• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7725-7730
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• 2013

Objective: The purpose of this study was to evaluate secondhand smoke (SHS) exposure inside selected public places to provide basic data for the development and promotion of smoke-free policies. Methods: Between March and May 2009, an SHS exposure survey was conducted. $PM_{2.5}$ levels and air nicotine concentrations were measured in hospitals (n=5), government buildings (4), restaurants (10) and entertainment venues (10) in Seoul, Republic of Korea, using a common protocol. Field researchers completed an observational questionnaire to document evidence of active smoking (the smell of cigarette smoke, presence of cigarette butts and witnessing people smoking) and administered a questionnaire regarding building characteristics and smoking policy. Results: Indoor $PM_{2.5}$ levels and air nicotine concentrations were relatively higher in monitoring sites where smoking is not prohibited by law. Entertainment venues had the highest values of $PM_{2.5}$(${\mu}g/m^3$) and air nicotine concentration(${\mu}g/m^3$), which were 7.6 and 67.9 fold higher than those of hospitals, respectively, where the values were the lowest. When evidence of active smoking was present, the mean $PM_{2.5}$ level was 104.9 ${\mu}g/m^3$, i.e., more than 4-fold the level determined by the World Health Organization for 24-hr exposure (25 ${\mu}g/m^3$). Mean indoor air nicotine concentration at monitoring sites with evidence of active smoking was 59-fold higher than at sites without this evidence (2.94 ${\mu}g/m^3$ vs. 0.05 ${\mu}g/m^3$). The results were similar at all specific monitoring sites except restaurants, where mean indoor $PM_{2.5}$ levels did not differ at sites with and without active smoking evidence and indoor air nicotine concentrations were higher in sites without evidence of smoking. Conclusion: Nicotine was detected in most of our monitoring sites, including those where smoking is prohibited by law, such as hospitals, demonstrating that enforcement and compliance with current smoke-free policies in Korea is not adequate to protect against SHS exposure.

• 보건교육건강증진학회지
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• 제32권1호
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• pp.11-21
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• 2015

Objectives: This study aims to identify the psychosocial factors affecting on happiness among the general population in South Korea. Methods: This cross-sectional study was conducted using the multiple-stratified random sampling on the Korea Census of 2005. In October 2009, investigators conducted 15-minute face-to-face interviews with 1,500 South Korean volunteers ranging from 30 to 69 years old with no history of cancer. The questionnaire included socio-demographics, stress levels, coping strategies, social support, SOC, and happiness levels. Results: The multivariate analysis identified that married persons were more likely to be happy than those who were not married, respondents who had a higher score of stress and SOC were less likely to be happy, and those who had a higher score of social support from family were more likely to be happy. Conclusions: Interventions designed to increase happiness may need to include activities to control stress and promote social support from family.

• 한국대기환경학회지
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• 제34권4호
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• pp.542-553
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• 2018

Since many previous studies reported the health effect of air pollution and indicated traffic as a major pollution source, significant policy efforts have been made to control traffic to reduce air pollution. However, there have been few studies that evaluated such policy implementation. In Seoul, Korea, the exclusive median bus lane system was implemented in 2004, and the metropolitan government applied air pollution reduction policies such as conversion of diesel buses to compressed natural gas buses and installation of emission control devices. This paper aimed to investigate the impact of the exclusive median bus lane system on air pollution reduction. Using hourly concentrations of particulate matter ($PM_{10}$) and nitrogen dioxide ($NO_2$) measured at 131 regulatory monitoring sites in Seoul and Gyeonggi-do for 2001-2014, we calculated annual and daily average concentrations at each site. We assessed the impact of the policy using differences-in-differences analysis by annual and daily average models after adjusting for geographic and/or meteorological variables. This method divides population into treatment and control groups with and without policy application, and compares the difference between the two time periods before and after the policy implementation in the treatment group with the difference in the control group. We classified all monitoring sites into treatment and control groups using two definitions: 1) Seoul vs. Gyeonggi-do; 2) within vs. outside 300 meters from the median bus lane. Pre- and post-policy periods were defined as 2001-2005 and 2006-2014, and 2004 and 2014 in the annual and daily models, respectively. The decrease in $PM_{10}$ concentrations between the two periods across monitoring sites in the treatment group was larger by $1.73-5.88{\mu}g/m^3$ than in the control group. $NO_2$ also showed the decrease without statistical significance. Our findings suggest that an efficient public transport policy combined with pollution abatement policies can contribute to reduction in air pollution.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.81-85
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• 2016

