• Environmental Analysis Health and Toxicology
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• v.29
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• pp.5.1-5.7
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• 2014

Objectives Numerous studies have revealed the adverse health effects of acute and chronic exposure to particulate matter less than $10{\mu}m$ in aerodynamic diameter ($PM_{10}$). The aim of the present study was to examine the spatial distribution of $PM_{10}$ concentrations and cardiovascular mortality and to investigate the spatial correlation between $PM_{10}$ and cardiovascular mortality using spatial scan statistic (SaTScan) and a regression model. Methods From 2008 to 2010, the spatial distribution of $PM_{10}$ in the Seoul metropolitan area was examined via kriging. In addition, a group of cardiovascular mortality cases was analyzed using SaTScan-based cluster exploration. Geographically weighted regression (GWR) was applied to investigate the correlation between $PM_{10}$ concentrations and cardiovascular mortality. Results An examination of the regional distribution of the cardiovascular mortality was higher in provincial districts (gu) belonging to Incheon and the northern part of Gyeonggi-do than in other regions. In a comparison of $PM_{10}$ concentrations and mortality cluster (MC) regions, all those belonging to MC 1 and MC 2 were found to belong to particulate matter (PM) 1 and PM 2 with high concentrations of air pollutants. In addition, the GWR showed that $PM_{10}$ has a statistically significant relation to cardiovascular mortality. Conclusions To investigate the relation between air pollution and health impact, spatial analyses can be utilized based on kriging, cluster exploration, and GWR for a more systematic and quantitative analysis. It has been proven that cardiovascular mortality is spatially related to the concentration of $PM_{10}$.

• Journal of Environmental Health Sciences
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• v.40 no.5
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• pp.346-354
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• 2014

Objectives: Although a number of epidemiologic studies have examined the association between air pollution and mortality, data limitations have resulted in fewer studies of particulate matter with an aerodynamic diameter of ${\leq}2.5{\mu}m$ ($PM_{2.5}$). We conducted a time-series study of the acute effects of particulate matter with an aerodynamic diameter of ${\leq}10{\mu}m$($PM_{10}$) and $PM_{2.5}$ on the increased risk of death for all causes and cardiovascular mortality in Seoul, Korea from 2006 to 2010. Methods: We applied the generalized additive model (GAM) with penalized splines, adjusting for time, day of week, holiday, temperature, and relative humidity in order to investigate the association between risk of mortality and particulate matter. Results: We found that $PM_{10}$ and $PM_{2.5}$ were associated with an increased risk of mortality for all causes and of cardiovascular mortality in Seoul. A $10{\mu}g/m^3$ increase in the concentration of $PM_{10}$ corresponded to 0.44% (95% Confidence Interval [CI]: 0.25-0.63%), and 0.95% (95% CI: 0.16-1.73%) increase of all causes and of cardiovascular mortality. A $10{\mu}g/m^3$ increase in the concentration of $PM_{2.5}$ corresponded to 0.76% (95% CI: 0.40-1.12%), and 1.63% (95% CI: 0.89-2.37%) increase of all causes and cardiovascular mortality. Conclusion: We conclude that $PM_{10}$ and $PM_{2.5}$ have an adverse effect on population health and that this strengthens the rationale for further limiting levels of $PM_{10}$ and $PM_{2.5}$ in Seoul.

• Korean Journal of Adult Nursing
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• v.17 no.3
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• pp.464-473
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• 2005

Purpose: The purpose of this study was to evaluate and compare the predictive ability of three mortality scoring systems; Acute Physiology and Chronic Health Evaluation(APACHE) III, Simplified Acute Physiology Score(SAPS) II, and Mortality Probability Model(MPM) II in discriminating in-hospital mortality for intensive care unit(ICU) patients with spontaneous intracerebral hemorrhage. Methods: Eighty-nine patients admitted to the ICU at a university hospital in Daejeon Korea were recruited for this study. Medical records of the subject were reviewed by a researcher from January 1, 2003 to March 31, 2004, retrospectively. Data were analyzed using SAS 8.1. General characteristic of the subjects were analyzed for frequency and percentage. Results: The results of this study were summarized as follows. The values of the Hosmer-Lemeshow's goodness-of-fit test for the APACHE III, the SAPS II and the MPM II were chi-square H=4.3849 p=0.7345, chi-square H=15.4491 p=0.0307, and chi-square H=0.3356 p=0.8455, respectively. Thus, The calibration of the MPM II found to be the best scoring system, followed by APACHE III. For ROC curve analysis, the areas under the curves of APACHE III, SAPS II, and MPM II were 0.934, 0.918 and 0.813, respectively. Thus, the discrimination of three scoring systems were satisfactory. For two-by-two decision matrices with a decision criterion of 0.5, the correct classification of three scoring systems were good. Conclusion: Both the APACHE III and the MPM II had an excellent power of mortality prediction and discrimination for spontaneous intracerebral hemorrhage patients in ICU.

