• Asian Pacific Journal of Cancer Prevention
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• 제13권4호
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• pp.1709-1710
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• 2012

Cancer is a major public health problem in Indonesia, becoming the 7th largest cause of death based on a national survey in 2007, accounting for 5.7 of all mortality. A cancer registry was started in 1970, but it was partial and was stopped mainly because no government body was responsible. Realizing the above situation, the Indonesian government established the Sub Directorate of Cancer Control within the Ministry of Health, with responsibility for developing a national cancer control program, including a cancer registry. A sustainable cancer registry was then started in 2007 within Jakarta Province, first hospital-based but then expanded to be population-based. Steps of cancer registration in Jakarta are data collection, data verification, data validation, data management and analysis, and data publication. Data collection is conducted by health facilities (hospitals, laboratories, primary health centers) at the district/municipal level, with reports to the provincial level. Data are collected passively by holding meetings every three months in the district/municipality. Verification of data is the responsibility of the medical doctor or pathologist in each data source. Data validation is conducted by a team in the cancer registry, consisting of district/municipal/province health officers, pathologists, and registrars. Data management and analyses are conducted by a cancer registry team at the provincial level, assisted by the national team. We use software named Indonesian Cancer Registry System (SRIKANDI) which is adopted from CanReg4 IARC. Data from the population-based cancer registry in Jakarta Province showed the leading cancers among females in 2005-2007 to be breast cancer, cervical cancer, ovarian cancer, colorectal cancer and among males are bronchus and lung cancer, colorectal cancer, liver cancer, pharyngeal cancer, and prostate cancer. The leading childhood cancers are leukaemia and retinoblastoma.

• 한국환경보건학회지
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• 제45권2호
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• pp.142-153
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• 2019

Objectives: The aim of this study was to determine environmental chemical exposure related to residential and personal lifestyle characteristics in the adult Korean population. The observations of this study can provide information useful for developing reduction approaches for exposure to chemicals among the general adult population. Methods: The second stage of the Korean National Environmental Health Survey (KoNHES) was conducted from 2012 to 2014, with 6,478 persons participating. Using the results of the survey, the relationship between exposure levels of heavy metals and organic chemicals and exposure factors, e.g. residential and personal lifestyle characteristics, were analyzed. Results: The exposure levels of VOCs and PAHs were significantly lower in participants living at a distance of more than 100 m from roads versus living closer to roads. Home ventilation lowered VOC and PAH exposure but did not lower chemical exposure from household products. Use of public transportation showed lower exposure to heavy metals, VOCs, and PAHs. Current smoker was significantly higher for levels of heavy metals, VOCs, and PAHs, and the exposure trend was similar for current drinkers. Physical activity was related with higher exposure to phthalates and environmental phenols. Conclusion: Our observations based on a nationally representative population for Korea show that exposure to chemicals varies by residential and personal lifestyle, and this should be considered for developing appropriate mitigation measures and policies. Given the health concerns surrounding environmental chemicals, it is necessary to develop comprehensive measures to reduce chemical exposure.

• Safety and Health at Work
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• 제14권4호
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• pp.368-374
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• 2023

Background: Recognizing that access to safe and healthy working conditions is a human right, the World Health Organization (WHO) calls for specific occupational safety and health (OSH) programs for health workers (HWs). The WHO health systems' building blocks, and the International Labour Organization (ILO), highlight the importance of information as part of effective systems. This study examined how OSH stakeholders access, use, and value an occupational health information system (OHIS). Methods: A cross-sectional survey of OSH stakeholders was conducted as part of a larger quasi experimental study in four teaching hospitals. The study hospitals and participants were purposefully selected and data collected using a modified questionnaire with both closed and open-ended questions. Quantitative analysis was conducted and themes identified for qualitative analysis. Ethics approval was provided by the University of Pretoria and University of British Columbia. Results: There were 71 participants comprised of hospital managers, health and safety representatives, trade unions representatives and OSH professionals. At least 42% reported poor accessibility and poor timeliness of OHIS for decision-making. Only 50% had access to computers and 27% reported poor computer skills. When existing, OHIS was poorly organized and needed upgrades, with 85% reporting the need for significant reforms. Only 45% reported use of OHIS for decision-making in their OSH role. Conclusion: Given the gap in access and utilization of information needed to protect worker's rights to a safe and healthy workplace, more attention is warranted to OHIS development and use as well as education and training in South Africa and beyond.

