• Korean Journal of Adult Nursing
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• v.12 no.1
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• pp.99-111
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• 2000

The purpose of this study was to identify risk factors related to sexual function of women with coronary artery disease, and to determine the predictors of sexual function. The study design, a descriptive correlational study, was done through structural questionnaire and interview. A total of 50 subjects from C University Hospital at Kwang-ju city who have undergone coronary angiography at department of cardiology were observed and interviewed from Feb. 22, 1999 to March. 23, 1999. The number of affected vessels, the level of total serum cholesterol, and the ejection fraction of 2-D echo cardiography were analyzed to evaluate the severity of coronary artery disease. And also type A behavior pattern, health behavior, Brief Index of Sexual Functioning for Women (BISF-W) were measured. The data obtained were analyzed using percentage, mean and standard deviation, t-test, ANOVA, Pearson's correlation coefficient, and stepwise multiple regression analysis via SPSS PC+. The results of this study were as follows: 1. The mean age of the subjects were 58.1 and 72.0% of those have been married over 30 years. Seventy two percentage were unemployed and monthly family income of 56.6% was less than 1,000,000 won (approximately $ 840). Eighty percent were in their postmenopausal state, and the frequency of sexual intercourse of 84.0% were two to three times per month. 2. The scores of type A behavior pattern were from 16 to 38(mean 24.94) and health behavior ranged from 21 to 43(mean 31.2). Abstinence from smoking, alcohol, and caffeine were best compliant factors and weight control and exercise were least abided ones. The result of 2D-ECHO EF showed that the half of the subjects were abnormal, and 24% had more than 240mg/dl of total serum cholesterol. The coronary angiography showed that 64% of the subjects had more than one affected vessels. 3. The predictors to explain the factor score of 'orgasm' were number of health examination, the pre- or post-menopausal state, protestant, number of coronary vessel affected, level of serum total cholesterol, and comorbid group of hypertension and diabetes, and it's total variance accounted for 52.4%. The predictors to explain the factor score of 'sexual activity' were comorbid group of hypertension and diabetes and type A behavior pattern, which accounted for 22.4% of total variance. The predictors to explain the factor score of 'sexual satisfaction' were type A behavior pattern, no religion, exercise, level of serum total cholesterol, and pre or post menopausal state, which accounted for 52.1%. The predictors to explain the factor score of 'sexual desire' were the period of marriage, type A behavior, employment or unemployment, and weight control, which accounted for 43.2%. The predictors to explain the factor score of 'external force of sexual functioning' were physical overload and exercise, which accounted for 41.1%. The predictors to explain the factor score of 'sexual activity' were family monthly income, catholics, and exercise, and which accounted for 35.4%. Above results lead us to some consensus that sexual function of women with coronary artery disease is related to various factors including vasogenic factors such as total serum cholesterol level, number of coronary vessel affected, an endocrinal factor such as menopausal state, and type A behavior pattern as a sociopshychological factor. And also health behaviors such as fitness care, overwork, weight control, and emotional tension are contributed to sexual function.

• Korean Journal of Psychosomatic Medicine
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• v.14 no.1
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• pp.53-61
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• 2006

Objectives: This study was designed to evaluate difference of the alexithymia between panic patients and normal controls by examination of the relationships between different components of the alexithymia construct and level of anxiety and depression in panic patients and normal controls. Methods The subjects were 167 patients who met DSM-IV criteria for panic disorder and 110 normal controls. They drew up symptom checklists and self-rating scales, and were measured by Anxiety Disorders Interview Schedule-Panic attack & Agoraphobia(ADIS-P & A), Korean version of Toronto Alexithymia Scale (TAS-20K), Spielberger State-Trait Anxiety Inventory-State & Trait (STAI-S & T), Beck Depression Inventory (BDI), and Revised Anxiety Sensitivity Index (ASI-R). For statistical analysis, we performed t-test to compare the sociodemographic characteristics and the scores of self reported scales between panic patients and normal controls. Pearson correlation was performed between TAS-20K and it's subfactors, STAI-S & T, ASI-R and BDI in panic patients and normal controls. And stepwise multiple regression analysis was preformed to explain results of correlation analysis for alexithymia. Results: The panic patients reported more significant alexithymic (p<0.001), more difficulty identifying feeling (p<0.001) and describing feeling (p=0.001) than normal controls. Futhermore, panic patients were more significant anxious, sensitive to anxious feeling and depressive than normal controls. Moreover, the alexithymia of panic patients was explained by trait-anxiety $({\Delta}R^2=0.255)$ and anxiety sensitivity $({\Delta}R^2=0.062)$, that of normal controls was predicted by depression $({\Delta}R^2=0.144)$ and anxiety sensitivity $({\Delta}R^2=0.033)$ Conclusion: The panic patients reported more anxious and sensitive to anxious feeling, and these symptoms predict alexithymia in panic patients. However, the alexithymia of normal controls was explained by depression more than anxiety sensitivity, and such a result isn't consistent with previous studies and this may be mainly due to difference of the homogeneity in object of the studies.

