• Title/Summary/Keyword: epidemiology investigation

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Wastewater-based epidemiology for the management of community lifestyle and health: An unexplored value of water infrastructure (하수기반역학을 이용한 커뮤니티 생활상 및 건강 관리: 물 인프라의 새로운 가치)

  • Jho, Eun-Hea;Kim, Hyoung-Il;Choi, Yongju;Youn, Youngho;Lee, Doyeon;Kim, Geunyoung
    • Journal of Korean Society of Water and Wastewater
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    • v.33 no.1
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    • pp.63-77
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    • 2019
  • Traditional wastewater research mainly focuses on 1) estimating the amount of waste entering sewage treatment facilities, 2) evaluating the treatment efficiency of sewage facilities, 3) investigating the role of sewage treatment effluent as a point source, and 4) designing and managing sewage treatment facilities. However, since wastewater contains a variety of chemical and biological substances due to the discharge of human excreta and material used for daily living into it, the collective constituents of wastewater are likely a reflection of a community's status. Wastewater-based epidemiology (WBE), an emerging and promising field of study that involves the analysis of substances in wastewater, can be applied to monitor the state of a defined community. WBE provides opportunities for exploiting indicators in wastewater to fulfill various objectives. The data analyzed under WBE are those pertaining to selected natural and anthropogenic substances in wastewater that are a result of the discharge of metabolic excreta, illicit or legal drugs, and infectious pathogens into the wastewater. This paper reviews recent progress in WBE and addresses current challenges in the field. It primarily discusses several representative applications including the investigation of drug consumption across different communities and the management of community disease and health. Finally, it summarizes established indicators for WBE.

Reproductive Risk Factors for Thyroid Cancer: A Prospective Cohort Study in Khon Kaen, Thailand

  • Sungwalee, Wararat;Vatanasapt, Patravoot;Kamsa-ard, Siriporn;Suwanrungruang, Krittika;Promthet, Supannee
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5153-5155
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    • 2013
  • Background: Because of the gender disparity in the incidence of thyroid cancer, this study aimed to determine the association between reproductive factors and thyroid cancer. Methods: A total of 10,767 eligible women from the Khon Kaen Cohort, recruited and interviewed between 1990 and 2001, were followed up until 2011. The data were linked to the Khon Kaen Population-Based Cancer Registry to detect thyroid cancer cases. Results: There was 17 thyroid cancer cases detected, an incidence of 11.2 per 100,000 person-years, of which 70.6 % were papillary tumors. The incidence was apparently greater among those with an early age of menarche, nulligravida women, and oral contraceptive users. Conlusions: There was a trend for thyroid cancer to develop in relation to longer estrogen exposure. This evidence is inconclusive but warrants further investigation.

Epidemiological Characteristics of COVID-19 in Chungju City from 2021 July to 2021 December (2021년 7월 - 2021년 12월 충주시 COVID-19의 역학적 특성)

  • Cheon-Hoo Jeon;Jungtae Leem
    • The Journal of Korean Medicine
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    • v.44 no.3
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    • pp.47-58
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    • 2023
  • Objectives: This study aimed to investigate the epidemiological characteristics of COVID-19 in Chungju City from July to December 2021. Methods: The authors processed and analyzed the epidemiological analysis report written by researcher. The estimated reproduction rate was analyzed using web-based software that calculates time-varying reproduction numbers. The results were analyzed through univariate multiple regression analysis, with a maximum significance level set at 0.05. Results: During the study period, a total of 1,188 patients were identified, with 7.9% of them progressing to a severe status. The maximum reproduction rate recorded was 3.48. Factors associated with the transition to a severe status included the presence of symptoms at the time of diagnosis, lack of vaccination, and belonging to the age group over 40. Conclusion: Based on the findings of this study, it can be strongly supported that the measures implemented in Chungju City, such as social distancing, vaccination, and preemptive diagnostic tests, were appropriate. Furthermore, it demonstrates that Chungju City effectively managed the impact of COVID-19. Korean Medicine Doctors made significant contributions to the epidemiological investigations of COVID-19. To comprehensively manage infectious diseases, it is crucial to provide administrative and legal support and encourage active research to expand the role of Korean Medicine Doctors in this area.