• Epidemiology and Health
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• 제39권
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• pp.36.1-36.8
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• 2017

OBJECTIVES: To investigate the screening rates for gastric, breast, and cervical cancer in people with diabetes compared with people without diabetes. METHODS: Data from the Korea National Health and Nutrition Examination Survey (2007-2009) were used. Cancer-free men who were 40 years old and over and cancer-free women who were 30 years old and over were included. The lifetime screening rate and regular screening rate were compared in people with and without diabetes. RESULTS: Fewer people with diabetes than people without diabetes had ever received cancer screening (53.5 vs. 59.5%, p<0.001 for gastric cancer; 60.5 vs. 71.5%, p<0.001 for breast cancer; and 49.1 vs. 59.6%, p<0.001 for cervical cancer). Fewer people with diabetes than people without diabetes received the recommended screenings for gastric cancer (38.9 vs. 42.9%, p<0.001), breast cancer (38.8 vs. 44.6%, p<0.001), and cervical cancer (35.1 vs. 51.2%, p<0.001). In subgroup analyses according to socioeconomic factors, the lifetime and recommended screening rates were lower in the diabetic population in most socioeconomic subgroups. In the multivariate analysis adjusted for socioeconomic factors, people with diabetes showed lower lifetime screening rates for gastric and cervical cancer (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.7 to 0.9 and OR, 0.7; 95% CI, 0.6 to 0.9), and lower regular screening rates for breast and cervical cancer (OR, 0.7; 95% CI, 0.6 to 0.9 and OR, 0.7; 95% CI, 0.5 to 0.9). CONCLUSIONS: The cancer screening rate in people with diabetes was lower than in people without diabetes. Considering the higher cancer risk in people with diabetes, efforts to increase the screening rate in this high-risk population should be implemented.

• 한국병원경영학회지
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• 제13권1호
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• pp.1-23
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• 2008

In the shortest period of time, we achieved both industrialization and democratization. We also achieved good performance in health care sector. Whole population are covered by health insurance since 1989 and health outcomes, such as infant mortality, life expectance show good level. However, health care system has several problems, rapidly increasing rate of health care expenditure, dissatisfaction of both consumers and suppliers. Current health care system does not reconcile with market competition principle. Causes of these problems originated from 1977 paradigm which was formed to expand health insurance to whole population within short period. Dominant assumption of 1977 paradigm is to assure equitable access of health care by government's command and control. We urgently demand to reform the 1977 paradigm to suitable in 21th century. Our economy entered into a road to advancement. We have concerns how President Lee's administration reform health care system to harmonize with economic development and to achieve advancement in health care sector.

• 지역사회간호학회지
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• 제29권1호
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• pp.21-32
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• 2018

Purpose: This study attempted to identify regional disparities of self-rated health among Korean wage workers and to investigate the influencing factors on them. Methods: The study subjects were 25,069 workers in 16 regions who were extracted from the 2014 Korean Working Condition Survey (KWCS). A multilevel analysis was conducted by building hierarchical data at individual and regional level. Results: In this study, 'financial autonomy rate' and 'current smoking rate' were identified as regional factors influencing the workers' self-rated health. When the socio-demographic and occupational factors of the workers were controlled, 'current smoking rate', a health policy factor, explained the regional disparity of workers' health status. Conclusion: We found that the health status of workers can be affected by the health behavior level of the whole population in their residential area. In order to improve the health status of working population and to alleviate their regional health inequalities, it is necessary to strengthen macro and structural level interventions.

• 한국지역지리학회지
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• 제20권4호
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• pp.444-453
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• 2014

