• Safety and Health at Work
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• v.9 no.3
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• pp.249-256
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• 2018

This article aims to provide a systematic review of the exposure assessment methods used to assign wafer fabrication (fab) workers in epidemiologic cohort studies of mortality from all causes and various cancers. Epidemiologic and exposure-assessment studies of silicon wafer fab operations in the semiconductor industry were collected through an extensive literature review of articles reported until 2017. The studies found various outcomes possibly linked to fab operations, but a clear association with the chemicals in the process was not found, possibly because of exposure assessment methodology. No study used a tiered assessment approach to identify similar exposure groups that incorporated manufacturing era, facility, fab environment, operation, job and level of exposure to individual hazardous agents. Further epidemiologic studies of fab workers are warranted with more refined exposure assessment methods incorporating both operation and job title and hazardous agents to examine the associations with cancer risk or mortality.

• Journal of Preventive Medicine and Public Health
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• v.34 no.2
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• pp.119-126
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• 2001

Air pollution epidemiologic studies are intrinsically difficult because the expected effect size at general environmental levels is small, exposure and misclassification of exposure are common, and exposure is not selective to a specific pollutant. In this review paper, epidemiologic study designs and analytic methods are described, and two nationwide projects on air pollution epidemiology are introduced. This paper also demonstrates that possible confounding issues in time-series analysis can be resolved and the impact on the use of data from ambient monitoring stations may not be critical. In this paper we provide a basic understanding of the types of air pollution epidemiologic study designs that be subdivided by the mode of air pollution effects on human health (acute or chronic). With the improvements in the area of air pollution epidemiologic studies, we should emphasize that elaborate models and statistical techniques cannot compensate for inadequate study design or poor data collection.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.22 no.1
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• pp.9-19
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• 2012

Objectives: The aim of this study is to critically review the exposure surrogates and estimates used to associate health effects in wafer fabrication workers such as spontaneous abortion and cancer, as well as to identify the limitations of retrospective exposure assessment methods Methods: Epidemiologic and exposure-assessment studies of wafer fabrication operations in the semiconductor industry were collected. Retrospective exposure-assessment methods used in cancer risk and mortality and reproductive toxicity were reviewed. Results: Eight epidemiologic papers and two reports compared cancer risk among workers in wafer fabrication facilities in the semiconductor industry with the risk of the general population. Exposure surrogates used in those cancer studies were fabrication(vs. non-fabrication), employment duration, manufacturing eras, job title (operator vs. maintenance worker) and qualitative classifications of agents without assessing specific agent or job-specific exposure. In contrast, specific operation, job title and agents were used to classify the exposure of fabrication workers, contributing to finding a significant association with spontaneous abortion (SAB). Conclusion: Further epidemiologic studies of fabrication workers using more refined exposure assessment methods are warranted in order to examine the associations between fabrication work, environment, and specific agents with cancer risk or mortality as used in SAB epidemiologic studies.

• Journal of Preventive Medicine and Public Health
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• v.42 no.2
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• pp.135-142
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• 2009

Objectives : An appropriate sampling strategy for estimating an epidemiologic volume of diabetes has been evaluated through a simulation. Methods : We analyzed about 250 million medical insurance claims data submitted to the Health Insurance Review & Assessment Service with diabetes as principal or subsequent diagnoses, more than or equal to once per year, in 2003. The database was re-constructed to a 'patient-hospital profile' that had 3,676,164 cases, and then to a 'patient profile' that consisted of 2,412,082 observations. The patient profile data was then used to test the validity of a proposed sampling frame and methods of sampling to develop diabetic-related epidemiologic indices. Results : Simulation study showed that a use of a stratified two-stage cluster sampling design with a total sample size of 4,000 will provide an estimate of 57.04%(95% prediction range, 49.83 - 64.24%) for a treatment prescription rate of diabetes. The proposed sampling design consists, at first, stratifying the area of the nation into "metropolitan/city/county" and the types of hospital into "tertiary/secondary/primary/clinic" with a proportion of 5:10:10:75. Hospitals were then randomly selected within the strata as a primary sampling unit, followed by a random selection of patients within the hospitals as a secondly sampling unit. The difference between the estimate and the parameter value was projected to be less than 0.3%. Conclusions : The sampling scheme proposed will be applied to a subsequent nationwide field survey not only for estimating the epidemiologic volume of diabetes but also for assessing the present status of nationwide diabetes control.