Globally, the burden of breast cancer (BC) continues to increase. BC related lymphedema (BCRL) is currently non curable and as a life time risk it affects at least 25% of BC patients. Knowing more about BCRL and appropriate control of its modifiable risk factors can improve quality of life (QOL) of the affected patients. In this case control study to detect factors, 400 women with BCRL (as the case group) and 283 patients with BC without lymphedema (as the control group) that were referred to Shiraz University of Medical Sciences affiliated BC clinic center were assessed. The data were analyzed in SPSS. The mean age of the case group was $52.3{\pm}11.0years$ and of the control group was $50.1{\pm}10.9years$. In patients with BCRL, 203(50.7%) had left (Lt) side BC and in non- lymphedema group 151 (53.3%) had Lt side BC. Out of all BCRL patients, 204 (51%) had lymphedema in all parts of their affected upper extremities, 100 (25%) had swelling in the arm and forearm and 23 (5.7%) had edema in both the upper extremity and trunk. Edema, heaviness, concern about changing body image, pain and paresthesia were the most common signs/symptoms among patients with BCRL. In BCRL patients, the difference of circumference between the affected upper limb and non-affected limb was $4.4{\pm}2.5cm$ and the difference in volume displacement was $528.7{\pm}374.4milliliters$. Multiple variable analysis showed that moderate to severe activity (OR; odds ratio =14, 95% CI :2.6-73.3), invasiveness of BC (OR =13.7, 95% CI :7.3-25.6), modified radical mastectomy (OR=4.3, 95% CI :2.3-7.9), BMI =>25 (OR=4.2, 95% CI :2-8.7), radiotherapy (OR=3.9, 95% CI :1.8-8.2), past history of limb damage (OR=1.7, 95% CI :0.9-3.1) and the number of excised lymph nodes (OR=1.06, 95% CI :1.02-1.09) were the significant predictors of lymphedema in women with BC. Modifiable risk factors of BCRL such as non-guided moderate to severe physical activity, high BMI and trauma to the limb should be controlled as early as possible in BC patients to prevent development of BCRL and improve QOL of these patients.

• Asian Pacific Journal of Cancer Prevention
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• 제14권6호
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• pp.3411-3417
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• 2013

Over the last 10 years, the number of cancer survivors in South Korea has reached nearly one million with a survival rate of 49.4%. However, integrated supportive care for cancer survivors is lagging. One area in which the current cancer control policy needs updating is in the utilization of information and communication technology (ICT). The remarkable progress in the field of ICT over the past 10 years presents exciting new opportunities for health promotion. Recent communication innovations are conducive to the exchange of meta-information, giving rise to a new service area and transforming patients into active medical consumers. Consequently, such innovations encourage active participation in the mutual utilization and sharing of high-quality information. However, these benefits from new ICTs will almost certainly not be equally available to all, leading to so-called communication inequalities where cancer survivors from lower socioeconomic classes will likely have more limited access to the best means of making use of the health information. Therefore, most essentially, emphasis must be placed on helping cancer survivors and their caregivers utilize such advances in ICT to create a more efficient flow of health information, thereby reducing communication inequalities and expanding social support. Once we enhance access to health information and better manage the quality of information, as a matter of fact, we can expect an alleviation of the health inequalities faced by cancer survivors.

• Journal of Preventive Medicine and Public Health
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• 제42권4호
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• pp.243-250
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• 2009

Objectives : The purposes of this study is to estimate the cost of cancer care after its diagnosis and to identify factors that can influence the cost of cancer care. Methods : The study subjects were patients with an initial diagnosis one of four selected tumors and had their first two-years of cancer care at a national cancer center. The data were obtained from medical records and patient surveys. We classified cancer care costs into medical and nonmedical costs, and each cost was analyzed for burden type, medical service, and cancer stage according to cancer types. Factors affecting cancer care costs for the initial phase included demographic variables, socioeconomic status and clinical variables. Results : Cancer care costs for the initial year following diagnosis were higher than the costs for the following successive year after diagnosis. Lung cancer (25,648,000 won) had higher costs than the other three cancer types. Of the total costs, patent burden was more than 50% and medical costs accounted for more than 60%. Inpatient costs accounted for more than 60% of the medical costs for stomach and liver cancer in the initial phase. Care for latestage cancer was more expensive than care for early-stage cancer. Nonmedical costs were estimated to be between 4,500,000 to 6,000,000 won with expenses for the caregiver being the highest. The factors affecting cancer care costs were treatment type and cancer stage. Conclusions : The cancer care costs after diagnosis are substantial and vary by cancer site, cancer stage and treatment type. It is useful for policy makers and researchers to identify tumor-specific medical and nonmedical costs. The effort to reduce cancer costs and early detection for cancer can reduce the burden to society and improve quality of life for the cancer patients.