• Korean Journal of Occupational Health Nursing
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• v.11 no.1
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• pp.13-30
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• 2002

Industrial shift workers feels suffer mental stresses which are caused by unfamiliar day sleep, noisy environment, sleeping disorder by bright light, unusual contacts with family, difficulty in meeting with friends or having formal social meetings and other social limitations such as the use of transportation. Such stresses influence health of the workers negatively. Thus the health promotion policy for shift workers should be made considering the workers' ways of living and shift work specially. This study attempted to provide basic information for development of the health promotion program for industrial shift workers by examining predictive factors influencing health promotion behaviors of those workers. In designing the study, three power generation plants located in Pusan and south Kyungsang province were randomly selected and therefrom 280 workers at central control, boiler and turbine rooms and environmental chemistry parts whose processes require shift works were sampled as subjects of the study. Data were collected two times from September 17 to October 8, 1999 using questionnaires with helps of safety and health managers of the plants. The questionnaires were distributed through mails or direct visits. Means for the study included the measurement tool of health promotion behavior provided by Park(1995), the tool of self-efficacy measurement by Suh(1995), the tool of internal locus of control measurement by Oh(1987), the measurement tool of perceived health state by Park(1995) and the tool of social support measurement by Paek(1995). The collected data were analyzed using SPSS program. Controlling factors of the subjects were evaluated in terms of frequency and percentage ratio Perceived factors and health promotion behaviors of the subjects were done so in terms of mean and standard deviation, and average mark and standard deviation, respectively. Relations between controlling and perceived factors were analyzed using t-test and ANOVA and those between perceived factors and the performance of health promotion behaviors, using Pearson's Correlation Coefficient. The performance of health promotion behaviors was tested using t-test, ANOVA and post multi-comparison (Scheffe test). Predictive factors of health promotion behavior were examined through the Stepwise Multiple Regression Analysis. Results of the study are summarized as follows. 1. The performance of health promotion behaviors by the subjects was evaluated as having the value of mean, $161.27{\pm}26.73$ points(min.:60, max.:240) and average mark, $2.68{\pm}0.44$ points(min.:1, max.:4). When the performance was analyzed according to related aspects, it showed the highest level in harmonious relation with average mark, $3.15{\pm}.56$ points, followed by hygienic life($3.03{\pm}.55$), self-realization ($2.84{\pm}.55$), emotional support($2.73{\pm}.61$), regular meals($2.71{\pm}.76$), self-control($2.62{\pm}.63$), health diet($2.62{\pm}.56$), rest and sleep($2.60{\pm}.59$), exercise and activity($2.53{\pm}.57$), diet control($2.52{\pm}.56$) and special health management($2.06{\pm}.65$). 2. In relations between perceived factors of the subjects(self-efficacy, internal locus of control, perceived health state) and the performance of health promotion behaviors, the performance was found having significantly pure relations with self-efficacy (r=.524, P=.000), internal locus of control (r=.225, P=.000) and perceived health state(r=.244, P=.000). The higher each evaluated point of the three factors was, the higher the performance was in level. 3. When relations between the controlling factors(demography-based social, health-related, job-related and human relations characteristics) and the performance of health promotion behaviors were analyzed, the performance showed significant differences according to marital status (t=2.09, P= .03), religion(F=3.93, P= .00) and participation in religious activities (F=8.10, P= .00) out of demography-based characteristics, medical examination results (F=7.20, P= .00) and methods of the collection of health knowledge and information(F=3.41, P= .01) and methods of desired health education(F=3.41, P= .01) out of health-related characteristics, detrimental factors perception(F=4.49, P= .01) and job satisfaction(F=8.41, P= .00) out of job-related characteristics and social support(F=14.69, P= .00) out of human relations characteristics. 4. The factor which is a variable predicting best the performance of health promotion behaviors by the subjects was the self-efficacy accounting for 27.4% of the prediction, followed by participation in religious activities, social support, job satisfaction, received health state and internal locus of control in order all of which totally account for 41.0%. In conclusion, the predictive factor which most influence the performance of health promotion behaviors by shift workers was self-efficacy. To promote the sense, therefore, it is necessary to develop the nursing intervention program considering predictive factors as variables identified in this study. Further industrial nurses should play their roles actively to help shift workers increase their capability of self-management of health.

