• Health Policy and Management
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• v.22 no.2
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• pp.163-182
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• 2012

This study was performed to identify the difference of the area-based deprivation and the educational level on the cerebrovascular mortality in Korea. Data used in this study was obtained from the Death Certificate Data 2000 and the 2000 Census produced by Korean National Statistics(NSO). We classified the whole country into 246 areas based on the administrative districts. Then, the Standardized Mortality Ratio (SMR) in cerebrovascular disease was calculated according to the sex, education level and 246 areas. Its Predicted SMR was calculated by the Empirical Bayes Methods to reduce the variation of the SMR values. The area-based deprivation of 246 areas were measured using the modified Carstairs index in which the 5 indicators consisted of overcrowding, the unemployment ratio of men, the percentage of households classified low social class, the percentage of non home owners, and finally those houses lacking basic amenities. The correlation between the area-based deprivation and the SMR of the whole country and the correlation between the area-based deprivation and the SMR of each metropolitan cities or provinces was analyzed by the Pearson correlation analysis method. After classifying the deprivation of 246 areas into 5 levels, we performed the random intercept Poisson regression analysis after adjusting education level and age using Empirical Bayes Method to investigate the relationship between the 5 deprivation levels and the cerebrovascular mortality. The SMR was increased in lower education level. Each 246 areas had different values in SMR, Predicted SMR and area-based deprivation. The area-based deprivation and the SMR of the whole country was not correlated in both sexes. The education level of an individual was associated the risk of cerebrovascular mortality in men. The risk of cerebrovascular mortality increased with age compared to the reference(<30). The area-based deprivation was not associated with the risk of cerebrovascular in both sexes. The findings of this study suggest that the SMR had positive and negative correlations with area-based deprivation depending on the metropolitan cities or province. It also suggests that the individual education level and age were related with mortality and finally that the area-based deprivation was not associated to the cerebrovascular mortality in Korea.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10787-10790
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• 2015

Background: Ovarian cancer is an important cause of mortality in women. The aim of this study was to evaluate the incidence and mortality rates and trends in the Iranian population and make predictions. Materials and Methods: National incidence from Iranian annual of National Cancer Registration report from 2003 to 2009 and National Death Statistics reported by the Ministry of Health and Medical Education from 1999 to 2004 were included in this study. A time series model (autoregressive) was used to predict the mortality for the years 2007, 2008, 2012 and 2013, with results expressed as annual mortality rates per 100,000. Results: The general mortality rate of ovarian cancer slightly increased during the years under study from 0.01 to 0.75 and reaching plateau according to the prediction model. Mortality was higher for older age. The incidence also increased during the period of the study. Conclusions: Our study indicated remarkable increasing trends in ovarian cancer mortality and incidence. Therefore, attention to high risk groups and setting awareness programs for women are needed to reduce the associated burden in the future.

• Journal of Gastric Cancer
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• v.11 no.3
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• pp.135-140
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• 2011

Gastric cancer has been the most commonly diagnosed cancer in Korea although the age-standardized mortality and incidence has decreased gradually during last two decades. $Helicobacter$ $pylori$ infection and cigarette smoking are well-established risk factors, and the role of dietary factors, such as salted foods, fresh vegetables and fruits, soy foods, and processed or grilled meats on gastric carcinogenesis has been suggested. In this review, we review national and international gastric cancer statistics, studies on environmental risk factors conducted in the Korean population, and gastric cancer screening activities.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7251-7256
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• 2013

Objectives: To estimate the proportion of liver cancer cases and deaths due to infection with hepatitis B virus (HBV), hepatitis C virus (HCV), aflatoxin exposure, alcohol drinking and smoking in China in 2005. Study design: Systemic assessment of the burden of five modifiable risk factors on the occurrence of liver cancer in China using the population attributable fraction. Methods: We estimated the population attributable fraction of liver cancer caused by five modifiable risk factors using the prevalence data around 1990 and data on relative risks from meta-analyses, and large-scale observational studies. Liver cancer mortality data were from the 3rd National Death Causes Survey, and data on liver cancer incidence were estimated from the mortality data from cancer registries in China and a mortality/incidence ratio calculated. Results: We estimated that HBV infection was responsible for 65.9% of liver cancer deaths in men and 58.4% in women, while HCV was responsible for 27.3% and 28.6% respectively. The fraction of liver cancer deaths attributable to aflatoxin was estimated to be 25.0% for both men and women. Alcohol drinking was responsible for 23.4% of liver cancer deaths in men and 2.2% in women. Smoking was responsible for 18.7% and 1.0%. Overall, 86% of liver cancer mortality and incidence (88% in men and 78% in women) was attributable to these five modifiable risk factors. Conclusions: HBV, HCV, aflatoxin, alcohol drinking and tobacco smoking were responsible for 86% of liver cancer mortality and incidence in China in 2005. Our findings provide useful data for developing guidelines for liver cancer prevention and control in China and other developing countries.

