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Systematic Review
Adverse health effects of climate change and air pollution in people with disabilities: a systematic review
Nakyung Rhim, Seohyun Lee, Kyung-Hwa Choi
Epidemiol Health. 2024;46:e2024080.   Published online September 27, 2024
DOI: https://doi.org/10.4178/epih.e2024080
  • 1,192 View
  • 139 Download
AbstractAbstract AbstractSummary PDF
Abstract
Global warming and air pollution adversely affect the health of the entire human population, particularly older adults, people with disabilities (PWDs), and children. In this systematic review, we investigated the adverse health effects of climate change and air pollution in PWDs. We conducted a comprehensive literature search of the PubMed database using the terms “disab*,” “air pollution,” and “climate change” on July 4, 2023, and August 8, 2023 and searched the Web of Science (WOS) database on December 28, 2023. We identified 425 and 1,169 studies on climate change cited in PubMed and WOS, respectively, as well as 333 studies on air pollution in PubMed and 495 studies on air pollution in WOS. The studies were classified by type of exposure, and full-text screening was conducted to confirm that the population, intervention or exposure, comparator, outcome statement, and inclusion and exclusion criteria were met. The Newcastle-Ottawa Scale was used to assess the quality of the included cohort and case-control studies and for data analysis. In extreme temperatures, PWDs experienced higher rates of injury, heat-related illness, functional impairment, heart disease, mental disorders, and mortality than people who were non-disabled (ND). Exposure to air pollution resulted in higher rates of obesity, cardiovascular disease, poststroke neurological and functional disability, and mortality in PWDs than in people who were ND. Therefore, because PWDs were more affected by climate change and air pollution than people who were ND, sensitive policies and preparedness measures should be developed for PWDs.
Summary
Korean summary
전체 인구, 특히 취약 계층의 건강은 기후 변화와 대기 오염으로 인해 부정적인 영향을 받을 수 있습니다. 본 체계적 고찰 연구는 장애인이 비장애인에 비해 환경적 요인에 노출되어 더 심각한 신체적, 정신적 건강 문제를 겪는다는 것을 보여줍니다.
Key Message
The health of the entire human population, especially vulnerable people, might be negatively impacted by climate change and air pollution. This systematic review study implies that people with disabilities (PWDs) suffer more severe physical and mental health consequences from exposure to environmental challenges compared to non-disabled individuals.
Brief Communication
The association between employee lifestyles and the rates of mental health-related absenteeism and turnover in Japanese companies
Atsuya Fujimoto, Hiroshi Kanegae, Kaori Kitaoka, Mizuki Ohashi, Kunio Okada, Koichi Node, Kenkichi Takase, Hiroshi Fukuda, Tomoyuki Miyazaki, Yuichiro Yano
Epidemiol Health. 2024;46:e2024068.   Published online August 2, 2024
DOI: https://doi.org/10.4178/epih.e2024068
  • 2,435 View
  • 189 Download
AbstractAbstract PDF
Abstract
We assessed the association of employee lifestyles (e.g., smoking, exercise, drinking, and sleep habits) with mental health-related absenteeism and turnover rates utilizing data from the annual Health and Productivity Management survey by Japan’s Ministry of Economy, Trade and Industry. This analysis included data from 1,748 companies, encompassing 4,199,021 employees. The average proportions of mental health-related absenteeism and employee turnover rates were 1.1±1.0% and 5.0±5.0%, respectively. In multivariable regression models that incorporated all lifestyle factors and confounders, a 1 percentage point increase in the proportion of employees who slept well was associated with reductions in their turnover rate (mean, -0.020%; 95% confidence interval [CI], -0.038 to -0.002) and in mental health-related absenteeism (mean, -0.005%; 95% CI, -0.009 to 0.001). A similar increase in the proportion of employees engaging in regular physical activity corresponded with a 0.005% decrease in the prevalence of mental health-related absenteeism (95% CI, -0.010 to -0.001). A 1 percentage point increase in the proportion of employees who smoked was associated with a 0.013% reduction in mental health-related absenteeism (95% CI, -0.017 to -0.008). Nonetheless, the current study’s observational and cross-sectional design restricted the ability to establish causality between employee lifestyle factors and mental health issues.
Summary
Original Articles
Genetic associations and parent-of-origin effects of PVRL1 in non-syndromic cleft lip with or without cleft palate across multiple ethnic populations
Ji Wan Park, Geon Kang, Seung-Hak Baek, Young Ho Kim
Epidemiol Health. 2024;46:e2024069.   Published online August 9, 2024
DOI: https://doi.org/10.4178/epih.e2024069
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AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
This study investigated the associations of <i>PVRL1</i> gene variants with non-syndromic cleft lip with or without cleft palate (NSCL/P) by evaluating transmission distortion and parent-of-origin (POO) effects in multiple ethnic populations.