• Journal of the Korean Society of Food Science and Nutrition
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• v.33 no.1
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• pp.107-113
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• 2004

This study explored the association between the bone nutrition indicators and the bone mineral density (BMD) in 138 apparently healthy elderly (male: 38, female: 100) dwelling in a low income area of the city. Dietary intakes were estimated from two meals (breakfast ＆ dinner) and snack using 24 hr-recall method and lunch with weighing over 3 consecutive days. Female elderly showed significant lower intakes (p<0.001∼p<0-05) for most of the nutrients except calcium and vitamin C than the elderly male. Calcium and vitamin D intakes for both male and female were 331.0 mg, 1.89 $\mu\textrm{g}$ and 308.6 mg, 1.21 $\mu\textrm{g}$, respectively and they were below the 50% of the RDA. Both the BMDs at lumbar spine (LS) and femoral neck (FN) were positively correlated with the energy intake, calcium intake and vitamin D intake (p<0.05, respectively) for male. In female BMDs of the both sites were positively correlated with the intakes of carbohydrates, protein, lipid, calcium and vitamin D (p<0.01∼p<0.05). Female showed higher serum osteocalcin (p<0.01) and urinary deoxypyridinoline/creatinine (DPYR/CR) (p<0.001), meaning that female had elevated rate in bone turn over and bone resorption. The proportion of subjects with vitamin D deficiency assessed with serum 25(OH)VitD$_3$<10 mg/mL was 35.0% for female and 23.7% for male, respectively Both the BMDs at lumbar spine and trochanter were positively correlated with serum 25(OH)VitD$_3$ but BMDs in most of the sites were negatively associated with urinary DPYR/CR, phosphate/CR. Stepwise multiple regression showed physical activity, serum alkaline phosphatase, weight, vitamin D explained 47.6% of the variation of the LS BMD. The indicator variable for serum alkaline phosphatase was negatively associated with LS BMD. However, the indicator variable for weight and vitamin D intake were positive and significant (p=0.0087, p=0.0007, respectively). For FN BMD, the indicator variable for age and serum alkaline phosphatase were negative and significant (p<0.0075, p<0.0015, respectively) and the weight was positively associated with the FN BMD.

• Clinical and Experimental Pediatrics
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• v.51 no.5
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• pp.474-480
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• 2008

Purpose : Stress hyperglycemia is common in critically ill adult patients. It is known as a predictor of increased mortality, and intensive insulin therapy has been shown to improve the prognosis in such patients. We have investigated the relationship between early stress hyperglycemia and clinical outcomes in preterm infants. Methods : In this study, 141 preterm infants with a gestational age of less than 30 weeks were enrolled. The hyperglycemic group was defined as that having maximum glucose of more than 150 mg/dL (n=61) during the first 48 h of life, and the non-hyperglycemic group was defined as that having maximum glucose of less than 150 mg/dL (n=80). Perinatal history, severity of illness using the Clinical Risk Index for Babies (CRIB) score, clinical outcomes, and mortality of the two groups were compared. Results : There was no significant difference in the gestational age between the two groups, but the birth weight (P<0.001) was significantly lower, and the CRIB score (P<0.001) was significantly higher in the hyperglycemic group. Disseminated intravascular coagulation (P<0.001) and clinically suspected sepsis (P=0.046) were more common in the hyperglycemic group. Mortality was markedly higher in the hyperglycemic group (11.3% vs. 41.0%, P<0.001). On performing a stepwise multiple logistic regression analysis, hyperglycemia (OR 3.787; 95% CI 1.324 to 10.829), the CRIB score (OR 1.252; 95% CI 1.047 to 1.496) and birth weight (OR 0.997; 95% CI 0.994 to 1.000) was independently associated with higher mortality. Conclusion : Stress hyperglycemia within the first 48 h of life is independently related to increased morbidity and mortality in preterm infants.

