• Journal of Preventive Medicine and Public Health
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• v.38 no.2
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• pp.175-181
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• 2005

Objectives: This study estimated the burden of disease due to high alcohol consumption using DALY, a composite indicator recently developed by the Global Burden of Disease study group. The results were analyzed by age and sex. Methods: Firstly, high alcohol consumption-related diseases, and their relative risk (RR), were selected. Secondly, population attributable fractions (PAFs) were computed using formulae, including the relative risk (RR) and prevalence of exposure (Pe). Thirdly, the DALYs of high alcohol consumption-related diseases were estimated. Lastly, the attributable burdens of diseases due to high alcohol consumption wereconcluded as being the sum of the products that multiplied the DALYs of high alcohol consumption-related diseases by their population attributable fraction (PAF). Results : The burden of high alcohol consumption in Korea was 2992.3 person years (PYs) per 100,000 persons in men, and 1426.6 in women. For men, the high alcohol consumption-induced diseases with the five biggest burdens were liver cirrhosis, hypertensive disease, liver cancer, cerebral infarction and intracerebral hemorrhage. For women, these were cerebral infarction, intracerebral hemorrhage, hypertensive disease, liver cirrhosis and liver cancer. Conclusion: This study highlighted the attributable fraction of diseases due to exposure to high alcohol consumption, by quantifying the results of exposure to risk factors. Therefore, it is now possible to assess interventions for risk factors in quantifiable terms in each population. Finally, measuring the risk factor burdens was expected to contribute to priority setting and effective resource allocation in public health policy.

• Journal of Preventive Medicine and Public Health
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• v.40 no.3
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• pp.227-232
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• 2007

Objectives : The purpose of this study was to determine the population-attributable risk (PAR) and estimate the total medical expenditure of the Korean National Health Insurance (KNHI) due to smoking. Methods : We used data from the Korean Cancer Prevention Study of 1,178,138 Koreans aged 30 to 95. These data were available from 1992 to 2003 and covered a long-term follow-up period among the Korean population. Results : The total medical expenditure of KNHI related to smoking increased by 27% from $324.9 million in 1999 to $413.7 million in 2003. By specific diseases, smoking-attributable KNHI medical expenditure was the highest for lung cancer ($74.2 million), followed by stroke ($65.3 million), COPD ($50.1 million), CHO ($49 million) and stomach cancer ($30 million). A total of 1.3 million KNHI patients were suffering from smoking-related diseases in 2003. We predicted rises in total KNHI medical expenditure related to smoking to $675.1 million (63% increase compared with that of 2003) and in the total number of KNHI patients suffering from smoking-related diseases to about 2.6million (an approximate 100% increase compared with those in 2003) in 2015. Conclusions : We found a substantial economic burden related to the high smoking prevalence in South Korea.

• Journal of Preventive Medicine and Public Health
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• v.34 no.3
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• pp.191-199
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• 2001

Objective : In this study, we focused on estimating the burden of premature death in Korea caused by smoking using the YLL(years of life lost due to premature death) measurement. Methods : First, we determined parameters: such as age-specific standard life expectancy, age on death, sex, and cause of death by analyzing the national death certificate data and life table collected during 1997. These were provided by the National Statistical Office. Secondly, we estimated the age group- specific years of life lost due to premature death by employing the standard expected years of life lost(SEYLL) measurement. Thirdly, the burden of premature death caused by smoking was estimated using the YLLs measurement which was developed by the global burden of disease study group. Fourthly, We calculated the risk related to smoking using the population attributable risk. Results : The following results were obtained in this study: 1) Premature death that is attributable to smoking in males could be prevented in 60.9%(513,582 person-year) by non-smoking. 2) The burden of premature death by smoking for female was prevented to 17.7%(513,582 person-year) by non-smoking. Conclusion : We found that the YLL method employed in this study was appropriate in quantifying the burden of premature death. This provides a rational basis for planning a national health policy regarding premature deaths caused by smoking and other related risk factors.

• 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.