METHODS
We conducted allelic and genotypic transmission disequilibrium tests (TDT) on 10 single-nucleotide variants (SNVs) in <i>PVRL1</i> using data from 142 Korean families with an affected child. POO effects were analyzed using the POO likelihood ratio test, comparing transmission rates of maternally and paternally inherited alleles. To assess generalizability and ethnic heterogeneity, we compared results from Korean families with data from the Center for Craniofacial and Dental Genetics, which included 2,226 individuals from 497 European and 245 Asian trios.
RESULTS
TDT analysis identified significant over-transmission of the rs7940667 (G361V) C allele in Korean families (p=0.007), a finding replicated in both Asian (p=6.5×10<sup>-7</sup>) and European families (p=1.6×10<sup>-10</sup>). Eight SNVs showed strong TDT evidence in larger Asian and European datasets after multiple comparison corrections (p<0.0073). Of these, 4 SNVs (rs7940667, rs7103685, rs7129848, and rs4409845) showed particularly robust association (p<5×10<sup>-8</sup>). POO analysis revealed significant maternal over-transmission of the rs10790330-A allele in Korean families (p=0.044). This finding was replicated in European families (p=9.0×10<sup>-4</sup>). Additionally, 3 other SNVs, rs7129848 (p=0.001) and the linked SNVs rs3935406 and rs10892434 (p=0.025), exhibited maternal over-transmission in the validation datasets.
CONCLUSIONS
Our findings provide robust evidence supporting the associations of <i>PVRL1</i> variants with NSCL/P susceptibility. Further research is necessary to explore the potential clinical applications of these findings.
Summary
Associations between taxi drivers’ aggressive driving behavior and sleep, cognition, and psychological factors in Korea: negative binomial regression analysis
Jong Sun Ok, Hyeongsu Kim, Soo Young An, Mi Young Kim
Epidemiol Health. 2024;46:e2024085.   Published online October 17, 2024
DOI: https://doi.org/10.4178/epih.e2024085
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Aggressive driving behavior is a significant predictor of traffic accidents. In particular, the driving behavior of taxi drivers is a critical issue that can impact the safety of both drivers and passengers. This study explored the sleep, cognitive, and psychological factors associated with taxi drivers’ aggressive driving behavior.
METHODS
In this descriptive study, a self-report questionnaire was distributed to taxi drivers in Seoul and Gyeonggi Province from August 22, 2022 to December 30, 2022. In all, 992 respondents were analyzed using negative binomial regression.
RESULTS
The mean score for aggressive driving behavior among taxi drivers was 13.76±11.47, with sub-scores of 3.46±3.48 for lapse, 3.31±3.16 for error, and 6.99±5.76 for violation. Contributing factors included sleep disorders, cognitive decline, and psychological factors. A higher score for aggressive driving behavior was associated with an increased severity of insomnia and daytime sleepiness, higher rates of cognitive failure, and elevated levels of depression and stress.
CONCLUSIONS
Our findings highlight the importance of addressing the sleep, cognitive, and psychological factors associated with aggressive driving behaviors among taxi drivers. Further study is needed to evaluate the causal relationship. In addition, it is imperative to develop educational programs and interventions to manage these issues effectively.
Summary
Korean summary
택시 기사의 안전운전 행동은 교통사고, 운전자와 승객의 안전과 연결된 이슈이다. 기존 연구에서 택시 기사의 가파른 고령화와 열악한 직업 환경 등이 과격한 운전행위의 영향요인으로 보고하고 있다. 이 연구에서 택시기사의 수면, 인지기능 및 심리적인 요인도 과격한 운전행위와 관련이 있음으로 보여주고 있다.
Key Message
It is important to predict taxi drivers’ aggressive driving behavior to decrease the traffic accidents that result from such be- havior. Previous studies have shown that general and occupational characteristics have a significant impact on aggressive driving behavior, whereas research on the psychological factors is limited. Our comprehensive investigation of the psycho- logical factors as well as the sleep factors and cognitive functions of taxi drivers (as part of a rapidly aging population) showed a significant relationship between these factors and aggressive driving behavior.
Homelessness and mortality: gender, age, and housing status inequity in Korea
Gum-Ryeong Park, Dawoon Jeong, Seung Won Lee, Hojoon Sohn, Young Ae Kang, Hongjo Choi
Epidemiol Health. 2024;46:e2024076.   Published online September 12, 2024
DOI: https://doi.org/10.4178/epih.e2024076
  • 1,743 View
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We compared mortality rates among various housing statuses within the homeless population and investigated factors contributing to their deaths, including housing status, gender, and age.
