• Journal of Environmental Health Sciences
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• v.37 no.4
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• pp.250-257
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• 2011

Objectives: This study was aimed at re-assessing the environmental burden of disease attributable to waterrelated diseases using available local data from Korea. Methods: The general methods and the operational definitions for water, sanitation and hygiene applied to the study were based on an environmental burden of disease study conducted by WHO. Eleven water-related diseases were selected. The attributable fraction for diarrhea was calculated by assessing local exposure levels to drinking water, sanitation and hygiene according the scenario-based approach. The attributable fractions for the other ten diseases were derived from the results of the environmental burden of diseases study. The attributable DALYs were measured by using the attributable fractions and local health statistics. Results: The total environmental burden of disease attributable to water, sanitation and hygiene for Korea was 0.9210 DALY per 1000 capitals. Of the total burden of disease, the attributable burden of diarrhea was 0.8863 (96.1%), the attributable burden of malaria and malnutrition was 0.0236 and 0.0063 DALY per 1000 capitals, respectively. There was little burden of disease measured for other diseases. Conclusions: This study is meaningful in re-assessing the environmental burden of disease using available local exposure data and health statistics. Quantitative analysis of the environmental risk factors and a health impact assessment would be helpful to prioritize health policies or interventions in the future.

• Journal of Preventive Medicine and Public Health
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• v.48 no.4
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• pp.180-187
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• 2015

Objectives: Metabolic syndrome is an important etiologic factor in the development of certain types of cancers. The economic cost of the treatment of cancer has been steadily increasing. We therefore estimated the economic burden of cancers attributable to metabolic syndrome in Korea. Methods: We reviewed metabolic syndrome-related cancers and relative risk and then calculated population attributable fractions. We analyzed insurance claims data for metabolic syndrome-related cancers in 2012 in order to estimate the direct costs associated with these cancers, including hospitalization, outpatient visits, transportation costs, and caregivers' costs as well as indirect costs such as loss of productivity due to cancer treatment and premature death. Results: In 2012, 18 070 patients in Korea had cancers attributable to metabolic syndrome. The economic burden was USD 199.8 million and the direct and indirect costs were USD 124.5 million and USD 75.3 million, respectively. Conclusions: We estimated the economic burden of cancers attributable to metabolic syndrome in Korea and the efforts are necessary to reduce this burden.

• Journal of Environmental Health Sciences
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• v.38 no.6
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• pp.460-471
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• 2012

Objectives: Due to global warming resulting from climate change, there has been increasing interest in the relationship between temperature and mortality. These temperature-related deaths depend on diverse conditions related to a given place and person, as well as on time. This study examined changes in the impact of high temperatures on death in summer, using the effect and burden of elevated temperatures on deaths in Seoul and Daegu. Methods: A Poisson regression model was used to estimate short-term temperature effects on mortality. Temperature-related risks were divided into three time periods of equal length (1996-2000, 2001-2005, and 2006-2010). In addition, in order to compare the impact of high temperatures on deaths, this study calculated the proportion of attributable deaths to population, which simultaneously considers the threshold and the slope above the threshold. Results: The effect and burden of high temperatures on deaths is high in Daegu. However, the impact (i.e. the effect and burden) of elevated summer temperatures on deaths has declined over the past 15 years. Sensitivity analyses using alternative thresholds show the robustness of these findings. Conclusion: This study suggests that the attributable burden of high temperatures on deaths to be more plausible than relative risk or threshold for comparing the health impact of high temperatures across populations. Moreover, these results contain important implications for the development or the adjustment of present and future strategies and policies for controlling the temperature-related health burden on populations.

• Yonsei Medical Journal
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• v.59 no.9
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• pp.1123-1130
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• 2018

Purpose: Exposure to indoor radon is associated with lung cancer. This study aimed to estimate the number of lung cancer deaths attributable to indoor radon exposure, its burden of disease, and the effects of radon mitigation in Korea in 2010. Materials and Methods: Lung cancer deaths due to indoor radon exposure were estimated using exposure-response relations reported in previous studies. Years of life lost (YLLs) were calculated to quantify disease burden in relation to premature deaths. Mitigation effects were examined under scenarios in which all homes with indoor radon concentrations above a specified level were remediated below the level. Results: The estimated number of lung cancer deaths attributable to indoor radon exposure ranged from 1946 to 3863, accounting for 12.5-24.7% of 15623 total lung cancer deaths in 2010. YLLs due to premature deaths were estimated at 43140-101855 years (90-212 years per 100000 population). If all homes with radon levels above $148Bq/m^3$ are effectively remediated, 502-732 lung cancer deaths and 10972-18479 YLLs could be prevented. Conclusion: These findings suggest that indoor radon exposure contributes considerably to lung cancer, and that reducing indoor radon concentration would be helpful for decreasing the disease burden from lung cancer deaths.