• Environmental Analysis Health and Toxicology
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• v.26
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• pp.9.1-9.9
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• 2011

Objectives: In order to evaluate which temperature index is the best predictor for the health impact assessment of heat stress in Korea, several indexes were compared. Methods: We adopted temperature, perceived temperature (PT), and apparent temperature (AT), as a heat stress index, and changes in the risk of death for Seoul and Daegu were estimated with $^1{\circ}C$ increases in those temperature indexes using generalized additive model (GAM) adjusted for the non-temperature related factors: time trends, seasonality, and air pollution. The estimated excess mortality and Akaike's Information Criterion (AIC) due to the increased temperature indexes for the $75^{th}$ percentile in the summers from 2001 to 2008 were compared and analyzed to define the best predictor. Results: For Seoul, all-cause mortality presented the highest percent increase (2.99% [95% CI, 2.43 to 3.54%]) in maximum temperature while AIC showed the lowest value when the all-cause daily death counts were fitted with the maximum PT for the $75^{th}$ percentile of summer. For Daegu, all-cause mortality presented the greatest percent increase (3.52% [95% CI, 2.23 to 4.80%]) in minimum temperature and AIC showed the lowest value in maximum temperature. No lag effect was found in the association between temperature and mortality for Seoul, whereas for Daegu one-day lag effect was noted. Conclusions: There was no one temperature measure that was superior to the others in summer. To adopt an appropriate temperature index, regional meteorological characteristics and the disease status of population should be considered.

• Journal of Environmental Health Sciences
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• v.39 no.1
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• pp.90-98
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• 2013

Objectives: Many studies have shown that air pollution and temperature have adverse effects on mortality and morbidity. But the interactive effect between air pollution and temperature on mortality has been rarely investigated. This study aims to explore whether temperature modifies the associations between ambient particulate matter less than $10{\mu}m$ in diameter ($PM_{10}$) and mortality in Seoul, Korea. Methods: The time-series analysis examined the effect of the interaction between $PM_{10}$ and temperature on mortality from 1999 to 2010 in Seoul. In order to examine the interactive effect between $PM_{10}$ and temperature on mortality, we fitted a response surface model controlling the time-trends and meteorological variables. The effects of $PM_{10}$ were stratified by temperature stratum to quantitatively estimate the $PM_{10}$-health outcome associations. Results: When temperature was low (below the threshold temperature), the percentage increases per $10{\mu}g/m^3$ increase of $PM_{10}$ increased 0.38% (95% Confidence Interval[CI]: 0.09~0.68%) and 0.31% (95% CI: - 0.07~0.68%) of mortality in the all age group and ${\geq}65$ year age group, respectively. When temperature was high (above the threshold temperature), the percentage increases per $10{\mu}g/m^3$ increase of $PM_{10}$ increased 1.09% (95% CI: 0.47~1.72%) and 1.35% (95% CI: 0.65~2.06%) for mortality in the all age group and ${\geq}65$ year age group, respectively. Conclusion: The results of this study showed strong modification by temperature in the association between $PM_{10}$ and mortality. We recommend that public health strategies to minimize adverse health impact of heat and $PM_{10}$ should be considered in control and prevention measures for air pollution and weather-related health impacts.

• The Korean Journal of Applied Statistics
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• v.28 no.4
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• pp.703-719
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• 2015

We propose an extension of the Lee and Jho (2015) mean reverting the two factor mortality model by incorporating a period-specific cohort effect. We found that the consideration of cohort effect improves the mortality fit of Korea male data above age 65. Parameters are estimated by the weighted least squares method and Metropolis algorithm. We also emphasize that the cohort effect is necessary to choose the base survival index to calculate longevity bond issue price. A key contribution of the article is the proposal and development of a method to calculate the longevity bond price to hedge the longevity risk exposed to Korea National Pension Services.

