• Journal of Environmental Health Sciences
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• v.47 no.2
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• pp.155-165
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• 2021

Objectives: Acute exposure to high concentrations of chemicals can occur when a chemical accident takes place. As such exposure can cause ongoing environmental pollution, such as in the soil and groundwater, there is a need for a tool that can assess health effects in the long term. The purpose of this study was assessing the health risks of residents living near a chemical accident site due to long-term exposure while considering the temporal concentration changes of the toxic chemicals leaked during the accident until their extinction in the environment using a multimedia environmental dynamics model. Methods: A health risk assessment was conducted on three cases of formaldehyde chemical accidents. In this study, health risk assessment was performed using a multimedia environmental dynamics model that considers the behavior of the atmosphere, soil, and water. In addition, the extinction period of formaldehyde in the environment was regarded as extinction in the environment when the concentration in the air and soil fell below the background concentration prior to the accident. The subjects of health risk assessment were classified into four groups according to age: 0-9 years old, 10-18 years old, 19-64 years old, and over 65 years old. Carcinogenic risk assessment by respiratory exposure and non-carcinogenic risk assessment by soil intake were conducted as well. Results: In the assessment of carcinogenic risk due to respiratory exposure, the excess carcinogenic risk did not exceed 1.0×10-6 in all three chemical accidents, so there was no health effect due to the formaldehyde chemical accident. As a result of the evaluation of non-carcinogenic risk due to soil intake, none of the three chemical accidents had a risk index of 1, so there was no health effect. For all three chemical accidents, the excess cancer risk and hazard index were the highest in the age group 0-9. Next, 10-18 years old, 65 years old or older, and 19-64 years old showed the highest risk. Conclusion: This study considers environmental changes after a chemical accident occurs and until the substance disappears from the environment. It also conducts a health risk assessment by reflecting the characteristics of the long-term persistence and concentration change over time. It is thought that it is of significance as a health risk assessment study reflecting the exposure characteristics of the accident substance for an actual chemical accident.

• Journal of the Korean association of regional geographers
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• v.20 no.4
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• pp.444-453
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• 2014

Inequality of environmental impact is forecast to deepen due to the damage of environmental risk by the interaction between environmental and social inequalities causing more harms to environmentally vulnerable population. This study assessed the integrated cumulative impact of Seoul using Environmental Health Screening Tool developed by Environmental Protection Agency of California. In order to screen vulnerable area to environmental health, 10 indexes have been selected according to the environmental burden of exposure to environment and public health effects, population characteristics of sensitive populations and socio-economic factors. As a result of assessment conducted on cumulative impact of Seoul for years 2009~2011 through Environmental Health Screening Tool, risk factor for districts of Gangseo and Gangnam of Seoul showed high - Gangseo area indicated high risk factor both in environmental burden and population characteristics, while Gangnam area appeared high in environmental burden. The result of survey will be able to suggest scientific basis to push through fair and effective environmental policy in consideration of environment vulnerable population.

• Safety and Health at Work
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• v.13 no.4
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• pp.408-414
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• 2022

Background: This study aimed to determine and define the elements of an Fatigue Risk Management System (FRMS) diagnostic tool to assist an organization in systematically assessing its level of implementation of an FRMS. Methods: A modified Delphi process was used involving 16 participants with expertise in sleep science, chronobiology, and fatigue risk management within occupational settings. The study was undertaken in two stages 1) review of elements and definitions; 2) review of statements for each element. Each stage involved an iterative process, and a consensus rule of ≥ 60% was applied to arrive at a final list of elements, definitions, and statements. Results: Stage 1: a review of elements (n = 12) and definitions resulted in a final list of 14 elements and definitions with a consensus of ≥ 60% achieved after 2 Delphi rounds. Stage 2: a review of statements (n = 131) resulted in a final list of 119 statements with a consensus of ≥ 60% achieved after 2 Delphi rounds. Conclusion: The final FRMS diagnostic tool will enable an organization to systematically assess the level of implementation of their current FRMS and identify gaps and opportunities to reduce risk.

