• 한국환경보건학회지
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• 제37권1호
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• pp.1-11
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• 2011

Recent advances in Geographic Information Systems and spatial statistical and analytical methods, along with the availability of spatially referenced health and environmental data, have created unique opportunities to investigate spatial associations between environment exposures and health outcomes at multiple spatial scales and resolutions. However, the increased use of spatial data also faces challenges, one of which is to ensure certainty and accuracy of locational data that meets the needs of a study. This article critically reviews the use of spatially referenced data in epidemiologic studies, focusing on the issue of locational uncertainty generated from the process of geocoding health and environmental data. Primarily, major issues involving the use of spatially referenced data are addressed, including completeness and positional accuracy, potential source of bias and exposure misclassification, and implications for epidemiologic studies. The need for critical assessment and caution in designing and conducting spatial epidemiology studies is briefly discussed.

• Asian Pacific Journal of Cancer Prevention
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• 제16권8호
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• pp.3579-3586
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• 2015

Geographic information system (GIS) technology has useful applications for epidemiology, enabling the detection of spatial patterns of disease dispersion and locating geographic areas at increased risk. In this study, we applied GIS technology to characterize the spatial pattern of mortality due to liver cancer in the autonomous region of Guangxi Zhuang in southwest China. A database with liver cancer mortality data for 1971-1973, 1990-1992, and 2004-2005, including geographic locations and climate conditions, was constructed, and the appropriate associations were investigated. It was found that the regions with the highest mortality rates were central Guangxi with Guigang City at the center, and southwest Guangxi centered in Fusui County. Regions with the lowest mortality rates were eastern Guangxi with Pingnan County at the center, and northern Guangxi centered in Sanjiang and Rongshui counties. Regarding climate conditions, in the 1990s the mortality rate of liver cancer positively correlated with average temperature and average minimum temperature, and negatively correlated with average precipitation. In 2004 through 2005, mortality due to liver cancer positively correlated with the average minimum temperature. Regions of high mortality had lower average humidity and higher average barometric pressure than did regions of low mortality. Our results provide information to benefit development of a regional liver cancer prevention program in Guangxi, and provide important information and a reference for exploring causes of liver cancer.

• 대한지리학회지
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• 제47권5호
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• pp.677-699
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• 2012

기후변화가 가져올 벡터매개 질병(vector-borne diseases or VBDs)의 증가는 인구 집단의 건강에 대한 중요한 위협 요인이며, 앞으로 국제사회가 심각하게 대처해야 할 공중보건 문제로 부각되고 있다. 지구온난화로 대표되는 광범위한 기후변화로 한반도 기후 특성이 아열대화 되어가는 가운데, 토지이용, 인구분포, 생태환경 변화에 따른 영향으로 각종 질병의 발생과 확산 가능성이 유례없이 높아지고 있다. 특히, 모기, 진드기와 같은 매개체에 의해 전염되는 벡터매개 질병은 최근 20년 동안 이들 매개 곤충의 서식범위가 확대되어 질병 발생 빈도가 현격하게 증가했다. 보건지리학은 국지적인 환경과 보건 자료뿐 아니라 보다 광역적인 자료들을 통합하여 처리, 분석하고, 공간 및 비공간 자료간의 연관성 또는 상호관계를 파악하여 궁극적으로 질병의 시공간적 변화를 탐구하는 것에 초점을 두고 발전되어 왔다. 인문 및 자연환경 요인들을 GIS를 통해 다면적으로 분석하여, 개인의 건강관련 지표들과의 상관성을 기술하고 분석하는 공간역학(spatial epidemiology)은 보건지리학의 새로운 영역으로, 공간과학, 환경과학, 그리고 역학을 세 가지 주요 축으로 하여 급속히 성장하고 있다. 향후 보건지리학이 기여할 수 있는 주요 연구영역 중 하나로는, 보건 연구에서 주요 수단으로 사용되고 있는 보건 감시체계에 지리정보시스템을 기반으로 한 모니터링 시스템을 도입하는 것을 들 수 있다. 특히, 실시간 모니터링 방법론, 조기발생 감식 시스템의 구축, 그리고 관련 요인들의 공간변이를 예측하는 연구 등은 벡터매개 질병의 역학을 이해하는 데 필수적인 주요 연구 과제들이 될 것이다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권9호
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• pp.4025-4029
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• 2015

Background: Gastrointestinal tract cancers are among the most common cancers in Iran and comprise approximately 38% of all the reported cases of cancer. This study aimed to describe the epidemiology and to investigate spatial clustering of common cancers of the gastrointestinal tract across the counties of Iran using full Bayesian smoothing and Moran I Index statistics. Materials and Methods: The data of the national registry cancer were used in this study. Besides, indirect standardized rates were calculated for 371 counties of Iranand smoothed using Winbug 1.4 software with a full Bayesian method. Global Moran I and local Moran I were also used to investigate clustering. Results: According to the results, 75,644 new cases of cancer were nationally registered in Iran among which 18,019 cases (23.8%) were esophagus, gastric, colorectal, and liver cancers. The results of Global Moran's I test were 0.60 (P=0.001), 0.47 (P=0.001), 0.29 (P=0.001), and 0.40 (P=0.001) for esophagus, gastric, colorectal, and liver cancers, respectively. This shows clustering of the four studied cancers in Iran at the national level. Conclusions: High level clustering of the cases was seen in northern, northwestern, western, and northeastern areas for esophagus, gastric, and colorectal cancers. Considering liver cancer, high clustering was observed in some counties in central, northeastern, and southern areas.