Community-acquired Legionnaires' Disease in a Newly Constructed Apartment Building

  • Ryu, Sukhyun;Yang, Kyungho;Chun, Byung Chul
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.4
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    • pp.274-277
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    • 2017
  • Objectives: Legionnaires' disease (LD) is a severe type of pneumonia caused by inhalation of aerosols contaminated with Legionella. On September 22, 2016, a single case of LD was reported from a newly built apartment building in Gyeonggi province. This article describes an epidemiologic investigation of LD and identification of the possible source of infection. Methods: To identify the source of LD, we interviewed the patient's husband using a questionnaire based on the Legionella management guidelines from the Korea Centers for Disease Control and Prevention. Water samples from the site were collected and analyzed. An epidemiological investigation of the residents and visitors in the apartment building was conducted for 14 days before the index patient's symptoms first appeared to 14 days after the implementation of environmental control measures. Results: Legionella pneumophila serogroup 1 was isolated from the heated-water samples from the patient's residence and the basement of the apartment complex. Thirty-two suspected cases were reported from the apartment building during the surveillance period, yet all were confirmed negative based on urinary antigen tests. Conclusions: The likely source of infection was the building's potable water, particularly heated water. Further study of effective monitoring systems in heated potable water should be considered.

Epidemiologic Investigation for the Etiology of an Epidemic Ocurred among Animals and Humans in an Isolated Island, Korea(I) (신안군(新安郡) 낙도(落島)에서 발생(發生)한 괴질(怪疾)의 원인(原因)에 관한 역학적(疫學的) 조사(調査)(I))

  • Kim, J.S.;Heo, Y.;Yoon, H.Y.;Lee, W.Y.
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.2 s.26
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    • pp.290-301
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    • 1989
  • This is preliminary report on anthrax epidemic occurred in an island with about 100 residents. Since 1982 there had been sudden deaths among all kinds of domestic animals including cattle, dogs, ducks, chicken and goat but only a few among cats in an isolated island about three hours distance away by ferry boat from Mokpo city. From 1986 through 1988 nine human deaths and four patients occurred, which made the government intervene for investigation on June 25 1988. The epidemiological investigation consisted of interview survey and medical examination, medical record analysis, laboratory work to isolate the pathogens under the direction of hypothesis derived from the study and further confirmation of the pathogens by international institute. The summarized results are as followings: 1. According to the interview survey there were many deaths among domestic animals usually in cold and dry season such as January through March and September through November; 36 heads of cattle leaving one head, more than 40 hogs(all), hundreds of chicken leaving few alive, goats that had taken home from mountain and two or three cats out of around 40 had sudden deaths from 1982 till 1985, when the residents stopped to purchase and take them into the island anymore. Also there were eleven persons who had experienced the similar syndrome complex to those of admitted and expired patients and four of them revealed typical chest X-ray findings; from one of these four patients(Rho) B. anthracis is isolated. 2. Medical record on patients who had been admitted, showed common characteristics of the disease course. On admission they had either gastrointestinal or upper respiratory infection symptoms which invariably progressed to septicemic nature with pulmonary interstitial infiltration and mediastinal widening/bulging, and then to deadly acute respiratory distress syndrome. At the end stage chest X-ray revealed multiple bullous emphysema. One of another characteristics was oral ulceration with bleeding occurred in about 50% of the patients. Laboratory test results in common were leukocytosis with left shift and abnormal liver and kidney functions, particularly at the later stage of the illness. 3. Epidemiological characteristics was striking in that both mortality and incidence rates were high: the mortality rate was 8.7% average, male being three times higher than females but there was no distictive clustering by age group. The incidence rate for both sexes was 28.2% and there was no sex difference although a tendency of higher incidence among older ages was noticed. The highest mortality and incidence were observed in Won village where the first death of animal occurred and with the highest frequency among three villages of the island. 4. Among twelve bacilli species isolated from various specimens, two strains, one from patient and the other from soil where the recently died cow is hurried, were confirmed as B. anthracis by Pasteur Institute and CDC of USA(strain from soil). CDC reported that the strain did not produce capsule in bicarbonate media but reacted with the bacteriophage and one of five sera taken from the patients. Mode of transmission as well as incubation period of the agent has not been established yet, which needs further investigation in relation to the antigenic structure of the variant when it is confirmed.