• Tuberculosis and Respiratory Diseases
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• v.83 no.4
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• pp.268-275
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• 2020

Background: It is not evident that the attributable risk of smoking on mortality in Korea has decreased. We investigated the impact of smoking on all-cause mortality and estimated the attributable risk of smoking in Korean adults. Methods: Those aged ≥20 years with smoking history in the Korean National Health and Nutrition Examination Surveys (KNHANES) 2007-2015 were enrolled. We categorized the participants into three groups as follows: never smoker, <20 pack-years (PY) smokers, and ≥20 PY smokers. We applied inverse probability weighting using propensity scores to control various confounders between the groups. All-cause mortality risks were compared between the groups using the Kaplan-Meier log-rank test. The effects of smoking-attributable risks (ARs) on mortality were also calculated. Results: A total of 50,458 participants were included. Among them, 19,334 (38.3%) were smokers and 31,124 (61.7%) were never smokers. Those with a smoking history of 20 PY or more (≥20 PY smokers), those with a smoking history of less than 20 PY (<20 PY smokers), and never smokers were 18.1%, 20.2%, and 61.7%, respectively, of the study population. Smokers had a higher risk of all-cause mortality compared to never smokers (log-rank test p<0.01). The ARs of smoking were 21.8% (95% confidence interval [CI], 5.7%-37.9%) and 9.0% (95% CI, 6.1%-12.0%) in males and females, respectively. ARs decreased from 24.2% to 19.5% in males and from 9.5% to 4.1% in females between 2007-2010 and 2011-2015. Conclusion: Our study using KNHANES IV-VI data demonstrated that smoking increased the risk of all-cause mortality in a dose-response manner and the ARs of smoking on mortality were 21.8% in males and 9.0% in females during 2007-2015. This suggests that the ARs of smoking on mortality have decreased since around 2010.

• Journal of Environmental Health Sciences
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• v.37 no.5
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• pp.387-395
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• 2011

Purpose: This study measured the burden of disease in Korea related to outdoor air pollution using disability-adjusted life year (DALY). Materials and Methods: As a risk factor of outdoor air pollution, particulate matter with a diameter less than 10 ${\mu}m$($PM_{10}$) was used. First, $PM_{10}$-related diseases and their relative risk (RR) were selected by means of a literature review. Second, population attributable fractions were computed by using formulae including RR and population exposure to $PM_{10}$. Third, DALYs of $PM_{10}$-related diseases in Korea were estimated. Finally, the attributable burden of disease due to $PM_{10}$ was measured as the sum of the products that multiplied the DALYs of $PM_{10}$-related diseases by their population attributable fractions. Results: The disease burden of PM10 was 6.9 DALY per 1,000 persons in 2007. The attributable burden of $PM_{10}$ was 2.68 for lung cancer, 2.41 for COPD, 0.62 for ischemic heart disease, 0.61 for pneumonia, 0.55 for asthma, and 0.03 for preterm. Conclusions: This study showed the environmental burden of disease of $PM_{10}$ and burden of $PM_{10}$-related disease through objective data. It also suggested that active efforts are needed to continuously measure and reduce the burden of environmental diseases in Korea.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.2827-2832
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• 2016

Purpose: To estimate the number of deaths attributable to second hand smoking (SHS) in Morocco in 2012. Materials and Methods: prevalence based study focusing on mortality from ischaemic heart disease (IHD) and lung cancer among non-smokers aged 35 and over. Prevalence of SHS among never smokers was gathered from a national cross sectional survey on tobacco and population attributable risk (PAR) was calculated by applying PARs to mortality. The analyses were stratified by sex, age and area of exposure. Results: Rates for exposure to SHS among men aged 35-64 years ranged from 20.0% at home to 57.4% at work. Among non-smoking Moroccans aged 35 and over, 233 (IC: 147 - 246) deaths were attributable to exposure to SHS; 156 (IC: 100 - 221) in women and 77 (IC: 44 -125) in men. A total of 173 (122 - 222) deaths were estimated to have been caused by exposure only at home, 34 (9 - 76) by exposure only at the work place and 26 (15 - 58) by exposure both at home and work places. Exposure to SHS could be responsible for 182 (128 - 237) deaths from IHD and 51 (19 - 109) from lung cancer. Conclusions: These data confirm that SHS needs urgent attention in Morocco.