• 한국환경보건학회지
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• 제38권5호
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• pp.369-379
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• 2012

Objectives: Spatial analysis is useful for understanding complicated causal relationships. This paper focuses trends and appling methods for spatial analysis associated with environmental asbestos exposure. Methods: Literature review and reflection of experience of authors were conducted to know academic background of spatial analysis, appling methods on epidemiology and asbestos exposure. Results: Spatial analysis based on spatial autocorrelation provides a variety of methods through which to conduct mapping, cluster analysis, diffusion, interpolation, and identification. Cause of disease occurrence can be investigated through spatial analysis. Appropriate methods can be applied according to contagiousness and continuity. Spatial analysis for asbestos exposure source is needed to study asbestos related diseases. Although a great amount of research has used spatial analysis to study exposure assessment and distribution of disease occurrence, these studies tend to focus on the construction of a thematic map without different forms of analysis. Recently, spatial analysis has been advanced by merging with web tools, mobile computing, statistical packages, social network analysis, and big data. Conclusions: Because the trend in spatial analysis has evolved from simple marking into a variety of forms of analyses, environmental researchers including asbestos exposure study are required to be aware of recent trends.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.59-64
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• 2016

Breast cancer (BC) is the most common cancer in females (27% of the total) and the main cause of death (16%) due to cancer in women in developed and developing countries. Variations in its incidence rate among geographical areas are due to various contributing factors. Since there have been a lack of studies on this topic in our country, the present spatial analysis of breast cancer incidence in Iran in 2009 was conducted using data from the national cancer registry system. The reported incidences of the disease were standardized according to the World Health Organization population and the direct method. Then data was inserted into the GIS software and finally, using the Hot Spot Analysis (Geties-Ord Gi), high-risk areas were drawn. Provinces with incidences 1.96 SD higher or lower than the national average were considered as hot spots or cold spots, at the significance level of 0.05%. In 2009, a total of 7,582 cases of BC occurred in Iran. The annual incidence was 33.2 per hundred thousand people. Our study showed that the highest incidence of BC in women occurred in the central provinces of the country, Tehran, Isfahan, Yazd, Markazi and Fars. The results of hot spots analysis showed that the distribution of high-risk BC was focused in central parts of Iran, especially Isfahan province (p <0.01). The other provinces were not significantly different from the national average. The higher incidence in central provinces may be due to greater exposure to carcinogens in urban areas, a Western lifestyle and high prevalence of other risk factors. Further epidemiological studies about the etiology and early detection of BC are essential.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.27-32
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• 2016

Stomach cancer, the fourth most common cancer and the second leading cause of cancer-related death through the world, is very common in parts of Iran. Geographic variation in the incidence of stomach cancer is due to many different factors. The aim of this study was to assess the geographical and spatial distribution of stomach cancer in Iran using data from the cancer registry program in Iran for the year 2009. The reported incidences of stomach cancer for different provinces were standardized to the world population structure. ArcGIS software was used to analyse the data. Hot spots and high risk areas were determined using spatial analysis (Getis-Ord Gi). Hot and cold spots were determined as more than or less than 2 standard deviations from the national average, respectively. A significance level of 0.10 was used for statistical judgment. In 2009, a total of 6,886 cases of stomach cancers were reported of which 4,891 were in men and 1,995 in women (standardized incidence rates of 19.2 and 10.0, respectively, per 100,000 population). The results showed that stomach cancer was concentrated mainly in northwest of the country in both men and women. In women, northwest provinces such as Ardebil, East Azerbaijan, West Azerbaijan, Gilan, and Qazvin were identified as hot spots (p<0.1). In men, all northwest provinces, Ardabil, East Azerbaijan, Gilan, Qazvin, Zanjan and Kurdistan, the incidences were higher than the national average and these were identified as hot spots (P<0.01). As stomach cancer is clustered in the northwest of the country, further epidemiological studies are needed to identify factors contributing to this concentration.