• Health Policy and Management
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• v.16 no.4
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• pp.147-168
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• 2006

Technological innovation has been regarded as the core competence for the economic growth of individual, as well as organization and country. Pharmaceutical innovation, what we call new medicines, influence people's longevity and productivity by increasing output per hour worked. Therefore, using claims data on virtually all the drugs and diseases of over 550,000 people enrolled in National Health Insurance Program in Korea, we examined the impact of the vintage (original FDA and KFDA approval year) of drugs used to treat a patients from July 1st to December 31st in 2002 on the patient's mortality at the end of 2004, controlling for demographic characteristics(age and sex), utilization of medical services, and the nature and complexity of illness. We found that people using newer drugs are less likely to die at the end of 2004, conditional on covariates. The estimated mortality rates were declining with respect to drug vintage for 1970s, 1980s and 1990s and highly significant. In addition to estimating the model for the entire sample, we estimated the model separately for several disease categories classified by Korean Classification of Disease. Estimates of three drug vintage variables for subgroups of people with (1)neoplasms, (2)endocrine, nutritional and metabolic diseases, and (3)the diseases of circulatory system displayed similar patterns.

• Korean Journal of Adult Nursing
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• v.29 no.1
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• pp.98-107
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• 2017

Purpose: The purpose of this study was to investigate the effect of geriatric syndrome on mortality among community-dwelling older adults in Korea. Methods: Data were obtained from the Actual Living Condition of the Elderly and Welfare Need Survey, with a baseline study in 2008 and a 3-year follow-up of mortality data. The mortality risk was measured using the hierarchical Cox proportional hazard model. Results: In Cox regression analysis, male (Hazard Ratio [HR], 2.53; 95% Confidence Interval [CI], 2.12~3.01), old age (HR, 2.14; 95% CI, 1.82~2.53), low education level (HR, 1.31; 95% CI, 1.04~1.65), limitation in instrumental activities of daily living (HR, 1.91; 95% CI, 1.60~2.28), depressive symptoms (HR, 1.21; 95% CI, 1.01~1.43), and frailty (HR, 2.32; 95% CI, 1.78~3.03) significantly affected mortality risk. Conclusion: Based on the results of this study, nursing intervention programs should be provided to decrease preventable death in older adults.

• Animal cells and systems
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• v.14 no.4
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• pp.291-296
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• 2010

Population ecological characteristics of growth and mortality play an important role in understanding the population dynamics of marine mammals. The instantaneous coefficients of natural and bycatch mortality were estimated for minke whales (Balaenoptera acutorostrata) in Korean waters using a population assessment model composed of bycatch and abundance data. The survivorship curve of this population was fitted to the data, and then the curve was revised using age-specific relative bycatchability coefficients ($q_t$). Instantaneous coefficients of natural and bycatch mortality of minke whales were estimated as 0.024/year and 0.076/year, respectively, and from this the survival rate was estimated as 0.905. This estimated survival rate was comparable to other cetaceans in other regions. The $q_t$ for this population ranged from 0.020 to 0.193. The revised survival rates were higher when the $q_t$ was taken into account. The mortality coefficient, survival rate, $q_t$ and survivorship curves had not previously been determined for minke whale in this area. This estimate could serve as fundamental information to assess the status of this population and for conservation and rational management.

• Journal of Preventive Medicine and Public Health
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• v.45 no.5
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• pp.323-328
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• 2012

Objectives: Economic growth and development of medical technology help to improve the average life expectancy, but the western diet and rapid conversions to poor lifestyles lead an increasing risk of major chronic diseases. Coronary heart disease mortality in Korea has been on the increase, while showing a steady decline in the other industrialized countries. An age-period-cohort analysis can help understand the trends in mortality and predict the near future. Methods: We analyzed the time trends of ischemic heart disease mortality, which is on the increase, from 1985 to 2009 using an age-period-cohort model to characterize the effects of ischemic heart disease on changes in the mortality rate over time. Results: All three effects on total ischemic heart disease mortality were statistically significant. Regarding the period effect, the mortality rate was decreased slightly in 2000 to 2004, after it had continuously increased since the late 1980s that trend was similar in both sexes. The expected age effect was noticeable, starting from the mid-60's. In addition, the age effect in women was more remarkable than that in men. Women born from the early 1900s to 1925 observed an increase in ischemic heart mortality. That cohort effect showed significance only in women. Conclusions: The future cohort effect might have a lasting impact on the risk of ischemic heart disease in women with the increasing elderly population, and a national prevention policy is need to establish management of high risk by considering the age-period-cohort effect.