METHODS
Using a comprehensive multi-year dataset (n=15,445) curated by the National Tuberculosis Screening and Case Management Programs, matched with the 2019-2021 Vital Statistics Death Database and National Health Insurance claims data, we calculated age-standardized mortality rates and conducted survival analysis to estimate differences in mortality rates based on housing status.
RESULTS
The mortality rate among the homeless population was twice as high as that of the general population, at 1,159.6 per 100,000 compared to 645.8 per 100,000, respectively. Cancer and cardiovascular diseases were the primary causes of death. Furthermore, individuals residing in shelter facilities faced a significantly higher risk of death than those who were rough sleeping, with an adjusted hazard ratio of 1.70 (95% confidence interval, 1.37 to 2.11). This increased risk was especially pronounced in older adults and women.
CONCLUSIONS
The study highlights the urgent need for targeted interventions, as the homeless population faces significantly higher mortality rates. Older adults and women in shelter facilities are at the highest risk.
Summary
Korean summary
전체 인구의 사망률은 큰 폭으로 줄어들면서 홈리스와 전체 인구 간의 사망 불평등이 1.3배에서 1.8배로 증가했다. 특히 쪽방주민이나 거리 홈리스보다 시설 거주 홈리스의 사망 위험이 더 높았으며, 동일 조건하에서 거리 홈리스 대비 약 1.7배 높은 사망 위험을 보였다. 본 연구는 홈리스의 탈시설화를 촉진하는 정책 전환의 필요성을 시사한다.
Key Message
The mortality rate of the general population has significantly declined, leading to an increase in mortality inequality between the homeless and the general population from 1.3 to 1.8 times. In particular, the mortality risk for homeless individuals in facilities was higher than that of those living in jjokbang or on the streets. This study highlights the need for a policy shift to promote deinstitutionalization for the homeless population.
The associations of cardiovascular and lifestyle factors with mortality from chronic kidney disease as the underlying cause: the JACC study
Shuai Guo, Tomoko Sankai, Kazumasa Yamagishi, Tomomi Kihara, Akiko Tamakoshi, Hiroyasu Iso, for the JACC Study Group
Epidemiol Health. 2024;46:e2024077.   Published online September 13, 2024
DOI: https://doi.org/10.4178/epih.e2024077
  • 1,248 View
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AbstractAbstract PDF
Abstract
OBJECTIVES
This study investigated conventional cardiovascular and lifestyle risk factors affecting mortality from chronic kidney disease as the underlying cause in the general Japanese population.
METHODS
We conducted an 18.8-year follow-up study of 44,792 men and 61,522 women aged 40-79 from the Japan Collaborative Cohort Study for Evaluation of Cancer Risk between 1986 and 1990. Cox proportional hazard models were used to analyze the association between risk factors and mortality from chronic kidney disease.
RESULTS
During the follow-up period, 373 participants (185 men and 188 women) died from chronic kidney disease. A body mass index of ≥27.0 kg/m<sup>2</sup> (hazard ratio [HR], 2.00; 95% confidence interval [CI], 1.19 to 3.36 for men and HR, 1.91; 95% CI, 1.19 to 3.07 for women, compared with 23.0-24.9 kg/m2), a history of hypertension (HR, 2.32; 95% CI, 1.67 to 3.22 for men and HR, 2.01; 95% CI, 1.44 to 2.81 for women) and a history of diabetes mellitus (HR, 5.21; 95% CI, 3.68 to 7.37 for men and HR, 7.10; 95% CI, 4.93 to 10.24 for women) were associated with an increased risk of mortality from chronic kidney disease in both genders. In men, smoking was also associated with an increased risk (HR, 1.91; 95% CI, 1.25 to 2.90), while current drinking (HR, 0.58; 95% CI, 0.34 to 0.98 for <23 g/day; HR, 0.48; 95% CI, 0.29 to 0.80 for 23-45 g/day and HR, 0.53; 95% CI, 0.32 to 0.86 for ≥46 g/day) and exercising ≥5 hr/wk (HR, 0.42; 95% CI, 0.18 to 0.96) were associated with a lower risk. Similar but non-significant associations for smoking and drinking were observed in women.
CONCLUSIONS
In addition to a history of hypertension and a history of diabetes mellitus, body mass index, smoking status, drinking status, and exercise habits were associated with the risk of mortality from chronic kidney disease.