• 보건행정학회지
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• 제21권3호
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• pp.397-413
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• 2011

Purpose: The purpose of this study is to examine the relationship between the income level and the healthcare utilization by health insurance type in all cancer patients in year 2005. Methods: The target population was cancer patients with health insurance who used healthcare as a diagnosis code (C00-C97) from January 1 to December 31 of 2005. The Korea Central Cancer Registry Center's Cancer Patient Registry Data, the list of cancer patients of the National Health Insurance Corporation, and the claim data of the Health Insurance Review & Assessment Service were used. The I was the wealthiest, followed by II, III, IV. The V was the poorest in this study. For the analysis, the $x^2$-test, ANOVA (and Kruskal-Wallis test), and regression were used. Results: Outpatient and hospitalization medical expenses, and outpatient visit days of cancer patients with self-employed health insurance were highest in I (p<.001, respectively), and the hospitalization days were the highest in II (p<.001, respectively). Outpatient and hospitalization medical expenses, and outpatient visit and hospitalization days of cancer patients with occupational health insurance were the highest in I (p<.001, respectively). Outpatient and hospitalization medical expenses, and outpatient visit and hospitalization days in cancer patients were higher in I compared to V, and higher in II and III, IV compared to V (p<.001, respectively). Conclusion: Supporting plan for cancer patients' outpatient healthcare utilization are necessary. Moreover, we should make specialized strategy for low income cancer patients with self-employed health insurance when we develop quality improvement policy for inpatient service.

• Journal of Preventive Medicine and Public Health
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• 제40권4호
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• pp.329-335
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• 2007

Objectives : To identify the effects of supplemental private health insurance on health care utilization and expenditure under the mandatory National Health Insurance(NHI) system in Korea. Methods : The data were collected by the National Cancer Center in Korea. Cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer were included as study subjects. Data were gathered using a structured questionnaire from face-to-face interviews, the hospital Order Communication System (OCS) and medical records. Clinical, socio-demographic and private health insurance related factors were also gathered. The differences of health care utilization and expenditure were compared between those who have private health insurance and those who do not using t-test and multivariable regression analysis. Results : Individuals with private health insurance spent larger inpatient costs than those without, but no differences were found in utilization in other service such as hospital admissions, hospital days and physician visits. Conclusions : We found that private health insurance exerts a significant effect on the health care expenditure in inpatient service. These study results can provide a rational basis to plan a national health policy regarding private health insurance. Further studies are needed to investigate the impacts of private health insurance on cancer patients' outcomes and survival rates.

• Asian Pacific Journal of Cancer Prevention
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• 제15권1호
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• pp.335-341
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• 2014

Cancer is a menace fast gaining momentum in Nigeria and other developing countries. It is an expensive disease requiring a major financial and human resources for prevention, diagnosis and treatment. With no national policy on cancer control in the conntry, incidence (111.7/100,000 population) and mortality (86.6/100,000) rates in Nigeria are spiraling beyond control. This literature search study was primarily aimed at providing recommendations on cost-effective strategies for development interventions to promote self-management for cancer survivors in Nigeria with a goal to improve quality of life and overall survival.

• Journal of Preventive Medicine and Public Health
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• 제36권1호
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• pp.39-46
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• 2003

Objectives : To investigate the availability and demand for overall cancer-related information, and to establish a basic plan for the construction of a cancer database and information system based on the research results from Korea. Methods : Postal and telephone surveys were carried out, between August 2001 and November 2001, of 323 affiliated faculty professors from medical universities and colleges in Korea. The data were analyzed with descriptive statistical methods, with regard to the present status and demand for health and cancer-related information. Results : Most (over 80%) subjects studied utilized the health-related information provided on Internet website from foreign countries, such as Medline, but similar comprehensive information system lacked in Korea. The construction of a cancer-related database of domestic research results was revealed to be in a great demand. Information on registration and statistics (52.8%), study results (48.5%) and study resources (37.4%) were the major ingredients required in the database. In constructing a database of the cancer-related research results, a full-text service, continuous updating of data, and the development of standardized user-friendly searching tool were regarded as the necessary components. The formulation of an information sharing system, regarding cancer-related clinical trials, was investigated as being quite feasible. Conclusion : This study demonstrated the great importance of cancer information systems, and much demand for an available cancer-related database based on Korean research results.