• Journal of Environmental Health Sciences
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• v.37 no.5
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• pp.387-395
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• 2011

Purpose: This study measured the burden of disease in Korea related to outdoor air pollution using disability-adjusted life year (DALY). Materials and Methods: As a risk factor of outdoor air pollution, particulate matter with a diameter less than 10 ${\mu}m$($PM_{10}$) was used. First, $PM_{10}$-related diseases and their relative risk (RR) were selected by means of a literature review. Second, population attributable fractions were computed by using formulae including RR and population exposure to $PM_{10}$. Third, DALYs of $PM_{10}$-related diseases in Korea were estimated. Finally, the attributable burden of disease due to $PM_{10}$ was measured as the sum of the products that multiplied the DALYs of $PM_{10}$-related diseases by their population attributable fractions. Results: The disease burden of PM10 was 6.9 DALY per 1,000 persons in 2007. The attributable burden of $PM_{10}$ was 2.68 for lung cancer, 2.41 for COPD, 0.62 for ischemic heart disease, 0.61 for pneumonia, 0.55 for asthma, and 0.03 for preterm. Conclusions: This study showed the environmental burden of disease of $PM_{10}$ and burden of $PM_{10}$-related disease through objective data. It also suggested that active efforts are needed to continuously measure and reduce the burden of environmental diseases in Korea.

• Journal of Preventive Medicine and Public Health
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• v.34 no.3
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• pp.191-199
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• 2001

Objective : In this study, we focused on estimating the burden of premature death in Korea caused by smoking using the YLL(years of life lost due to premature death) measurement. Methods : First, we determined parameters: such as age-specific standard life expectancy, age on death, sex, and cause of death by analyzing the national death certificate data and life table collected during 1997. These were provided by the National Statistical Office. Secondly, we estimated the age group- specific years of life lost due to premature death by employing the standard expected years of life lost(SEYLL) measurement. Thirdly, the burden of premature death caused by smoking was estimated using the YLLs measurement which was developed by the global burden of disease study group. Fourthly, We calculated the risk related to smoking using the population attributable risk. Results : The following results were obtained in this study: 1) Premature death that is attributable to smoking in males could be prevented in 60.9%(513,582 person-year) by non-smoking. 2) The burden of premature death by smoking for female was prevented to 17.7%(513,582 person-year) by non-smoking. Conclusion : We found that the YLL method employed in this study was appropriate in quantifying the burden of premature death. This provides a rational basis for planning a national health policy regarding premature deaths caused by smoking and other related risk factors.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.31 no.4
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• pp.510-520
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• 2021

Objective: This paper aimed to provide estimates the burden of cancer attributable to occupational exposures in South Korea and to review the processes of estimating the population attributable fraction(PAF). Methods: The PAFs of occupational cancer were reviewed from previous studies. The number and proportion of cancer cases attributable to occupational carcinogens were estimated by multiplying the PAFs by recent Korean cancer data(up to 2016 for incidence and 2017 for death) obtained from the Statistics Korea. The estimation of PAFs included occupational exposures defined as definite or probable human carcinogens by the International Agency for Research on Cancer. Results: In South Korea, an estimated 10,769 new cancer cases(9,017 among men, 1,752 among women) in 2016, and 7,030 cases of death from cancer(6,047 in men, 983 in women) in 2017, were attributable to occupational exposures, representing 1.5-4.7% of all new cancer cases(2.1-7.5% and 0.3-1.6% among men and women, respectively) and 2.7-8.9% of all cancer death cases(3.4-12.4% and 0.5-3.3% among men and women, respectively). Among men and women, lung cancer was the most impactful. The estimation process of PAFs, however, has a variety of uncertainties. Conclusions: Occupational exposures contribute to a substantial burden of cancer in South Korea. PAFs for cancer provide useful information for prevention initiatives and prioritizing health policies for workers. However, PAFs need to be interpreted cautiously and updated regularly.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.6903-6908
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• 2015