• Journal of Environmental Health Sciences
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• v.41 no.6
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• pp.425-437
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• 2015

Objectives: Risk assessment is a tool for predicting and reducing uncertainty related to the effects of future activities. Probability approaches are the main elements in risk assessment, but confusion about the interpretation and use of assessment factors often undermines the message of the analyses. The aim of this study is to provide a guideline for systematic reduction plans regarding uncertainty in risk assessment. Methods: Articles and reports were collected online using the key words "uncertainty analysis" on risk assessment. Uncertainty analysis was conducted based on reports focusing on procedures for analysis methods by the World Health Organization (WHO) and U.S. Environmental Protection Agency (USEPA). In addition, case studies were performed in order to verify suggested methods qualitatively and quantitatively with exposure data, including measured data on toluene and styrene in residential spaces and multi-use facilities. Results: Based on an analysis of the data on uncertainty, three major factors including scenario, model, and parameters were identified as the main sources of uncertainty, and tiered approaches were determined. In the case study, the risk of toluene and styrene was evaluated and the most influential factors were also determined. Five reduction plans were presented: providing standard guidelines, using reliable exposure factors, possessing quality controls for analysis and scientific expertise, and introducing a peer review system. Conclusion: In this study, we established a method for reducing uncertainty by taking into account the major factors. Also, we showed a method for uncertainty analysis with tiered approaches. However, uncertainties are difficult to define because they are generated by many factors. Therefore, further studies are needed for the development of technical guidelines based on the representative scenario, model, and parameters developed in this study.

• Journal of Environmental Health Sciences
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• v.47 no.5
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• pp.454-461
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• 2021

Background: Fish and fishery products (FFPs) unintentionally contaminated with various environmental pollutants are major exposure pathways for humans. To protect human health from the consumption of contaminated FFPs, it is essential to develop a systematic tool for evaluating exposure and risks. Objectives: To regularly, accurately, and quickly evaluate adverse health outcomes due to FFPs contamination, we developed an automated dietary exposure and risk assessment system called HERA (the Human Exposure and Risk Assessment system for chemicals in FFPs). The aim of this study was to develop an overall architecture design and demonstrate the major features of the HERA system. Methods: For the HERA system, the architecture framework consisted of multi-layer stacks from infrastructure to fish exposure and risk assessment layers. To compile different contamination levels and types of seafood consumption datasets, the data models were designed for the classification codes of FFP items, contaminants, and health-based guidance values (HBGVs). A systematic data pipeline for summarizing exposure factors was constructed through down-scaling and preprocessing the 24-hour dietary recalls raw dataset from the Korea National Health and Nutrition Examination Survey (KNAHES). Results: According to the designed data models for the classification codes, we standardized 167 seafood items and 2,741 contaminants. Subsequently, we implemented two major functional workflows: 1) preparation and 2) main process. The HERA system was developed to enable risk assessors to accumulate the concentration databases sustainably and estimate exposure levels for several populations linked to seafood consumption data in KNAHES in a user-friendly manner and in a local PC environment. Conclusions: The HERA system will support policy-makers in making risk management decisions based on a nation-wide risk assessment for FFPs.

• Journal of Haehwa Medicine
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• v.24 no.1
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• pp.15-24
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• 2015

Objectives : This study was carried out to assess the risk of bias of clinical trials on acne treatment with herbal medicine that have been published in Korea. Methods : 7 electronic databases in Korea were searched for clinical trials on acne treatment. Two independent reviewers selected clinical trials on herbal medicine treatment for acne. Selected studies are categorized according to DAMI(Study Design Algorithm for Medical literature of Intervention). RCTs are assessed according to Cochrane RoB(Risk of Bias), non-randomized studies(Before-after studies) are assessed according to RoBANS(Risk of Bias Assessment tool for Non-randomized Study). Results : After selection process, 25 articles are left. Among 25 articles, 3 RCTs and 4 before-after studies are finally included. In RCTs, the proportion of 'unclear' is high in criteria of 'random sequence generation', 'allocation concealment', and 'blinding'. In before-after studies, 'high' is high in criteria of 'blinding for outcome assessment' and 'incomplete outcome data'. Conclusions : Considering the above results of the assessment, it is necessary to conduct more well designed clinical trials on acne treatment with herbal medicine.