• Journal of Environmental Health Sciences
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• v.32 no.3
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• pp.240-248
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• 2006

The purposes of this study were to investigate the symptoms, diseases and deaths of residents living near the municipal solid waste landfill site, and to compare the relative risk ratio of their adverse health effects with control group. In self-evaluation, the scores were especially severe lowest in residents of v2 and v3 villages(which were located about 500 m toward under the landfill site) such as 32.2 and 16.7 for village-environment, 24.8 and 16.0 for management of landfill site, and 23.5 and 16.5 for confidence of environmental policy, respectively. On symptoms, relative risk ratios were also highest as 3.53 and 3.55 for breathing difficulty, and 3.36 and 3.00 for respiratory symptom in v2 and v3 villages, respectively. On morbidity, they were slightly high as much as 1.39 and 1.24 in v5 and v2 villages, respectively. On mortality, relative risk ratios were $1.15{\sim}2.46$ in experimental villages. They were especially high as much as 2.46 in v3 village where located near under the landfill site, and also 2.14 in v5 village where located at area affected with the landfill site, but near the sea. The rate of cancer causing death was average 35.2% of total deaths. It was very highest as much as 61.1 % in v2 village, where was closely located near under the landfill site. Cancers causing death in this village were lung cancer(3 cases), larynx cancer(2 cases), stomach cancer(2 cases), pancreatic cancer(1 case), thryoid cancer(1 case), leukemia(1 case) and other(1 case). Our data, although based on limited number of cases and geographical coverage, suggest that residents living near landfill site have the increasing relative risks of various symptoms and mortality causing cancer. No causal mechanisms are available to explain these findings. But the possibility of a causal association between the increased adverse health effects and the municipal solid waste landfill site cannot be fully excluded.

• Journal of Preventive Medicine and Public Health
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• v.35 no.2
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• pp.123-128
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• 2002

Objective : To examine the relationship between cigarette smoking, alcohol and cancer mortality in men in the Kangwha cohort after 12 years and 10 months of follow up. Methods : The subjects consisted of 2,681 men in the Kangwha cohort aged over 55 in 1985. Number of deaths and the time to death front all cancers and other cause were measured and the data for the smoking and drinking habits were obtained from the baseline survey data in 1985. All subjects were categorized into four groups according to their smoking habits: non-smokers, ex-smokers, mode(ate-smokers (1-19 cigarettes per day), heavy-smokers ($\geq$20 cigarettes per day). In addition, they were also categorized according to their drinking habits: non-drinkers, light-drinkers ($\leq$1 drink per week), moderate-drinkers (<3 drinks per day), heavy-drinkers ($\geq$3 drinks per day). The cancer specific death rates were calculated according to their smoking and drinking status. The adjusted risk ratio for all cancer deaths according to their smoking and drinking status were estimated using the Cox's proportional hazard regression model. Results : Using nonsmokers as the reference category, the adjusted risk ratio for all cancer deaths were 1.573(95% CI=1.003-2.468) for heavy-smokers. For lung cancer deaths, the adjusted risk ratios were 3.540(95% CI=1.251-10.018) for moderate-smoker and 4.114(95% CI=1.275-13.271) for heavy-smokers. Compared to non-drinkers, the adjusted risk ratio for stomach cancer was 2.204(95% CI=1.114-4.361) for light-drinkers. Conclusion : Smoking is the most significant risk factor for cancer deaths particularly lung cancer.

• Journal of Chest Surgery
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• v.56 no.2
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• pp.75-86
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• 2023

Background: We investigated the long-term outcomes of truncus arteriosus repair at a single institution with a 30-year study period. Methods: Patients who underwent repair of truncus arteriosus between 1993 and 2022 were reviewed retrospectively. Factors associated with early mortality, overall attrition, and reintervention were identified using appropriate statistical methods. Results: In total, 42 patients were enrolled in this study. The median age and weight at repair were 26 days and 3.5 kg, respectively. Thirty patients (71.4%) underwent 1-stage repair. There were 8 early deaths (19%). In the univariable analysis, undergoing surgery before 2011 was associated with early mortality (p=0.031). The overall survival rate at 10 years was 73.8%. In the multivariable analysis, significant truncal valve (TrV) dysfunction (p=0.010), longer cardiopulmonary bypass time (p=0.018), and the earlier era of surgery (p=0.004) were identified as risk factors for overall mortality. During follow-up, 47 reinterventions were required in 27 patients (64.3%). The freedom from all-cause reintervention rate at 10 years was 23.6%. In the multivariable analysis, associated arch obstruction (p<0.001) and significant TrV dysfunction (p=0.011) were identified as risk factors for all-cause reintervention. Arch obstruction (p=0.027) and a number of TrV cusps other than 3 (p=0.014) were identified as risk factors for right ventricle to pulmonary artery (RV-PA) reintervention, and significant TrV dysfunction was identified as a risk factor for TrV reintervention (p=0.002). Conclusion: Despite recent improvements in survival outcomes after repair of truncus arteriosus, RV-PA or TrV reinterventions were required in a significant number of patients during follow-up.