Summary
Special Article
Cancer risk based on alcohol consumption levels: a comprehensive systematic review and meta-analysis
Seunghee Jun, Hyunjin Park, Ui-Jeong Kim, Eun Jeong Choi, Hye Ah Lee, Bomi Park, Soon Young Lee, Sun Ha Jee, Hyesook Park
Epidemiol Health. 2023;45:e2023092.   Published online October 16, 2023
DOI: https://doi.org/10.4178/epih.e2023092
  • 9,592 View
  • 509 Download
  • 6 Web of Science
  • 9 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Alcohol consumption is a well-established risk factor for cancer. Despite extensive research into the relationship between alcohol consumption and cancer risk, the effect of light alcohol consumption on cancer risk remains a topic of debate. To contribute to this discourse, we conducted a comprehensive systematic review and meta-analysis.
METHODS
Our systematic review aimed to investigate the associations between different levels of alcohol consumption and the risk of several cancer types. We focused on analyzing prospective associations using data from 139 cohort studies. Among them, 106 studies were included in the meta-analysis after a quantitative synthesis.
RESULTS
Our analysis did not find a significant association between light alcohol consumption and all-cause cancer risk (relative risk, 1.02; 95% confidence interval, 0.99 to 1.04), but we observed a dose-response relationship. Light alcohol consumption was significantly associated with higher risks of esophageal, colorectal, and breast cancers. Light to moderate drinking was associated with elevated risks of esophageal, colorectal, laryngeal, and breast cancers. Heavy drinking was also found to contribute to the risk of stomach, liver, pancreas, and prostate cancers, thereby increasing the risk of almost all types of cancer. Additionally, females generally had lower cancer risks compared to males.
CONCLUSIONS
Our findings highlight that cancer risks extend beyond heavy alcohol consumption to include light alcohol consumption as well. These findings suggest that there is no safe level of alcohol consumption associated with cancer risk. Our results underscore the importance of public health interventions addressing alcohol consumption to mitigate cancer risks.
Summary
Korean summary
본 연구는 코호트 연구를 기반으로 하여 음주의 수준에 따른 암 위험 연관성에 대해 체계적 문헌고찰(139편)과 메타분석(106편)을 수행하였다. 연구 결과, 음주와 암 위험 사이에 용량-반응 관계가 나타났으며, 소량의 음주는 암 유형에 따라 차이가 있었으나, 식도암, 대장암, 전립선암(남성), 유방암(여성)에서 암 위험과의 연관성이 있음을 발견했다. 따라서, 암 위험 측면에서 음주에 안전한 수준이 없음을 시사하며, 음주와 관련된 잠재적 피해를 완화하기 위해서는 음주 지침 강화와 같은 공중보건개입이 필요하다.
Key Message
The aim of this study was to assess the relationship between different levels of alcohol consumption and the risk of various cancer types through a systematic review and meta-analysis, providing insights into the ongoing debate about alcohol consumption and cancer causality. The findings support a dose-response relationship between alcohol consumption levels and cancer risk and the light alcohol consumption was associated with risks of esophageal, colorectal, prostate (male), and breast (female) cancer. These results emphasize the absence of a safe threshold for alcohol consumption in terms of cancer risk.

Citations

Citations to this article as recorded by  
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    Chengdong Yu, Jiawei Xu, Siyi Xu, Lei Tang, Qinyuan Han, Xiaoqiang Zeng, Yanxiao Huang, Tenghua Yu, Zhengkui Sun
    Frontiers in Immunology.2024;[Epub]     CrossRef
  • The Impact of Tobacco Smoking and Alcohol Consumption on the Development of Gastric Cancers
    Waku Hatta, Tomoyuki Koike, Naoki Asano, Yutaka Hatayama, Yohei Ogata, Masahiro Saito, Xiaoyi Jin, Kaname Uno, Akira Imatani, Atsushi Masamune
    International Journal of Molecular Sciences.2024; 25(14): 7854.     CrossRef
  • Genetic Heterogeneity Across Dimensions of Alcohol Use Behaviors
    Jeanne E. Savage, Peter B. Barr, Tanya Phung, Younga H. Lee, Yingzhe Zhang, Vivia V. McCutcheon, Tian Ge, Jordan W. Smoller, Lea K. Davis, Jacquelyn Meyers, Bernice Porjesz, Danielle Posthuma, Travis T. Mallard, Sandra Sanchez-Roige
    American Journal of Psychiatry.2024; 181(11): 1006.     CrossRef
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    Preventive Medicine Reports.2024; 48: 102915.     CrossRef
  • Development of an algorithm for identifying paraneoplastic ischemic stroke in association with lung, pancreatic, and colorectal cancer
    Rebecca Kassubek, Marc-Andre G. R. Winter, Jens Dreyhaupt, Mona Laible, Jan Kassubek, Albert C. Ludolph, Jan Lewerenz
    Therapeutic Advances in Neurological Disorders.2024;[Epub]     CrossRef
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    FMC - Formación Médica Continuada en Atención Primaria.2024; 31(8): 403.     CrossRef
  • Alcohol consumption and its association with cancer, cardiovascular, liver and brain diseases: a systematic review of Mendelian randomization studies
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    Frontiers in Epidemiology.2024;[Epub]     CrossRef
  • Prévention et dépistage des cancers dans les rhumatismes inflammatoires chroniques
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Original Article
The prevention and response to infectious diseases in long-term care facilities in Korea: a nationwide survey
Sun Hee Na, Joong Sik Eom, Sun Bean Kim, Hyung Jin Yoon, So Yeon Yoo, Kyeong Sook Cha, Jong Rim Choi, Ji Youn Choi, Si Hyeon Han, Jin Ju Park, Tark Kim, Jacob Lee
Epidemiol Health. 2024;46:e2024084.   Published online October 17, 2024
DOI: https://doi.org/10.4178/epih.e2024084
  • 797 View
  • 60 Download
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Long-term care facilities (LTCFs) are communal environments for patients with chronic diseases or older adults, making them particularly susceptible to significant harm during infectious disease outbreaks. Nonetheless, LTCFs have historically been subject to less stringent infection prevention and control (IPC) mandates. This study aimed to assess the current state of LTCFs and to develop an IPC system tailored for these facilities following the coronavirus disease 2019 (COVID-19) pandemic.