• Journal of the Korean Society of Marine Environment & Safety
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• v.25 no.3
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• pp.298-305
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• 2019

The demand for the revitalization of marine tourism in Busan North Port is increasing due to changes in functions such as an increase in harbor traffic volume and the expansion of marine leisure space in Busan. As a result, Busan City plans to set a phased alleviation target for prohibition of cruise ship operations, and to lift the prohibition of excursion ship operations in North Port following the cancellation of the prohibition of excursion ship operations in South Port in 2017. The purpose of this study is to evaluate the risk of excursion ship operations in Busan North Port by applying the marine traffic assessment index and to examine the possibility of excursion ship operations. For this purpose, port status, marine accidents, and traffic flow of Busan North Port were investigated. In addition, marine traffic assessment indexes, such as traffic congestion, risk based on an ES Model, and IWRAP MkII, a maritime risk assessment tool, were used to assess the risk and possibility of excursion ship operations in Busan North Port. This study can be used as basic data for analyzing the risk factors that may occur when excursion ships are operated in Busan North Port and to define how excursion ships should operate, with related safety measures.

• Child Health Nursing Research
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• v.25 no.1
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• pp.56-64
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• 2019

Purpose: This study was conducted to obtain data for the development of an effective fall risk assessment tool for pediatric inpatients through a systematic review and meta-analysis of the diagnostic test accuracy of existing scales. Methods: A literature search using Medline, Science Direct, CINAHL, EMBASE, and the Cochrane Library was performed between March 1 and 31, 2018. Of 890 identified papers, 10 were selected for review. Nine were used in the meta-analysis. Stata version 14.0 was used to create forest plots of sensitivity and specificity. A summary receiver operating characteristic curve was used to compare all diagnostic test accuracies. Results: Four studies used the Humpty Dumpty Falls Scale. The most common items included the patient's diagnoses, use of sedative medications, and mobility. The pooled sensitivity and specificity of the nine studies were .79 and .36, respectively. Conclusion: Considering the low specificity of the pediatric fall risk assessment scales currently available, there is a need to subdivide scoring categories and to minimize items that are evaluated using nurses' subjective judgment alone. Fall risk assessment scales should be incorporated into the electronic medical record system and an automated scoring system should be developed.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10683-10690
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• 2015

The big gap between efficacy of population level prevention and expectations due to heterogeneity and complexity of cancer etiologic factors calls for selective yet personalized interventions based on effective risk assessment. This paper documents our research protocol aimed at refining and validating a two-stage and web-based cancer risk assessment tool, from a tentative one in use by an ongoing project, capable of identifying individuals at elevated risk for one or more types of the 80% leading cancers in rural China with adequate sensitivity and specificity and featuring low cost, easy application and cultural and technical sensitivity for farmers and village doctors. The protocol adopted a modified population-based case control design using 72, 000 non-patients as controls, 2, 200 cancer patients as cases, and another 600 patients as cases for external validation. Factors taken into account comprised 8 domains including diet and nutrition, risk behaviors, family history, precancerous diseases, related medical procedures, exposure to environment hazards, mood and feelings, physical activities and anthropologic and biologic factors. Modeling stresses explored various methodologies like empirical analysis, logistic regression, neuro-network analysis, decision theory and both internal and external validation using concordance statistics, predictive values, etc..

• Journal of Preventive Medicine and Public Health
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• v.56 no.4
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• pp.384-387
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• 2023

The aim of this study was to present a framework for clinicians to use when discussing electronic cigarette (e-cigarette) use and its association with pre-diabetes. A communication tool was designed using evidence-based strategies from the academic literature. A four-step framework is presented, which includes: step (1) helping patients to understand the association between e-cigarette use and pre-diabetes; step (2) the synergistic health impacts of e-cigarette use and pre-diabetes; step (3) management of diabetes-related lifestyle factors; and step (4) stages of change assessment related to e-cigarette reduction. This communication tool provides support for clinicians to discuss the risk of pre-diabetes associated with e-cigarette use. Moving forward, implementation and evaluation of this model are needed.