• Journal of Preventive Medicine and Public Health
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• 제51권1호
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• pp.33-40
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• 2018

Objectives: The aim of this study was to determine the factors associated with the spatial distribution of the incidence of colorectal cancer (CRC) in the neighborhoods of Tehran, Iran using Bayesian spatial models. Methods: This ecological study was implemented in Tehran on the neighborhood level. Socioeconomic variables, risk factors, and health costs were extracted from the Equity Assessment Study conducted in Tehran. The data on CRC incidence were extracted from the Iranian population-based cancer registry. The $Besag-York-Molli{\acute{e}}$ (BYM) model was used to identify factors associated with the spatial distribution of CRC incidence. The software programs OpenBUGS version 3.2.3, ArcGIS 10.3, and GeoDa were used for the analysis. Results: The Moran index was statistically significant for all the variables studied (p<0.05). The BYM model showed that having a women head of household (median standardized incidence ratio [SIR], 1.63; 95% confidence interval [CI], 1.06 to 2.53), living in a rental house (median SIR, 0.82; 95% CI, 0.71 to 0.96), not consuming milk daily (median SIR, 0.71; 95% CI, 0.55 to 0.94) and having greater household health expenditures (median SIR, 1.34; 95% CI, 1.06 to 1.68) were associated with a statistically significant elevation in the SIR of CRC. The median (interquartile range) and mean (standard deviation) values of the SIR of CRC, with the inclusion of all the variables studied in the model, were 0.57 (1.01) and 1.05 (1.31), respectively. Conclusions: Inequality was found in the spatial distribution of CRC incidence in Tehran on the neighborhood level. Paying attention to this inequality and the factors associated with it may be useful for resource allocation and developing preventive strategies in at-risk areas.

• Spatial Information Research
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• 제20권1호
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• pp.81-90
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• 2012

지리적 공간상에서 발생하는 대부분의 현상은 서로 인접한 곳에서 유사한 값을 가지는 특성이 있다. 이는 공간자기상관성과 관련이 있으며 공간분석의 존재 이유를 나타내는 개념이다. 또한 지리적 공간상에서 위치에 따라 값의 분포가 다양한 패턴을 보이게 된다. 이러한 패턴은 공간적 변이를 내포하고 있다. 즉, 특정 위치에서 항상 같은 값을 관찰할 수 있다고 단정하기는 불가능하기 때문에 이러한 변이는 본질적으로 확률론적 특성을 지닌다. 이러한 공간자료의 특성들을 무시하고 일반적 통계분석 등을 수행할 경우 공간자기상관성으로 인하여 통계분석에서 가정하는 자료 값들 간 독립성이 위배되고 분석결과는 왜곡될 가능성이 크다. 그러므로 공간자료 분석을 위해서는 공간자기상관성과 확률론적 변이를 적절하게 반영할 수 있는 수단이 필요하다. GIS는 공간적 위치정보를 처리하는데 적합하고 공간통계학은 공간적 변이를 다루는데 유용하다. 따라서 GIS를 기반으로 공간통계학을 통합하는 분석방식은 공간자료의 특성들을 고려하여 유의미한 분석을 하기에 적합한 장점이 있다. 본 연구의 목적은 공간자료 분석에 있어서 공간통계학과 GIS를 결합하는 접근방식의 유용성을 논의하고 실증적 사례분석을 통하여 구체적 활용성을 살펴보는 것이다. 이를 위하여 공간통계학을 주요 방법론으로 활용하는 공간역학(spatial epidemiology) 분야를 예시적으로 살펴보았다. 구체적으로는 공간검색통계량을 이용하여 미국 Erie 및 Niagara 카운티(New York 주) 내의 유방암 발생의 공간적 군집패턴 분석 논의하였다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권4호
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• pp.1557-1561
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• 2014

Background: Breast cancer is the most frequently diagnosed cancer in women and estimating its relative risks and trends of incidence at the area-level is helpful for health policy makers. However, traditional methods of estimation which do not take spatial heterogeneity into account suffer from drawbacks and their results may be misleading, as the estimated maps of incidence vary dramatically in neighboring areas. Spatial methods have been proposed to overcome drawbacks of traditional methods by including spatial sources of variation in the model to produce smoother maps. Materials and Methods: In this study we analyzed the breast cancer data in Iran during 2004-2008. We used a method proposed to cover spatial and temporal effects simultaneously and their interactions to study trends of breast cancer incidence in Iran. Results: The results agree with previous studies but provide new information about two main issues regarding the trend of breast cancer in provinces of Iran. First, this model discovered provinces with high relative risks of breast cancer during the 5 years of the study. Second, new information was provided with respect to overall trend trends o. East-Azerbaijan, Golestan, North-Khorasan, and Khorasan-Razavi had the highest increases in rates of breast cancer incidence whilst Tehran, Isfahan, and Yazd had the highest incidence rates during 2004-2008. Conclusions: Using spatial methods can provide more accurate and detailed information about the incidence or prevalence of a disease. These models can specify provinces with different health priorities in terms of needs for therapy and drugs or demands for efficient education, screening, and preventive policy into action.