METHODS
We conducted an online survey of 11,366 LTCFs in Korea from December 30, 2022 to January 20, 2023, to evaluate the components of IPC in LTCFs. The infectious diseases targeted for IPC included COVID-19, influenza, and scabies. Additionally, we compared institution-based and home-based long-term care insurance facilities.
RESULTS
Overall, 3,537 (31.1%) LTCFs responded to the survey, comprising 1,819 (51.4%) institution-based and 1,718 (48.6%) home-based facilities. A majority (87.4%, 2,376/2,720) of these facilities experienced COVID-19 outbreaks. However, only 42.2% of home-based facilities, in contrast to 90.6% of institution-based facilities, were equipped to manage concurrent COVID-19 cases. Similarly, while 92.1% of institution-based facilities were capable of managing influenza, only 50.5% of home-based facilities could do the same. The incidence of scabies was significantly higher in institution-based facilities than in home-based ones (26.1 vs. 4.3%). Additionally, 88.7% of institution-based facilities managed scabies cases effectively, compared to only 42.1% of home-based facilities.
CONCLUSIONS
Approximately half of the LTCFs had a basic capacity to respond to infectious diseases. However, there were differences in response capabilities between institution-based facilities and home-based facilities.
Summary
Korean summary
장기요양기관을 대상으로 실태조사가 시행되었습니다. 50% 기관에서 감염병에 대한 기본 대응능력을 가지고 있었지만 시설급여기관과 재가급여기관 사이 대응능력에 차이가 있었습니다.
Key Message
A survey of long-term care facilities (LTCFs) was conducted. Fifty per cent of LTCFs had a basic capacity to respond to infectious diseases. However, there were differences in response capacity between institution-based and home-based facilities.
Original article
Characteristics of imported and domestic malaria cases in Gyeonggi Province, Republic of Korea
Sunghee Hong, Jihye Kim, Soo-Nam Jo, Jong-Hun Kim, Boyoung Park, Bo Youl choi
Epidemiol Health. 2024;e2024087.   Published online November 8, 2024
DOI: https://doi.org/10.4178/epih.e2024087    [Accepted]
  • 498 View
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AbstractAbstract PDF
Abstract
OBJECTIVES
This study explored 11 years of malaria data from mandatory reporting in Gyeonggi Province, Korea, to provide information for prevention strategies by linkage to nationwide health claims data.
METHODS
Reported malaria cases in Gyeonggi Province from 2011 to 2021 were linked to medical usage data from the National Health Insurance Database. Data about hospitalization, antibiotic prescription and duration, malarial species, and sociodemographic information of the cases were included.
RESULTS
Between 2011 and 2021, a total of 3,011 malaria cases were reported, consisting of 2,828 domestic (93.9%) and 183 imported (6.1%) cases. Over 80% of the cases involved males, with the majority of patients being in their 20s. Both domestic and imported cases peaked between June and August over the years. Imported cases had a higher hospitalization rate (66.9%) compared to domestically-acquired cases (54.9%). There was a significant variation in treatment rates, with 80.7% of imported cases and 74.6% of domestic cases receiving treatment. For domestic cases, chloroquine combined with primaquine was the most commonly prescribed treatment (77.0%), while atovaquone-proguanil was frequently used for imported cases (25.9%). Plasmodium vivax was the predominant species in domestic cases (94.9%), whereas Plasmodium malariae was more common in imported cases (62.3%). The overall number of reported malaria cases declined following a sharp decrease in imported cases in 2020 and 2021.