환경위험의 피해가 환경불평등과 사회불평등의 상호작용으로 인해 환경약자가 더 많이 피해를 받게 되는 환경 피해 불평등이 심화될 것으로 전망되고 있다. 본 연구는 서울시를 대상으로 미국 캘리포니아 환경보호청에서 개발한 환경보건 스크리닝 툴을 적용하여 통합적인 지역 규모의 누적영향을 평가하였다. 환경보건 취약지역을 스크리닝하기 위하여 환경노출과 건강영향의 환경부담, 민감집단과 사회경제적 요인의 인구특성에 따라 10개 지표를 선정하였다. 환경보건 스크리닝 툴을 통하여 2009~2011년 서울시 누적영향평가를 실시한 결과, 서울의 강서와 강남지역에서 위험요인이 높게 나타났며 강서지역은 환경부담과 인구특성 모두에서 위험요인이 높았고, 강남지역은 환경부담요인이 높은 것으로 나타났다. 연구결과는 민감 취약계층 등 환경약자를 고려한, 공정하고 효율적인 환경정책을 추진하기 위한 과학적인 근거를 제공할 수 있다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권7호
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• pp.3105-3112
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• 2014

Purpose: To examine breast cancer (BC) incidence trends in relation to mammographic screening and risk factor prevalence in South Australia (SA). Materials and Methods: Trends in annual BC incidence rates were calculated using direct standardisation and compared with projected incidence derived from Poisson regression analysis of pre-screening rates. Annual percentage change and change time points were estimated using Joinpoint software. Biennial mammography screening participation rates were calculated using data from BreastScreen SA. Trends in overweight/obesity, alcohol use and hormone replacement therapy (HRT) use were examined using 1991-2009 Health Omnibus Survey data. Trends in total fertility were examined using data from the Australian Bureau of Statistics. Results: BC incidence increased around the time BreastScreen commenced and then stabilised in the mid-1990s. However rates have remained higher than projected, even though the proportion and age distribution of first time screening attendees stabilised around 1998. A decrease in BC incidence was observed among women aged 50-59yrs from the late-1990's but not among older women. Obesity and alcohol use have increased steadily in all age groups, while HRT use declined sharply from the late-1990s. Conclusions: BC incidence has remained higher than projected since mammography screening began. The sustained elevation is likely to be due to lead time effects, though over-diagnosis cannot be excluded. Declining HRT use has also impacted incidence trends. Implications: Studies using individual level data, which can account for changes in risk factor prevalence and lead time effects, are required to evaluate 'over-diagnosis' due to screening.

• Journal of Preventive Medicine and Public Health
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• 제38권4호
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• pp.379-385
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• 2005

The impact of the next influenza pandemic is difficult to predict. It is dependent on how virulent the virus is, how rapidly it spreads from population to population, and the effectiveness of prevention and response efforts. Despite the uncertainty about the magnitude of the next pandemic, estimates of the health and economic impact remain important to aid public health policy decisions and guide pandemic planning for health and emergency sectors. Planning ahead in preparation for an influenza pandemic, with its potentially very high morbidity and mortality rates, is essential for hospital administrators and public health officials. The estimat ion of pandemic impact is based on the previous pandemics- we had experienced at least 3 pandemics in 20th century. But the epidemiologi cal characteristics - ie, start season, the impact of 1st wave, pathogenicity and virulence of the viruses and the primary victims of population were quite different from one another. I reviewed methodology for estimation and modelling of pandemic impact and described some nations's results using them in their national preparedness plans. And then I showed the estimates of pandemic influenza impact in Korea with FluSurge and FluAid. And, I described the results of pandemic modelling with parameters of 1918 pandemic for the shake of education and training of the first-line responder health officials to the epidemics. In preparing influenza pandemics, the simulation and modelling are the keys to reduce the uncertainty of the future and to make proper policies to manage and control the pandemics.

• Journal of Preventive Medicine and Public Health
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• 제47권1호
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• pp.7-17
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• 2014

Risk assessment considers the situations and characteristics of the exposure environment and host. Various physiological variables of the human body reflects the characteristics of the population that can directly influence risk exposure. Therefore, identification of exposure factors based on the Korean population is required for appropriate risk assessment. It is expected that a handbook about general exposure factors will be used by professionals in many fields as well as the risk assessors of the health department. The process of developing the exposure factors handbook for the Korean population will be introduced in this article, with a specific focus on the general exposure factors including life expectancy, body weight, surface area, inhalation rates, amount of water intake, and soil ingestion targeting the Korean population. The researchers used national databases including the Life Table and the 2005 Time Use Survey from the National Statistical Office. The anthropometric study of size in Korea used the resources provided by the Korean Agency for Technology and Standards. In addition, direct measurement and questionnaire surveys of representative samples were performed to calculate the inhalation rate, drinking water intake, and soil ingestion.