• Journal of Preventive Medicine and Public Health
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• v.29 no.2 s.53
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• pp.239-254
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• 1996

Health services on industrial noisy environment have been provided only for noise-induced hearing loss management until now. But gradually, modem diseases and death have come to be related to stress and mental health deeply, therefore noise-induced mental disorder, like a stress became very important. In this point, the purpose of this study was to analyze the relationship between noise exposure level in worksite and workers' stress symptoms. This study included a survey of 786 manual workers selected from 89 worksites in 21 factories in Puchon. The results were as follows: 1. For demographic characteristics, most of the workers were males(80.8%), the $20\sim29years$ old were 34.5% and those who graduated from high school were 65.3%. The workers whose monthly income ranged from 100,000 to 800,000 won were 37.5% and who have a religion were 47.9%. 2. For occupational characteristics, workers who had worked $1\sim5$ years in the factories were 33.0%. Those who were much for them workload were 43.9% and who worked more than 8 hours a day were 73.9%. Those who were disatisfied with their job and pay were 31.9% and 50.6%. The workers who responsed ventilation condition of their worksites were bad were 51.9% and the dissatisfed with working environment of their worksites were 45.9%. 3. Workers who were suffering from tinnitus were 53.3% and those who perceived hearing loss were 50.1%. Persons who reported they always wore earplugs at work were 35.4%. Those who felt earplugs bigger than their ears were 30.6% and those who experienced eardiseases caused by earplugs were 25.6%. 4. For the noise exposure level in worksite, workers who were exposed to $80\sim90dB$ were 30.3%, $90\sim100dB$ were 26.4% and $50\sim70dB$ were 19.2%. 5. Workers' stress symptoms were significantly related to marital status and their monthly income(p<0.05). Workers who were single and had lower monthly income showed higher PSI (Psychiatric Symptom Index) scores than those who were married and had higher monthly income. Higher PSI scores were also significantly related to $1\sim2$ days hight-work per week, much for them workload, dissatisfaction with their job, and bad relationship with their bosses and coworkers. 6. Higher PSI scores were significantly related to severe tinnitus and perceived hearing losso(p<0.001). Workers who felt the earplugs they use did not fit their ears showed significantly higher PSI scores(p<0.01). Workers who reported that they did not feel they need earplugs showed. significantly higher PSI scores (p<0.05). Increased experience of eardisease caused by earplugs that did not fit were also significantly related to higher PSI scores(p<0.01). 7. The higher noise exposure level in worksite from 80dB was, the more severe stress symptoms including PSI subparts were reported; Anxiety, Anger, Depression, and Cognitive disorder(p<0.001). 5. According to the results of stepwise multiple regression analysis, factors affecting workers' PSI scores were perceived hearing loss$(R^2=0.160)$, noise exposure level in worksite$(R^2=0.110)$, realtionship with coworkers, amount of workload, monthly income and relationship with bosses orderly and the total $R^2$ of this 6 factors was 0.371. 9. The most significant factors that have impact on manual workers' stress symptoms were perceived hearing loss and noise exposure level in worksite, especially noise exposure level in the worksite was the most affective factor on the depression symptom.

• Clinical and Experimental Reproductive Medicine
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• v.26 no.2
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• pp.163-170
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• 1999