• Journal of Microbiology and Biotechnology
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• v.28 no.2
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• pp.338-346
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• 2018

Two molecular epidemiologic methods, IS6110 restriction fragment length polymorphism (IS6110-RFLP) and 24-locus mycobacterial interspersed repetitive unit-variable-number tandem repeat (MIRU-VNTR), are used worldwide in studies of Mycobacterium tuberculosis (MTB). Conversely, because of its poor resolution, pulsed-field gel electrophoresis (PFGE) is not widely used for MTB. In this study, we improved the 24-locus MIRU-VNTR and PFGE protocols and compared the effectiveness of these approaches for the molecular typing of MTB using 75 clinical isolates obtained from a cohort investigation of high-risk populations infected with MTB. The 24-locus MIRU-VNTR method demonstrated superior discriminatory ability, followed by PFGE and IS6110-RFLP. Next, we analyzed six isolates with clear epidemiologic connections; that is, isolates from patients who attended the same school. IS6110-RFLP and PFGE identified these samples as the same type. By contrast, according to MIRU-VNTR, two isolates differed from four other isolates at one locus each; one isolate was identified as Mtub29 and the other as QUB-26. In summary, the 24-locus MIRU-VNTR assay was the most useful molecular typing method among the three methods investigated due to its discriminatory power, short time required, and availability as an epidemiologic investigation tool. PFGE was the second-best method. Compared with the other loci assessed in the 24-locus MIRU-VNTR assay, the Mtub29 and QUB-26 loci appeared to exhibit greater variability during transmission.

• Journal of Preventive Medicine and Public Health
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• v.33 no.1
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• pp.125-133
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• 2000

Objectives : This study uses meta-analysis methodology to examine the statistical consistency and importance of random variation among results of epidemiologic studies of occupational electromagnetic field exposure and leukemia. Methods : Studies for this meta-analysis were identified from previous reviews and by asking researcher active in this field for recommendations. Overall, 27 studies of occupational electromagnetic field exposures and leukemia were reviewed. A variety of meta-analysis statistical methods have been used to assess combined effects, to identify heterogeneity, and to provide a single summary risk estimate based on a set of simiar epidemiologic studies. In this study, classification of exposure metircs on occupational epidemiologic studies are reported for (1) job classification (20 individual studies); (2) leukemia subtypes (13 individual studies); and (3) country (27 individual studies). Results : Results of this study, an inverse-variance weighted pooling of all the data leads to a small but significant elevation in risk of f 1% (OR=1.11, 95% CI : $1.06\sim1.16$) among 27 occupational epidemiologic studies. Publication bias was assessed by the 'fail-safe n' that may be not influence for all combined results exception a few categories, ie, 'power station operators' and 'electric utility workers' by job classification on occupational study. And ail combined odds ratio results were similar for fixed-effects models and random-effects models, with slightly higher risk estimates for the random-effects model in situations where there was significant heterogeneity, ie, Q-statistic significant (p<.05). Conclusions : We found a small elevation in risk of leukemia, but the ubiquitous nature of exposure to electromagnetic fields from workplace makes even a weak association a public health issue of substantial power to influence the present overall conclusion about relationship between electromagnetic fields exposure and leukemia.

• Environmental Analysis Health and Toxicology
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• v.31
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• pp.25.1-25.9
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• 2016

Objectives After the initial investigations by the Korea Centers for Disease Control in 2011, over 1000 suspicious cases of humidifier disinfectant (HD) victims were subsequently reported by 2015, and numbers are still increasing dramatically in 2016 in the midst of the prosecutors' office investigation. This study attempts to summarize the current understandings of the related health effects of HD based upon a systemic review of published epidemiologic studies and toxicology investigations. Methods Published studies of HDs were searched through PubMed and TOXLINE under the search words 'humidifier disinfectant,' and related reports were identified from the references and published report list of regulatory agencies including the Korean National Institute of Environmental Research, US Environmental Protection Agency, and EU European Chemicals Agency. Results Case reports and epidemiologic studies have reported the clinical features of severe forms of HD lung damage, together with epidemiologic findings of seasonal occurrence and demographic variations, including the heightened susceptibility of young children. Toxicological studies have reported inhalation toxicities together with positive findings of in vitro genotoxicity studies. Conclusions This study examined unsolved issues based on cases of upper respiratory diseases and diseases of other organs, including cancers, among suspected victims of HDs. These issues should be clarified in future research for the management and prevention of health effects from HDs and chemicals of other related household products.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.1
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• pp.41-51
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• 2022