Background: As smoking is the leading preventable cause of multiple diseases and premature cancer deaths, estimating the burden of cancer attributable to smoking has become the standard in documenting the adverse impact of smoking. In Indonesia, there is a dearth of studies assessing the economic costs of cancers related to smoking. This study aimed to estimate indirect mortality costs of premature cancer deaths and years of potential life lost (YPLL) attributable to smoking among the Indonesian population. Materials and Methods: A prevalence based method was employed. Using national data, we estimated smoking-attributable cancer mortality in 2013. Premature mortality costs and YPLL were estimated by calculating number of cancer deaths, life expectancy, annual income, and workforce participation rate. A human capital approach was used to calculate the present value of lifetime earnings (PVLE). A discount rate of 3% was applied. Results: The study estimated that smoking attributable cancer mortality was 74,440 (30.6% of total cancer deaths), comprised of 95% deaths in men and 5% in women. Cancers attributed to smoking wereresponsible for 1,207,845 YPLL. Cancer mortality costs caused by smoking accounted for USD 1,309 million in 2013. Among all cancers, lung cancer is the leading cause of death and economic burden. Conclusions: Cancers related to smoking pose an enormous economic burden in Indonesia. Therefore, tobacco control efforts need to be prioritized in order to prevent more losses to the nation. The data of this study are important for advocating national tobacco control policy.

• Journal of Preventive Medicine and Public Health
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• v.38 no.2
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• pp.175-181
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• 2005

Objectives: This study estimated the burden of disease due to high alcohol consumption using DALY, a composite indicator recently developed by the Global Burden of Disease study group. The results were analyzed by age and sex. Methods: Firstly, high alcohol consumption-related diseases, and their relative risk (RR), were selected. Secondly, population attributable fractions (PAFs) were computed using formulae, including the relative risk (RR) and prevalence of exposure (Pe). Thirdly, the DALYs of high alcohol consumption-related diseases were estimated. Lastly, the attributable burdens of diseases due to high alcohol consumption wereconcluded as being the sum of the products that multiplied the DALYs of high alcohol consumption-related diseases by their population attributable fraction (PAF). Results : The burden of high alcohol consumption in Korea was 2992.3 person years (PYs) per 100,000 persons in men, and 1426.6 in women. For men, the high alcohol consumption-induced diseases with the five biggest burdens were liver cirrhosis, hypertensive disease, liver cancer, cerebral infarction and intracerebral hemorrhage. For women, these were cerebral infarction, intracerebral hemorrhage, hypertensive disease, liver cirrhosis and liver cancer. Conclusion: This study highlighted the attributable fraction of diseases due to exposure to high alcohol consumption, by quantifying the results of exposure to risk factors. Therefore, it is now possible to assess interventions for risk factors in quantifiable terms in each population. Finally, measuring the risk factor burdens was expected to contribute to priority setting and effective resource allocation in public health policy.

• Journal of Korean Medical Science
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• v.33 no.46
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• pp.288.1-288.12
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• 2018

Background: Diarrheal and intestinal infectious disease caused by inadequate drinking water, sanitation, and hygiene (WASH) is not only a great concern in developing countries but also a problem in low-income populations and rural areas in developed countries. In this study, we assessed the exposure to inadequate WASH in Korea and estimated the burden of disease attributable to inadequate WASH. Methods: We used observational data on water supply, drinking water, sewage treatment rate, and hand washing to assess inadequate WASH conditions in Korea, and estimated the level of exposure in the entire population. The disease burden was estimated by applying the cause of death data from death registry and the morbidity data from the national health insurance to the population attributable fraction (PAF) for the disease caused by inappropriate WASH. Results: In 2013, 1.4% of the population were exposed to inadequate drinking water, and 1.0% were living in areas where sewerage was not connected. The frequency of handwashing with soap after contact with excreta was 23.5%. The PAF due to inadequate WASH as a cluster of risk factors was 0.353 (95% confidence interval [CI], 0.275-0.417), among which over 90% were attributable to hand hygiene factors that were significantly worse than those in American and European high-income countries. Conclusion: The level of hand hygiene in Korea has yet to be improved to the extent that it shows a significant difference compared to other high-income countries. Therefore, improving the current situation in Korea requires a continuous hand washing campaign and a program aimed at all people. In addition, continuous policy intervention for improvement of sewage treatment facilities in rural areas is required, and water quality control monitoring should be continuously carried out.