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Questions and Answers about the Humidifier Disinfectant Disaster as of February 2017 (가습기살균제 참사의 진행과 교훈(Q&A))

  • Choi, Yeyong
    • Journal of Environmental Health Sciences
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    • v.43 no.1
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    • pp.1-22
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    • 2017
  • 'The worstest environment disaster', 'World's first biocide massacre', 'Home-based Sewol ferry disaster' are all phrases attached to the recent humidifier disinfectant disaster. In the spring of 2011, four of 8 pregnant women including 1 adult man passed away at a university hospital in Seoul due to breathing failure. Epidemiologic investigation conducted by the Korean CDC soon revealed the inhalation of humidifier disinfectant, which had been widely used in Korea during the winter, to be responsible for the disease. As well as lung fibrosis hardening of the lungs, other diseases including asthma, rhinitis, skin disease, liver disease, fetal disease or cancers have been researched for their relation with exposure to the products. By February 9, 2017, 5,342 cases had registered for health problems and 1,131 of them were already dead (20.8% mortality rate). Based on studies by government agencies and a telephone survey of the general population by Seoul National University and civic groups, around 20% of the general public of Korea has used these products. Since the market release of the first product by SK Chemical in 1994, over 7.1 million items from around 20 brands were sold up to 2011. Most of the products were manufactured by well-known large conglomerates such as SK, Lotte, Samsung, Shinsegye, LG, and GS, as well as some European companies including UK-based Reckitt Benckiser and TESCO, the German firm Henkel, the Danish firm KeTox, and an Irish company. Even though this disaster was unveiled in 2011 by the Korean government, the issue of the victims was neglected for over five years. In 2016, an unexpected but intensive investigation by prosecutors found that Reckitt Benckiser manipulated and concealed animal tests for its own brand and brought several university experts and company employees to court. The matter was an intense social issue in Korea from May to June with a surge in media coverage. The prosecutor's investigation and a nationwide boycott campaign organized by victims and environmental groups against Reckitt Benckiser, whose product had been used by more than 70% of victims, led to the producer's official apology and a compensation scheme. A legislative investigation organized after the April 2016 national election revealed the producers' faults and the government's responsibility, but failed to meet expectations. A special law for the victims passed the National Assembly in January 2017 and a punitive system together with a massive environmental epidemiology investigation are expected to be the only solutions for this tragedy. Sciences of medicine, toxicology and environmental health have provided decisive evidence so far, but for the remaining problems the perspectives of social sciences such as sociology and jurisprudence are highly necessary, similar to with the Minamata disease and Wonjin Rayon events. It may not be easy to follow this issue using unfamiliar terminology from medical and chemical science and the long, complicated history of the event. For these reasons the author has attempted to write this article in a question and answer format to render it easier to follow. The 17 questions are: Q1 What is humidifier disinfectant? Q2 What kind of health problems are caused by humidifier disinfectant? Q3 How many victims are there? Q4 What is the analysis of the 1,112 cases of death? Q5 What is the problem with the government's diagnostic criteria and the solution? Q6 Who made what brands? Q7 Has there been a recall? What is still on sale? Q8 Was safety not checked by any producers? Q9 What are the government's responsibilities? Q10 Is it true that these products were sold only in Korea? Q11 Why and how was it unveiled only in 2011 after 17 years of sales? Q12 What delayed the resolution of the victim issue? Q13 What is the background of the prosecutor's investigation in early 2016? Q14 Is it possible to report new victim cases without evidence of product purchase? Q15 What is happening with the victim issue? Q16 How does it compare with the cases of Minamata disease and Wonjin Rayon? Q17 Are there prevention measures and lessons?

Risk-Accepting Personality and Associated Factors among Korean Farmers (농업인의 농작업 위험 수용도 및 관련 요인)

  • Youn, Ji Young;Choi, Yeongchull;Lee, Won Jin;Kim, Jaeyoung
    • Journal of Environmental Health Sciences
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    • v.42 no.5
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    • pp.333-344
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    • 2016
  • Objectives: This study aimed to examine risk-accepting personality traits and associated factors among farmers. Methods: Data were collected from farmers aged over 40 living in Goryeong, North Gyeongsang-do Province, Korea. Study participants were enrolled in the Korean Rural Cohort study from 2011 to 2014. Surveys for the risk perception of farming were made through face-to-face interviews. Chi-square tests and logistic regression analysis were conducted adjusting for gender, age, marital status, and education. Results: Several factors such as gender, age, marital status, age first worked as a farmer, duration of farming, and history of pesticide poisoning were associated with risk-accepting personality traits among farmers. Farmers with risk-accepting personalities tend to be older, less educated, and have self-employed health insurance. Farmers who started farming after the age of 50 are likely to be risk averse compared to farmers who started farming before the age of 20 (OR=0.41, 95% CI; 0.21, 0.82). Frequent spraying of pesticides was marginally associated with higher risk acceptance among female farmers (OR=1.61, 95% CI: 0.99, 2.64). Male farmers who had experienced pesticide poisoning in their lifetime showed higher odds of risk-accepting personality traits (OR=2.20, 95% CI: 1.03, 4.72) Conclusion: Risk-acceptors were more likely to spray pesticides frequently and to experience more pesticide poisoning compared to risk-averse individuals. This result suggests that farming hazards are to some degree driven by risk-accepting personality traits. Further investigation of how risk-accepting behaviors influence farming practices and pesticide poisoning is needed.