• Journal of Preventive Medicine and Public Health
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• v.48 no.1
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• pp.1-9
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• 2015

The purpose of the present review is to give an overview of the association between alcohol intake and the risk of developing cancer. Two large-scale expert reports; the World Cancer Research Fund (WCRF)/American Institute of Cancer Research (AICR) report from 2007, including its continuous update project, and the International Agency for Research of Cancer (IARC) monograph from 2012 have extensively reviewed this association in the last decade. We summarize and compare their findings, as well as relate these to the public health impact, with a particular focus on region-specific drinking patterns and disease tendencies. Our findings show that alcohol intake is strongly linked to the risk of developing cancers of the oral cavity, pharynx, larynx, oesophagus, colorectum (in men), and female breast. The two expert reports diverge on the evidence for an association with liver cancer and colorectal cancer in women, which the IARC grades as convincing, but the WCRF/AICR as probable. Despite these discrepancies, there does, however, not seem to be any doubt, that the Population Attributable Fraction of alcohol in relation to cancer is large. As alcohol intake varies largely worldwide, so does, however, also the Population Attributable Fractions, ranging from 10% in Europe to almost 0% in countries where alcohol use is banned. Given the World Health Organization's prediction, that alcohol intake is increasing, especially in low- and middle-income countries, and steadily high in high-income countries, the need for preventive efforts to curb the number of alcohol-related cancers seems growing, as well as the need for taking a region- and gender-specific approach in both future campaigns as well as future research. The review acknowledges the potential beneficial effects of small doses of alcohol in relation to ischaemic heart disease, but a discussion of this lies without the scope of the present study.

• Korean Journal of Health Education and Promotion
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• v.27 no.4
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• pp.83-90
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• 2010

objectives: This study was conducted to estimate medical expenditure attributable to overweight and obesity in adults with ischemic heart disease and stroke using Korea National Health and Nutrition Examination survey data and Korea National Health Corporation data. methods : The medical expenditure of ischemic heart disease and stroke related to overweight and obesity were composed of inpatient care costs, outpatient care costs and medication costs. The population attributable risk (PAR) of overweight and obesity was calculated from national representative data of Korea such as the National Health Insurance Corporation cohort data and 2005 Korea National Health and Nutrition Examination survey data. results: The medical expenditure attributable to overweight and obesity of ischemic heart disease were 97.4 billion won(74.1-122 billion won). and stroke were 64.6 billion won(33.1-98.1 billion won). Consequently, these costs corresponded to 11.4% of total medical expenditure due to ischemic heart disease and stroke. conclusion: We conclude that overweight and obesity have increased medical expenditure from ischemic heart disease and stroke in Korea. These findings provide important support for implementing overweight and obesity management strategies in Korea.

• Journal of Radiation Protection and Research
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• v.48 no.2
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• pp.90-99
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• 2023

Background: Quantitative risk assessments should be accompanied by uncertainty analyses of the risk models employed in the calculations. In this study, we aim to develop a computational code named SUMRAY for use in cancer risk projections from radiation exposure taking into account uncertainties. We also aim to make SUMRAY publicly available as a resource for further improvement of risk projection. Materials and Methods: SUMRAY has two versions of code written in R and Python. The risk models used in SUMRAY for all-solid-cancer mortality and incidence were those published in the Life Span Study of a cohort of the atomic bomb survivors in Hiroshima and Nagasaki. The confidence intervals associated with the evaluated risks were derived by propagating the statistical uncertainties in the risk model parameter estimates by the Monte Carlo method. Results and Discussion: SUMRAY was used to calculate the lifetime or time-integrated attributable risks of cancer under an exposure scenario (baseline rates, dose[s], age[s] at exposure, age at the end of follow-up, sex) specified by the user. The results were compared with those calculated using another well-known web-based tool, Radiation Risk Assessment Tool (RadRAT; National Institutes of Health), and showed a reasonable agreement within the estimated confidential interval. Compared with RadRAT, SUMRAY can be used for a wide range of applications, as it allows the risk projection with arbitrarily specified risk models and/or population reference data. Conclusion: The reliabilities of SUMRAY with the present risk-model parameters and their variance-covariance matrices were verified by comparing them with those of the other codes. The SUMRAY code is distributed to the public as an open-source code under the Massachusetts Institute of Technology license.