• Health Policy and Management
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• v.10 no.3
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• pp.169-187
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• 2000

Cigarette smoking has been identified as the most important source of preventable morbidity and premature mortality (WHO, 1995), The prevalence of smoking among men is very high in Korea. This study estimated productivity losses due to smoking in Korea, 1997. The derivation of cost estimates for mortality, disability, hospitalization and use of physician services related to cigarette smoking is bas 어 on the calculation of attributable fractions suggested by MacMahon and Cole and Smoking-Attributable Mortality, Morbidity, and Economic Cost(SAMMEC) software. To estimate the number of deaths from neoplastic, cardiovascular, respiratory diseases associated with cigarette smoking, estimates for adults(aged 20 years and over) were based on 1997 mortality data, 1995 data on smoking prevalence from Korea Institute for Health and Social Affairs. Smoking-attributable indirect morbidity cost data were obtained from the National Federation of Medical Insurance. As the result of cost estimation, these productivity losses were 336-430 billion won. During 1997, 8,620-10,804 deaths were attributed to smoking. Cigarette smoking resulted in 133,991-169,422 Years of Potential Life Lost (YPLL) to life expectancy. For smoking -attributable indirect mortality costs, the present value of future earnings(PVFE) for the age at death are 299-384 billion won. Smoking-attributable indirect morbidity costs, the costs of lost productivity for persons who are disabled by smoking-related chronic diseases are 37-46 billion won. In this study the productivity losses due to smoking were restricted to the health effects of smoking. It is possible that these costs were underestimated with the limitation of the data. Smoking is the leading preventable cause of illness and death. The results of this study can be used as elementary data for antismoking policy.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6561-6568
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• 2015

Background: Smokeless tobacco (SLT) has long been realized as an important component of the fight for global tobacco control. It still remains a major problem in countries like India, Bangladesh and Nepal. The objective of this study was to estimate the trends of SLT use in three countries of the SEARO WHO office. Materials and Methods: We used data from national surveys in three countries (Bangladesh, India and Nepal) to estimate trends in prevalence of current SLT use. All available nationally representative data sources were used. Estimates were weighted, age standardized and given along with 95% confidence intervals. Significance of linear trend in prevalence over time was tested using the Cochrane-Armitage test for trend. A p value of less than 0.05 was considered statistically significant. Results: We identified three surveys for Bangladesh, three for India and four for Nepal that met the selection criteria (such as Demographic and Health Surveys, WHO-STEPwise approach to Surveillance and Global Adult Tobacco Surveys). A significantly increasing trend was noticed in the prevalence of current SLT use among Bangladeshi men (20.2% to 23%, p=0.03). In India, a similar significantly increasing trend was seen among men (27.1% to 33.4%, p<0.001) and women (10.1% to 15.7%, p<0.001). In Nepal, there was a no significant trend among both men (39.1% to 31.6%, p=0.11) and women (5.6% to 4.7%, p=0.49). Conclusions: In the study countries SLT use has remained at alarmingly high levels. Usage trends do not show any signs of decline in spite of control efforts. Tobacco control measures should focus more on controlling SLT use.

• Journal of Veterinary Clinics
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• v.31 no.1
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• pp.40-45
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• 2014

Abalone herpes-like virus (AbHV) is a fatal disease of abalones that impose severe economic impacts on the industry of infected regions due to high mortality. The aim of this study was to quantify the risk of introducing AbHV into Korea through the importation of live abalones for human consumption by import risk analysis (IRA). Monte Carlo simulation models were developed to provide estimates of the probability that a ton of imported abalone contains at least one AbHV-infected individual, using historical trade data and relevant literatures. A sensitivity analysis with 5,000 iterations was also conducted to determine the extent to which input parameters affect the outcome of the model. Although many uncertainties were present in the data, the results indicated that, if 5,000 tons of abalone were imported from a hypothetical exporting country with low prevalence of AbHV (model 1), there would be at least one AbHV-infected abalones in 4,816 of those tons (96.3%), while there would be at least one AbHV-infected abalones in 100% of those tons imported from country with high prevalence (model 2). Sensitivity analysis indicated that for model 1, prevalence was the strongest influence factor on the predicted number of infections. For model 2, background mortality and washing to reduce the risk of surface contamination during processing were the major contributing factors. Risk management strategies need to be enforced to reduce the risk of AbHV introduction in that at least one infected abalone would remain in a consignment from country even with a low prevalence of AbHV infection. The methodology and the results presented here will contribute to improve the development of AbHV management program, and with more accurate data this IRA model will aid science-based decision-making on mitigation strategies to reduce the risk of AbHV introduction in Korea.