Objectives: The aims of this study are 1) to determine if GAST is a better indicator in predicting ovarian response to COH compared with patient's age or basal FSH level and 2) to evaluate its role in detecting abnormal ovarian response. Design: Prospective study in 118 patients undergoing IVF-ET using GnRH-a short protocol during May-September 1995. Materials and Methods: After blood sampling for basal FSH and estradiol $(E_2)$ on cycle day two, 0.5ml (0.525mg) GnRH agonist ($Suprefact^{(r)}$, Hoechst) was injected subcutaneously. Serum $E_2$ was measured 24 hours later. Initial $E_2$ difference $({\Delta}E_2)$ was defined as the change in $E_2$ on day 3 over the baseline day 2 value. Sixteen patients with ovarian cyst or single ovary or incorrect blood collection time were excluded from the analysis. The patients were divided into three groups by ${\Delta}E_2$; group A (n=30):${\Delta}E_2$<40 pg/ml, group B (n=52): 40 pg/ml${\leq}{\Delta}E_2$<100 pg/ml, group C (n=20): ${\Delta}E_2{\leq}100$ pg/ml. COH was done by GnRH agonist/HMG/hCG and IVF-ET was followed. Ratio of $E_2$ on day of hCG injection over the number of ampules of gonadotropins used ($E_2hCGday$/Amp) was regarded as ovarian responsiveness. Poor ovarian response and overstimulation were defined as $E_2$ hCGday less than 600 pg/ml and greater than 5000 pg/ml, respectively. Results: Mean age $({\pm}SEM)$ in group A, B and C were $33.7{\pm}0.8^*,\;31.5{\pm}0.6\;and\;30.6{\pm}0.5^*$, respectively ($^*$: p<0.05). Mean basal FSH level of group $A(11.1{\pm}1.1mlU/ml)$ was significantly higher than those of $B(7.4{\pm}0.2mIU/ml)$ and C $(6.8{\pm}0.4mIU/ml)$ (p<0.001). Mean $E_2hCGday$ of group A was significantly lower than those of group B or C, i.e., $1402.1{\pm}187.7pg/ml,\;3153.2{\pm}240.0pg/ml,\;4078.8{\pm}306.4pg/ml$ respectively (p<0.0001). The number of ampules of gonadotropins used in group A was significantly greater than those in group B or C: $38.6{\pm}2.3,\;24.2{\pm}1.1\;and\;18.5{\pm}1.0$ (p<0.0001). The number of oocytes retrieved in group A was significantly smaller than those in group B or C: $6.4{\pm}1.1,\;15.5{\pm}1.1\;and\;18.6{\pm}1.6$, respectively (p<0.0001). By stepwise multiple regression, only ${\Delta}E_2$ showed a significant correlation (r=0.68, p<0.0001) with $E_2HCGday$/Amp, while age or basal FSH level were not significant. Likewise, only ${\Delta}E_2$ correlated significantly with the number of oocytes retrieved (r=0.57, p<0.001). All four patients whose COH was canceled due to poor ovarian response belonged to group A only (Fisher's exact test, p<0.01). Whereas none of 30 patients in group A (0%) had overstimulation, 14 patients among 72 patients (19.4%) in group B and C had overstimulation (Fisher's exact test, p<0.01). Conclusions: These data suggest that initial $E_2$ difference after GAST may be a better prognostic indicator of ovarian response to COH than age or basal FSH level. Since initial $E_2$ difference demonstrates significant association with abnormal ovarian response such as poor ovarian response necessitating cycle cancellation or overstimulation, GAST may be helpful in monitoring and consultation of patients during COH in IVF-ET cycle.

• Journal of dental hygiene science
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• v.14 no.1
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• pp.59-66
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• 2014

The purpose of this study was to study of utilization of dental high school and according to the pain experienced dental fear and anxiety. This survey was conducted on 370 high school students in Suwon from November 21 to 23, 2011. A total of 352 questionnaires were collected and analyzed. The collected data was analyzed using the statistical package SPSS 15.0 using frequency, mean and standard deviation analysis, t-test, one-way ANOVA, Duncan's test correlation analysis and Stepwise multiple regression analysis. The results state that students feel fear and anxiety were feeling anesthetic needle ($3.19{\pm}1.43$), seeing anesthetic needle ($3.14{\pm}1.44$). We found that students feel more rear and anxiety from caries treatment than scaling. It influence that having dental fear with past dental pain experienced during dental treatment and also hearing dental treatment of pain from their family and friends. We found out that there are some influencing factors on dental fear and anxiety, gender, oral health condition, smoking, pain experienced during dental treatment. We need to care dental fear and anxiety continuously and have prevention program. We have to try understanding students have dental fear and anxiety. So it's better they have good experience visiting dental clinic. We should develop the system and specially treat well while they have dental treatment with anesthesia and some sharp instruments.

