overall proper care group was higher in the public health centers (22.1%) and private clinics (17.1%). Conclusions : The management system of hypertension should be reinforced urgently. Therefore, it is necessary to develop guidelines including the number of visiting days per year and prescription days per visit day, and make the system provide medical facilities to more properly care for hypertensive patients.

• 보건교육건강증진학회지
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• 제17권1호
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• pp.115-130
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• 2000

This study was conducted to examine health behaviors in hypertensive patients and the factors that would affect these healthy life-styles. and to provide basic data for effective and continuous hypertension control in private medical facilities. Among those patients diagnosed as hypertension who had visited the Department of Internal Medicine of Yeungnam University Hospital during the two month period from August 2 to September 30, 1999, the present study included 222 patients who were in more than one month after the initial diagnosis of hypertension and those who had hypertension for less than 10 years. Using a structured questionnaire, the present study was conducted by a self-administered survey method, and the obtained data were analyzed with t-test, $x^2$-test and one-way analysis of variance using the SPSS statistical program. The scores on knowledge related to hypertension were higher as the education level of a patient was higher(p〈0.05). As for occupation, those who performed office or management jobs showed higher scores than those who were into manufacturing jobs, and as for economic status, although those patients who were in middle class showed highest scores, however, no statistical significance was observed. The scores of knowledge on hypertension was higher when the family history of hypertension was present(p〈0.05). The scores of health-related behaviors were higher with higher education level and higher economic status, higher in those with family history of hypertension, and higher in those with office or management jobs than those who had manufacturing jobs(p〈0.05). Blood pressure measurement on regular basis was performed most frequently in those who were between 50-59 years old with 83.3% and was least frequent in those who were older than 70 years old with 50%(p〈0.05). The frequency of regular blood pressure measurement was higher with higher education level, higher economic status, higher in those with family history of hypertension, and the highest in those with management position with 93.5%, however, on statistical significance was observed. Changes in health-related behaviors after hypertension diagnosis were higher with higher education level, higher economic status, and in those patients performed office or management work. In particular, diet change was observed in female and higher economic status and smoking cessation was observed in 60-69 years old. Housewives and office workers or managers have taken exercise more regularly and those who had management jobs and had high scores on knowledge related to hypertension would participate health education program more actively. Thus, for improving health-related behaviors for continuous management of hypertension, changes in health-related behaviors can be followed through conduction health education to improve understanding of knowledge related to hypertension as the method of helping to improve changes in health life-styles in those with little education and those in low economic status.

• 보건행정학회지
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• 제21권4호
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• pp.585-598
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• 2011

This study was conducted to examine the trend of national health insurance service use with relation to pregnancy, childbirth, and the puerperium among pregnant and postpartum women older than 35 over the last decade. A descriptive analysis was conducted, using the data which were drawn from the "nationwide claim database of Korean National Health Insurance Corporation(NHIC)". Data were composed of the total cases related to pregnancy, childbirth, and the puerperium (International Classification of Disease, $10^{th}$revision [ICD-10] codes O00-O99) from 2001 to 2008. During 2001-2008, the number of pregnant and postpartum women older than 35 had continuously increased and the percentage of them also had increased in both hospital and ambulatory care. There are similar trends in their total use of national health insurance service and total expenditure. According to demographic characteristics, there was the biggest increase of the percentage in residents in large cities, self-employed workers, ones in the highest income level. According to ICD-10 codes, there was the biggest increase of the percentage in O10-O16 (oedema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium). According to the major prevalent disease, there was the biggest increase of the percentage in O60 (preterm labor and delivery). Throughout the past decade, the necessity has been emphasized of supporting pregnant and postpartum women older than 35. But in maternal and child health care, they are in an early stage of development. The findings of this study would be helpful in developing the support programs for the aged pregnant and postpartum women.