• Journal of Preventive Medicine and Public Health
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• v.55 no.1
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• pp.10-18
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• 2022

Disability-adjusted life-year (DALY) estimates may vary according to factors such as the standard life expectancy, age weighting, time preference and discount rate, calculation of disability weights, and selection of the estimation method. DALY estimation methods are divided into the following 3 approaches: the incidence-based approach, the pure prevalence-based approach, and the hybrid approach. These 3 DALY estimation approaches each reflect different perspectives on the burden of disease using unique characteristics, based on which the selection of a suitable approach may vary by the purpose of the study. The Global Burden of Disease studies, which previously estimated DALYs using the incidence-based approach, switched to using the hybrid approach in 2010, while the National Burden of Disease studies in Korea still mainly apply the incidence-based approach. In order to increase comparability with other international burden of disease studies, more DALY studies using the prevalence-based approach need to be conducted in Korea. However, with the limitations of the hybrid approach in mind, it is necessary to conduct more research using a disease classification system suitable for Korea. Furthermore, more detailed and valid data sources should be established before conducting studies using a broader variety of DALY estimation approaches. This review study will help researchers on burden of disease use an appropriate DALY estimation approach and will contribute to enhancing researchers' ability to critically interpret burden of disease studies.

• Journal of Preventive Medicine and Public Health
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• v.39 no.4
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• pp.317-324
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• 2006

Objectives: This study was conducted to estimate the unbiased smoking prevalence and its standard errors among adolescents in a large city in Korea, by design-based analysis. Methods: All the students in Daegu city were stratified by grade, gender and region, and then schools as primary sampling units (PSU) were selected by probability proportional to size (PPS) sampling. One or two classes were sampled randomly from each grade, from 5th grade in elementary schools to the 3rd grade in high schools. The students anonymously completed a standardized self-administered questionnaire from October to December 2004. The total number of respondents was 8,480 in the final analysis, excluding the third graders in the general high schools because of incomplete sampling. The sampling weight was calculated for each student after post-stratification adjustment, with adjustment being made for the missing cases. The data were analyzed with Stata 8.0 with consideration of PSU, weighting and the strata variables. Results: The smoking prevalence (%) and standard errors for male students from the fifth grade in elementary schools to the second grade in high schools were $0.93{\pm}0.47,\;1.83{\pm}0.74,\;3.16{\pm}1.00,\;5.12{\pm}1.02,\;10.86{\pm}1.13,\;15.63{\pm}2.44\;and\;17.96{\pm}2.67$, and those for the female students were $0.28{\pm}0.28,\;1.17{\pm}0.73,\;3.13{\pm}0.60,\;1.45{\pm}0.58,\;3.94{\pm}0.92,\;8.75{\pm}1.86\;and\;10.04{\pm}1.70$, sequentially. Conclusions: The smoking prevalence from this study was much higher than those from the other conventional studies conducted in Korea. The point estimates and standard errors from the design-based analysis were different from those of the model-based analysis. These findings suggest the importance of design-based analysis to estimate unbiased prevalence and standard errors in complex survey data and this method is recommended to apply to future surveys for determining the smoking prevalence for specific population.

• Journal of Preventive Medicine and Public Health
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• v.39 no.6
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• pp.499-504
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• 2006

Objectives : The aim of the study was to estimate the annual socioeconomic cost of diseases in Korea. Methods : We estimate both the direct and indirect costs of diseases in Korea during 2003 using a prevalence-based approach. The direct cost estimates included medical expenditures, traffic costs and caregiver's cost, and the indirect costs, representing the loss of production, included lost workdays due to illness and lost earnings due to premature death, which were estimated based on the human capital theory. The cost estimates were reported at three different discount rates (0, 3 and 5%). Results : The cost of diseases in Korea during 2003 was 38.4 trillion won based on 0% discount rate. This estimate represents approximately 5.3% of GDP The direct and indirect costs were estimated to be 22.5 trillion (58.5% of total cost) and 15.9 trillion won (41.5%), respectively. It was also found that the cost for those aged $40\sim49$ accounted for the largest proportion (21.7%) in relation to age groups. The cost of diseases for males was 23.5% higher than that for females. For major diseases, the total socioeconomic costs were 16.0, 13.4, 11.3 and 11.19% for neoplasms, and diseases of the digestive, respiratory and circulatory systems, respectively. Conclusions : This study can be expected to provide valuable information for determining intervention and funding priorities, and for planning health policies.