• Journal of Hospice and Palliative Care
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• v.17 no.4
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• pp.241-247
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• 2014

Purpose: Serum vitamin C is one of the indicators for antioxidant levels in the body and it is lower in cancer patients compared with the healthy population. However, there have been few studies on the levels of serum vitamin C in terminally ill cancer patients and related factors. Methods: We followed 65 terminal cancer patients who were hospitalized in two palliative care units. We collected data of age, sex, cancer type, functional status, clinical symptoms, history of cancer therapy, and various laboratory findings including serum vitamin C level. Patients were categorized into two groups according to the quartile of serum vitamin C level (Q1-3 vs. Q4), which were compared each other. Stepwise multiple logistic regression analysis was used to identify factors related to serum vitamin C levels. Results: The mean serum vitamin C level was $0.44{\mu}g/mL$, and all patients fell into the category of vitamin C deficiency. Univariate analysis showed that The serum vitamin C level was lower in non-lung cancer patients (P=0.041) and febrile patients (P=0.034). Multivariate analysis adjusted for potential confounders such as lung cancer, fever, dysphagia, dyspnea, C reactive protein, and history of chemotherapy demonstrated that odds for low serum vitamin C level was 3.7 for patients receiving chemotherapy (P=0.046) and 7.22 for febrile patients (P=0.02). Conclusion: Vitamin C deficiency was very severe in terminally ill cancer patients, and it was associated with history of chemotherapy and fever.

• Journal of Preventive Medicine and Public Health
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• v.24 no.2 s.34
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• pp.181-194
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• 1991

This study intended to obtain an useful information on the prevalence of subjective symptoms, and to clarify the interrelationships between blood lead and lead related symptoms in low level lead exposure. The 93 male workers exposed to lead and 56 male nonexposed workers were examined for their blood lead(PBB), Zinc-protoporphy(ZPP), hemoglobin(HB) and personnal history, and completed 15 questionnaires related to symptoms of lead absorption : also measured lead concentration in air (PBA) in the workplace. The results obtained were as follows ; 1. The means of blood lead (PBB), blood ZPP and hemoglobin (HB) among workers exposed to lead were $26.1{\pm}8.8{\mu}g/dl,\;28.3{\pm}26.0{\mu}g/dl$ and $16.2{\pm}1.2g/dl$ : whereas those of nonexposed workers were $18.7{\pm}5.1{\mu}g/dl,\;20.6{\pm}8.7{\mu}g/dl$ and $17.3{\pm}1.1g/dl$. The means of above three indicies between two groups showed significant difference statistically (p<0.05). 2. The means of blood lead (PBB), blood ZPP and hemoglobin of workers exposed .to different lead concentration in air were as follows : When it was below $25{\mu}g/m^3$, the indices were $24.7{\pm}79,\;26.1{\pm}26.8{\mu}g/dl\;and\;16.4{\pm}1.1g/dl$ respectively : These indices were $27.1{\pm}8.5,\;23.9{\pm}10.92{\mu}g/dl\;and\;16.2{\pm}1.3g/dl$ when the lead concentration in air was $25{\sim}50{\mu}g/m^3$ : and they were $3.4{\pm}9.3,\;42.3{\pm}31.3{\mu}g/dl\;and\;15.5{\pm}1.2g/dl$ when the concentration of lead was above $50{\mu}g/m^3$. Although there were statistical difference in blood lead and hemoglobin among three different lead concentration in air, there was no statistical difference of blood ZPP among the three groups with different exposure levels (p>0.05). 3. The most frequent by complained symptom was 'Generalized weakness and fatigue', and fewest symptom was 'Intermittent pains in abdomen' 4. Only two symptoms out of fifteen symptoms checked by themselves revealed significant difference between exposed and nonexposed groups. These were 'Intermittent pains of abdomen' and 'Joint pain or arthralgia' (p<0.05), No positive correlation was found between the levels of blood lead and symptom groups categorized as gastrointestinal, neuromuscular and constitutional symptoms, 5. Blood lead (r=0.3995) and ZPP (r=0.2837) showed statistically significant correlation with mean lead concentration in air, whereas correlations were not demonstrated between blood lead and lead related symptoms or blood ZPP and lead related symptoms. 6. Blood lead (PBB) and ZPP showed association (r=0.2466) and the equation PBB=23.75+0.0842 ZPP was derived. 7. On stepwise multiple regression, using blood lead level as a dependent variable and ZPP, hemoglobin (HB), age, work duration (WD) and symptom prevalence as a independent variables, only ZPP significantly contributed a lot to blood lead level. 8. While the ZPP measurement was found to be a good indicator in evaluating health effect of lead absorption in low level lead exposure, lead related symptoms were not sensitive enough to evaluate of lead absorption in low level exposure.