CONCLUSIONS
Despite a decreasing trend in malaria cases reported in Gyeonggi Province, imported cases exhibited higher hospitalization rates and different antibiotic prescription and treatment patterns, reflecting the presence of a different malarial species.
Summary
Cohort Profile
Cohort profile: the Taiwan Initiative for Geriatric Epidemiological Research - a prospective cohort study on cognition
Pei-Iun Hsieh, Te-Hsuan Huang, Jeng-Min Chiou, Jen-Hau Chen, Yen-Ching Chen
Epidemiol Health. 2024;46:e2024057.   Published online June 25, 2024
DOI: https://doi.org/10.4178/epih.e2024057
  • 3,578 View
  • 383 Download
AbstractAbstract AbstractSummary PDF
Abstract
The Taiwan Initiative for Geriatric Epidemiological Research (TIGER) was founded in 2011 to elucidate the interrelationships among various predictors of global and domain-specific cognitive impairment, with the aim of identifying older adults with an increased risk of dementia in the preclinical phase. TIGER, a population-based prospective cohort, recruited 605 and 629 (total of 1,234) older adults (aged 65 and above) at baseline (2011-2013 and 2019-2022) of phase I and II, respectively. Participants have undergone structured questionnaires, global and domain-specific cognitive assessments, physical exams, and biological specimen collections at baseline and biennial follow-ups to date. By 2022, TIGER I has included 4 biennial follow-ups, with the participants comprising 53.9% female and having a mean age of 73.2 years at baseline. After an 8-year follow-up, the annual attrition rate was 6.1%, reflecting a combination of 9.9% of participants who passed away and 36.2% who dropped out. TIGER has published novel and multidisciplinary research on cognitive-related outcomes in older adults, including environmental exposures (indoor and ambient air pollution), multimorbidity, sarcopenia, frailty, biomarkers (brain and retinal images, renal and inflammatory markers), and diet. TIGER’s meticulous design, multidisciplinary data, and novel findings elucidate the complex etiology of cognitive impairment and frailty, offering valuable insights into factors that can be used to predict and prevent dementia in the preclinical phase.
Summary
Key Message
1. The Taiwan Initiative for Geriatric Epidemiological Research (TIGER), established in 2001, aims to fill the knowledge gap regarding the longitudinal associations between environmental exposure, clinical factors, and performance in global and cognitive domains. 2. TIGER has made significant findings in various aspects, including the effects of exposure to low-level air pollutants, indoor air quality, clinical factors (brain and retinal images, dental health), nutrition, and biomarkers on cognition over time. 3. TIGER's multidisciplinary data and advanced analysis elucidate the predictors of cognitive impairment, identifying older adults at increased risk of dementia in the preclinical phase for early prevention and intervention.
Original Articles
Contrasting income-based inequalities in incidence and mortality of breast cancer in Korea, 2006-2015
Jinwook Bahk, Hee-Yeon Kang, Young-Ho Khang, Kyunghee Jung-Choi
Epidemiol Health. 2024;46:e2024074.   Published online September 11, 2024
DOI: https://doi.org/10.4178/epih.e2024074
  • 1,073 View
  • 67 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Breast cancer incidence and mortality rates in Korea are increasing. This study analyzed income-based inequalities in the incidence and mortality of women breast cancer from 2006 to 2015, using national data that covered all Korean women.
METHODS
We used the National Health Information Database from 2006 to 2015. For women aged 20 and older, the age-standardized incidence and mortality rates of breast cancer per 100,000 by income quintile per year were calculated using the direct method. The rate ratio and rate difference (RD) of the age-standardized incidence and mortality rates of breast cancer per 100,000 between the top and bottom income quintiles were calculated as relative and absolute measures for inequalities.
RESULTS
When comparing 2006 and 2015, both the incidence and mortality rates of breast cancer increased. The lowest income quintile experienced higher mortality rates despite having lower incidence rates. In 2015, the income-based RD in incidence and mortality rates between the highest and lowest income quintiles (Q1-Q5) was -19.9 (95% confidence interval [CI], -24.3 to -15.5) and 4.4 (95% CI, 2.9 to 5.8), respectively. Throughout this period, there was no statistically significant trend in income-based disparities in breast cancer incidence and mortality. The age-specific contributions to the absolute magnitude of inequality (RD) in incidence and mortality were more pronounced among middle-aged women than among older women.
CONCLUSIONS
This study found that breast cancer in Korea exhibited pro-rich inequalities in mortality despite pro-poor inequalities in incidence. More equitable policies for screening and treatment of breast cancer are needed.