• Safety and Health at Work
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• v.12 no.2
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• pp.174-183
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• 2021

Background: Toluene diisocyanate (TDI) is a highly reactive chemical that causes sensitization and has also been associated with increased lung cancer. A risk assessment was conducted based on occupational epidemiologic estimates for several health outcomes. Methods: Exposure and outcome details were extracted from published studies and a NIOSH Health Hazard Evaluation for new onset asthma, pulmonary function measurements, symptom prevalence, and mortality from lung cancer and respiratory disease. Summary exposure-response estimates were calculated taking into account relative precision and possible survivor selection effects. Attributable incidence of sensitization was estimated as were annual proportional losses of pulmonary function. Excess lifetime risks and benchmark doses were calculated. Results: Respiratory outcomes exhibited strong survivor bias. Asthma/sensitization exposure response decreased with increasing facility-average TDI air concentration as did TDI-associated pulmonary impairment. In a mortality cohort where mean employment duration was less than 1 year, survivor bias pre-empted estimation of lung cancer and respiratory disease exposure response. Conclusion: Controlling for survivor bias and assuming a linear dose-response with facility-average TDI concentrations, excess lifetime risks exceeding one per thousand occurred at about 2 ppt TDI for sensitization and respiratory impairment. Under alternate assumptions regarding stationary and cumulative effects, one per thousand excess risks were estimated at TDI concentrations of 10 - 30 ppt. The unexplained reported excess mortality from lung cancer and other lung diseases, if attributable to TDI or associated emissions, could represent a lifetime risk comparable to that of sensitization.

• Communications for Statistical Applications and Methods
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• v.24 no.2
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• pp.173-191
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• 2017

This study develops a new type of latent class analysis (LCA) in order to explain the associations between one latent variable and several other categorical latent variables. Our model postulates that the prevalence of the latent variable of interest is affected by another latent variable composed of other several latent variables. For the parameter estimation, we propose deterministic annealing EM (DAEM) to deal with local maxima problem in the proposed model. We perform simulation study to demonstrate how DAEM can find the set of parameter estimates at the global maximum of the likelihood over the repeated samples. We apply the proposed LCA model in an investigation of the effect of and joint patterns for drug-using behavior to violent behavior among US high school male students using data from the Youth Risk Behavior Surveillance System 2015. Considering the age of male adolescents as a covariate influencing violent behavior, we identified three classes of violent behavior and three classes of drug-using behavior. We also discovered that the prevalence of violent behavior is affected by the type of drug used for drug-using behavior.

• Tuberculosis and Respiratory Diseases
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• v.85 no.3
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• pp.205-220
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• 2022

This study aimed to describe the prevalence of comorbidities associated with chronic obstructive pulmonary disease (COPD) and their relation with relevant outcomes. A systematic review based on the PRISMA methodology was performed from January 2020 until July 2021. The MEDLINE, Lilacs, and Scielo databases were searched to identify studies related to COPD and its comorbidities. Observational studies on the prevalence of comorbidities in COPD patients and costs with health estimates, reduced quality of life, and mortality were included. Studies that were restricted to one or more COPD pain assessments and only specific comorbidities such as osteoporosis, bronchitis, and asthma were excluded. The initial search identified 1,409 studies and after applying the inclusion and exclusion criteria, 20 studies were finally selected for analysis (comprising data from 447,459 COPD subjects). The most frequent COPD comorbidities were: hypertension (range, 17%-64.7%), coronary artery disease (19.9%-47.8%), diabetes (10.2%-45%), osteoarthritis (18%-43.8%), psychiatric conditions (12.1%-33%), and asthma (14.7%-32.5%). Several comorbidities had an impact on the frequency and severity of COPD exacerbations, quality of life, and mortality risk, in particular malignancies, coronary artery disease, chronic heart failure, and cardiac arrhythmias. Comorbidities, especially cardiovascular diseases and diabetes, are frequent in COPD patients, and some of them are associated with higher mortality.

• Journal of the Korean Data and Information Science Society
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• v.28 no.2
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• pp.443-449
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• 2017

Estimation of population proportion like the distribution rate of LED TV and the prevalence of a disease are often estimated based on survey sample data. Population proportion is generally considered as a special form of population mean. In complex sampling like stratified multistage sampling with unequal probability sampling, the denominator of mean may be random variable and it is estimated like ratio estimator. In this research, we examined the estimation of distribution rate based on stratified multistage sampling, and determined some numerical outcomes using stratified random sample data with about 25% of missing observations. In the data used for this research, the survey weight was determined by deterministic way. So, the weights are not random variable, and the population distribution rate and its variance estimator can be estimated like population mean estimation. When the weights are not random variable, if one estimates the variance of proportion estimator using ratio method, then the variances may be inflated. Therefore, in estimating variance for population proportion, we need to examine the structure of data and survey design before making any decision for estimation methods.