• Journal of Environmental Health Sciences
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• v.47 no.5
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• pp.486-495
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• 2021

Background: Particulate matter (PM) is one of the leading causes of premature death worldwide. Previous studies in South Korea have applied a relative risk calculated from Western populations when estimating the disease burden attributable to PM. However, the relative risk of PM on health outcomes may not be the same across different countries or regions. Objectives: This study aimed to estimate the premature deaths and socioeconomic costs attributable to long-term exposure to PM in South Korea. We considered not only the difference in PM concentration between regions, but also the difference in relative risk. Methods: National monitoring data of PM concentrations was obtained, and missing values were imputed using the AERMOD model and linear regression model. As a surrogate for relative risk, hazard ratios (HRs) of PM for cardiovascular and respiratory mortality were estimated using the National Health Insurance Service-National Sample Cohort. The nation was divided into five areas (metropolitan, central, southern, south-eastern, and Gangwon-do Province regions). The number of PM attributable deaths in 2018 was calculated at the district level. The socioeconomic cost was derived by multiplying the number of deaths and the statistical value of life. Results: The average PM₁₀ concentration for 2014~2018 was 45.2 ㎍/m³. The association between long-term exposure to PM₁₀ and mortality was heterogeneous between areas. When applying area-specific HRs, 23,811 premature deaths from cardiovascular and respiratory disease in 2018 were attributable to PM₁₀ (reference level 20 ㎍/m³). The corresponding socioeconomic cost was about 31 trillion won. These estimated values were higher than that when applying nationwide HRs. Conclusions: This study is the first research to estimate the premature mortality caused by long-term exposure to PM using relative risks derived from the national population. This study will help precisely identify the national and regional health burden attributed to PM and establish the priorities of air quality policy.

• Tuberculosis and Respiratory Diseases
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• v.79 no.3
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• pp.158-164
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• 2016

Background: One to three percent of cases of acute tuberculosis (TB) require monitoring in the intensive care unit (ICU). The purpose of this study is to establish and determine the mortality rate and discuss the causes of high mortality in these cases, and to evaluate the clinical and laboratory findings of TB patients admitted to the pulmonary ICU. Methods: The data of patients admitted to the ICU of Yedikule Chest Diseases and Chest Surgery Education and Research Hospital due to active TB were retrospectively evaluated. Demographic characteristics, medical history, and clinical and laboratory findings were evaluated. Results: Thirty-five TB patients (27 males) with a median age of 47 years were included, of whom 20 died within 30 days (57%). The Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were significantly higher, and albumin and $PaO_2/FIO_2$ levels were significantly lower, and shock, multiple organ failure, the need for invasive mechanical ventilation and drug resistance were more common in the patients who died. The mortality risk was 7.58 times higher in the patients requiring invasive mechanical ventilation. The SOFA score alone was a significant risk factor affecting survival. Conclusion: The survival rate is low in cases of tuberculosis treated in an ICU. The predictors of mortality include the requirement of invasive mechanical ventilation and multiple organ failure. Another factor specific to TB patients is the presence of drug resistance, which should be taken seriously in countries where there is a high incidence of the disease. Finding new variables that can be established with new prospective studies may help to decrease the high mortality rate.

• Journal of Preventive Medicine and Public Health
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• v.46 no.1
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• pp.10-18
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• 2013

Objectives: We investigated the association between particulate matter less than $10{\mu}m$ in aerodynamic diameter ($PM_{10}$) exposure and non-accidental mortality in Asian populations by meta-analysis, using both time-series and case-crossover analysis. Methods: Among the 819 published studies searched from PubMed and EMBASE using key words related to $PM_{10}$ exposure and non-accidental mortality in Asian countries, 8 time-series and 4 case-crossover studies were selected for meta-analysis after exclusion by selection criteria. We obtained the relative risk (RR) and 95% confidence intervals (CI) of non-accidental mortality per $10{\mu}g/m^3$ increase of daily $PM_{10}$ from each study. We used Q statistics to test the heterogeneity of the results among the different studies and evaluated for publication bias using Begg funnel plot and Egger test. Results: Testing for heterogeneity showed significance (p<0.001); thus, we applied a random-effects model. RR (95% CI) per $10{\mu}g/m^3$ increase of daily $PM_{10}$ for both the time-series and case-crossover studies combined, time-series studies relative risk only, and case-crossover studies only, were 1.0047 (1.0033 to 1.0062), 1.0057 (1.0029 to 1.0086), and 1.0027 (1.0010 to 1.0043), respectively. The non-significant Egger test suggested that this analysis was not likely to have a publication bias. Conclusions: We found a significant positive association between $PM_{10}$ exposure and non-accidental mortality among Asian populations. Continued investigations are encouraged to contribute to the health impact assessment and public health management of air pollution in Asian countries.