Summary
Korean summary
2006년부터 2015년 한국의 유방암 불평등 추세를 분석하면, 소득수준이 낮은 여성의 발생률은 상대적으로 낮음에도 불구하고 사망률은 높은 양상을 보였다. 유방암 검진과 치료에 있어 보다 형평성을 고려한 정책이 요구된다.
Key Message
This study found that breast cancer in Korea exhibited pro-rich inequalities in mortality despite pro-poor inequalities in incidence. More equitable policies for screening and treatment of breast cancer are needed.
The role of supervisor support in the association between night work and depressive symptoms: a gender-stratified analysis of 22,422 full-time wage workers in Korea
Hee Won Kim, Ji-Hwan Kim, Garin Lee, Hye-Lin Lee, Hayoung Lee, Seung-Sup Kim
Epidemiol Health. 2024;46:e2024079.   Published online September 25, 2024
DOI: https://doi.org/10.4178/epih.e2024079
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
This study investigated the relationship between night work, supervisor support, and depressive symptoms among full-time wage workers, with a focus on gender differences.
METHODS
A nationwide sample of 22,422 full-time wage workers from the Sixth Korean Working Conditions Survey (2020-2021) was analyzed. Experiences of night work were categorized into 5 groups based on the number of night work days per month: 0, 1-5, 6-10, 11-15, and 16-31. Depressive symptoms were evaluated using the 5-item World Health Organization Well-Being Index. Supervisor support was assessed with 5 items.
RESULTS
Workers who engaged in 1-5 days (prevalence ratio [PR], 1.23; 95% confidence interval [CI], 1.12 to 1.36) and 6- 10 days (PR, 1.17; 95% CI, 1.06 to 1.30) of night work per month exhibited a higher prevalence of depressive symptoms than those without night work. After stratifying by supervisor support levels, workers with 1-5 days, 6-10 days, and 11-15 days of night work per month were more likely to experience depressive symptoms compared to those without night work in the low supervisor support group. In contrast, no association was found between night work (≥6 days) and depressive symptoms in the high supervisor support group. Furthermore, gender differences were notable: female workers with 6-10 days (PR, 1.45; 95% CI, 1.23 to 1.70), and 11-15 days (PR, 1.43; 95% CI, 1.08 to 1.90) of night work per month exhibited a higher prevalence of depressive symptoms, whereas their male counterparts did not. This pattern of gender difference was also found among those with low supervisor support.
CONCLUSIONS
Supervisor support may mitigate the adverse effects of night work on depressive symptoms among full-time wage workers, with differences manifested across genders.
Summary
Korean summary
야간 노동을 하는 사람들의 숫자가 급격히 늘어나고 있다. 이들이 겪는 여러 정신건강의 어려움이 사회적으로 문제가 되고 있지만, 그와 관련해 상사의 사회적 지지가 어떠한 영향을 주고 또 그 영향이 성별에 따라 어떻게 다른 지 충분히 연구된 바 없다. 한국의 6 차 근로환경조사를 분석한 결과, 한달에 1-10 일 야간 노동을 하는 사람들에게서 우울증상이 높게 나타났다. 성별 층화 분석했을 때, 한달에 6-15 일 야간 근무를 하는 여성이 상사의 사회적 지지를 받지 못할 경우 우울 증상이 특히 두드러지는 것으로 나타났습니다. 이번 연구는 야간 노동이 정신 건강에 미치는 부정적 영향을 확인하고, 직장에서의 사회적 지지와 건강한 조직 문화를 조성할 필요성을 보여준다.
Key Message
Night workers play a crucial role in society yet face unique mental health challenges. While a growing body of research have focused on their health problems, the role of supervisor support remains unexplored. Using a nationally representative dataset of workers in Korea, we found that night work was associated with depressive symptoms, especially for those working 1- 10 nights monthly and for females conducting 6-15 days of night work. Strong supervisor support may modify these effects. Our findings underscore the need for organizations to acknowledge the adverse mental health consequences of night work and to foster a supportive workplace culture.
Systematic Reviews
Tea consumption and risk of all-cause, cardiovascular disease, and cancer mortality: a meta-analysis of thirty-eight prospective cohort data sets
Youngyo Kim, Youjin Je
Epidemiol Health. 2024;46:e2024056.   Published online June 21, 2024
DOI: https://doi.org/10.4178/epih.e2024056
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Tea consumption has been considered beneficial to human health because tea contains phytochemicals such as polyphenols and theaflavins. We conducted a systematic review and meta-analysis on the association between tea consumption and mortality from all causes, cardiovascular disease (CVD), and cancer to provide a quantitative assessment of current evidence.
METHODS
The PubMed, Web of Science, and Scopus databases were searched through April 2024 to identify eligible studies. Random effects models were used to combine study-specific effect estimates (ESs).