Factors Associated with Periductal Fibrosis Diagnosed by Ultrasonography Screening among a High Risk Population for Cholangiocarcinoma in Northeast Thailand

  • Intajarurnsan, Sutheera;Khuntikeo, Narong;Chamadol, Nittaya;Thinkhamrop, Bandit;Promthet, Supannee
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.4131-4136
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    • 2016
  • Background: The population in northeast Thailand continues to present with hepatobiliary abnormalities, particularly periductal fibrosis (PDF) which is the result of chronic infection with liver fluke (Opisthorchis viverini; OV) and may lead to the development of cholangiocarcinoma (CCA). Although the prevalence of OV infection has been decreased due to a liver fluke control program over decades, the prevalence of PDF remains high. This study aimed to investigate demographic factors associated with PDF risk based on ultrasonography (US) screening. Materials and Methods: This cross-sectional study is part of the Cholangiocarcinoma Screening and Care Program (CASCAP), a prospective cohort study. Multiple logistic regression was used for data analysis. Results: In 55,246 subjects, the overall prevalence of PDF was 33.0% (95%CI: 32.6 - 33.4). Males (33.9 %) were at higher risk for developing PDF than females (32.2 %) (ORcrude = 0.93; 95%CI: 0.89 - 0.96; p-value < 0.001). Factors associated with an increased PDF risk, in addition to OV infection, included old age (${\geq}70$ years) (ORadj = 1.28, 95% CI: 1.14 - 1.44, p < 0.001) and hepatitis B infection (ORadj = 1.31, 95% CI: 1.11 - 1.55, p = 0.001). In contrast, number of praziquantel treatments (> 2 times) (ORadj = 0.54, 95% CI: 0.47 - 0.63, p < 0.001) and diabetes mellitus (ORadj = 0.57, 95% CI: 0.49 - 0.65, p < 0.001) were significantly associated with a decreased PDF risk. Conclusions: Future US screening should closely examine older people and hepatitis B subjects for the purpose of PDF surveillance among high risk groups for CCA. However, the results of inverse associations require further investigation in order to confirm our findings.

Causes of Child Mortality (1 to 4 Years of Age) From 1983 to 2012 in the Republic of Korea: National Vital Data

  • Choe, Seung Ah;Cho, Sung-Il
    • Journal of Preventive Medicine and Public Health
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    • v.47 no.6
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    • pp.336-342
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    • 2014
  • Objectives: Child mortality remains a critical problem even in developed countries due to low fertility. To plan effective interventions, investigation into the trends and causes of child mortality is necessary. Therefore, we analyzed these trends and causes of child deaths over the last 30 years in Korea. Methods: Causes of death data were obtained from a nationwide vital registration managed by the Korean Statistical Information Service. The mortality rate among all children aged between one and four years and the causes of deaths were reviewed. Data from 1983-2012 and 1993-2012 were analyzed separately because the proportion of unspecified causes of death during 1983-1992 varied substantially from that during 1993-2012. Results: The child (1-4 years) mortality rates substantially decreased during the past three decades. The trend analysis revealed that all the five major causes of death (infectious, neoplastic, neurologic, congenital, and external origins) have decreased significantly. However, the sex ratio of child mortality (boys to girls) slightly increased during the last 30 years. External causes of death remain the most frequent origin of child mortality, and the proportion of mortality due to child assault has significantly increased (from 1.02 in 1983 to 1.38 in 2012). Conclusions: In Korea, the major causes and rate of child mortality have changed and the sex ratio of child mortality has slightly increased since the early 1980s. Child mortality, especially due to preventable causes, requires public health intervention.