Purpose: Community-acquired bacterial enteritis (CABE) is a common problem in developed countries. It is important to understand the epidemiologic changes in bacterial pathogens for prevention and treatment. Therefore, we studied the epidemiologic changes in CABE in Korean children. Methods: A total of 197 hospitalized pediatric patients aged <19 years that presented with dysentery symptoms and showed positive polymerase chain reaction results for bacterial species in stool samples, were enrolled in this study for 10 years (June 2010 to June 2020). We classified patients in phase I (06, 2010-06, 2015) and phase II (07, 2015-06, 2020) and analyzed their epidemiologic and clinical characteristics. Results: The most common pathogens were Campylobacter species (42.6%) and Salmonella species were the second most common pathogens (23.9%). The abundance of pathogens decreased in the following order: Clostridium difficile (9.6%), Shigella (5.6%), and Clostridium perfringens (5.6%). Escherichia coli O157:H7 was found to be the rarest pathogen (2.0%). Campylobacter species showed an increase in the infection rate from 32.1% in phase I to 49.6% in phase II (p=0.0011). Shigella species showed a decline in the infection rate in phase I from 14.1% to 0.0% in phase II (p<0.001). C. difficile and C. perfringens showed an increase in infection rate in phase II compared to phase I, but the difference was not statistically significant. Conclusion: The infection rate of Campylobacter species in CABE has been rising more recently, reaching almost 50%. This study may help establish policies for prevention and treatment of CABE in Korean children.

• Korean Journal of Community Nutrition
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• v.3 no.2
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• pp.273-280
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• 1998

This study was designed to estimate the improvement of Validity for food frequency questionnaire(FFQ) by offering multiple choice portion size in developing a questionnaire. Validity of the two methods(food frequency questionnaire I=FFQ I & Food frequency questionnaire II=FFQ II) was tested in comparison with reference method of the 7-day weighed record(7DWR). Dietary consumption data of the three methods(FFQ I, FFQ II & 7DWR) were collected from 101 female university students for the analysis. Validity was measured in two categories : One was the nutrient intake value from the three methods, the other was the identification of between individual variation within the group. Spearman's rank order correlation test and distribution graphs were used for the analysis. The result showed that individual intake value of the FFQII was closer to that of the 7DWR than that of the FFQ I.Spearman's rank order correlation between the FFQII and the 7DWR did not show any improved correlation. The distribution graphs of nutrient intake derived from both the FFQ I and the FFQII were different from that of the 7DWR. Therefore, it could be suggested that single one portion size food frequency questionnaire is an equally efficient method as a multiple choice food frequency questionnaire to be adopted in epidemiologic studies.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.2
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• pp.95-100
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• 2017

Objectives : This study was designed for the purpose of the relationship between psychopathology and suicide in North Korean Refugee Adolescents. Methods : The subjects were 104 North Korean Refugee Adolescents. We investigated the The Korean version of the Center for Epidemiologic Studies for Depression, Revised Children's Manifest Anxiety Scale and Rosenberg Self-Esteem Scale. We also investigated the suicide ideation, planning and attempt. The self-report was taken to the North Korean Refugee Adolescents. Results : The Center for Epidemiologic Studies for Depression Score(Z=-4.050, p<0.001), Revised Children's Manifest Anxiety Score(t=-2.757, p<0.01), Rosenberg Self-Seteem Score(Z=-2.328, p<0.05) were significantly associated with the suicide ideation in North Korean Refugee Adolescents. In logistic regression analysis, only The Center for Epidemiologic Studies for Depression Score(p<0.005) expected the suicidal ideation. Conclusions : The management of depression would be helpful to reduce the suicide in North Korean Refugee Adolescents.