RESULTS
A total of 38 prospective cohort data sets (from 27 papers) with 1,956,549 participants were included in this meta-analysis. The pooled ESs of the highest versus lowest categories of tea consumption were 0.90 (95% confidence interval [CI], 0.86 to 0.95) for all-cause mortality, 0.86 (95% CI, 0.79 to 0.94) for CVD mortality, and 0.90 (95% CI, 0.78 to 1.03) for cancer mortality. In the dose-response analysis, a non-linear association was observed. The greatest risk reductions were observed for the consumption of 2.0 cup/day for all-cause mortality (ES, 0.91; 95% CI, 0.88 to 0.94) and 1.5 cup/day for cancer mortality (ES, 0.92; 95% CI, 0.89 to 0.96), whereas additional consumption did not show a further reduction in the risk of death. A plateau was observed for CVD mortality at moderate consumption levels (1.5-3.0 cup/day), but a sustained reduction in mortality risk was observed at higher intake levels.
CONCLUSIONS
Moderate tea consumption (e.g., 1.5-2.0 cup/day) was associated with lower all-cause, CVD, and cancer mortality compared to no tea consumption. Further well-designed prospective studies are needed for a definitive conclusion.
Summary
Korean summary
차는 전세계적으로 널리 소비되는 음료로 그 공중보건학적 영향력이 크다. 차의 섭취와 만성질환의 관련성은 아직 일관성 있게 결론이 나지 않았는데 최근에 이 주제에 대하여 대규모의 코호트 연구 결과들이 발표된 바 있었다. 38개의 코호트 데이터에 근거한 본 메타분석의 결과는 하루 한 잔 반에서 두 잔의 차를 마시는 것이 총사망위험과 심혈관계질환이나 암으로 인한 사망 위험을 낮추는 것과 관계가 있음을 나타내고 있다.
Key Message
Tea is a commonly consumed beverage worldwide and has a significant public health impact. The association between tea consumption and risk of mortality from chronic disease remains inconsistent, and extensive cohort studies have been published recently. In this meta-analysis, including thirty-eight cohort studies, people who drank one and a half to two cups of tea daily had a lower risk of mortality from all causes, cardiovascular disease, and cancer than those who drank less tea.

Citations

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  • Molecular mechanisms of action of DIM and its clinical application
    E. A. Nikitina, S. V. Orlova, T. T. Batysheva, N. V. Balashova, M. V. Alekseeva, A. N. Vodolazkaya, E. V. Prokopenko, Kh. A. Magomedova
    Medical alphabet.2024; (19): 9.     CrossRef
The effectiveness of protein supplementation combined with resistance exercise programs among community-dwelling older adults with sarcopenia: a systematic review and meta-analysis
Phatcharaphon Whaikid, Noppawan Piaseu
Epidemiol Health. 2024;46:e2024030.   Published online February 14, 2024
DOI: https://doi.org/10.4178/epih.e2024030
  • 5,570 View
  • 324 Download
  • 3 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
The combination of protein supplementation and resistance exercise shows promise for improving and maintaining muscle mass, strength, and performance in older adults with sarcopenia. This systematic review aimed to evaluate the effects of this combination on muscle mass, muscle strength, and physical performance in community-dwelling older adults with sarcopenia.
METHODS
We conducted a comprehensive search of 4 electronic databases: PubMed, Scopus, Embase, and the MEDLINE Library. The search covered literature from January 2013 to January 2023 and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two independent reviewers assessed the methodological quality of each study using the standard critical appraisal tool from the Joanna Briggs Institute (JBI). Meta-analysis was performed with the JBI Sumari program.
RESULTS
The review included 7 randomized controlled trials and 1 quasi-experimental study, encompassing a total of 854 participants aged 60 years and above. The study durations ranged from 10 weeks to 24 weeks. An analysis of standardized mean differences (SMDs) showed that protein supplementation combined with resistance exercise significantly increased muscle mass (SMD, 0.95; 95% confidence interval [CI], 0.13 to 1.78; p<0.05) and muscle strength (SMD, 0.32; 95% CI, 0.08 to 0.56; p<0.05).
CONCLUSIONS
Although the limited number of randomized controlled trials restricts the robustness of our conclusions, the evidence suggests that protein supplementation combined with resistance exercise is effective in enhancing muscle mass and strength in community-dwelling older adults with sarcopenia.
Summary
Key Message
Sarcopenia is a significant health concern. Given the contextual variations and the diverse factors that contribute to the prevalence of sarcopenia, delivering precision interventions to older adults diagnosed with sarcopenia who still reside in the community poses unique challenges. Therefore, precision interventions are vital for proper and feasible treatment planning, especially for early management actions, to reduce the impact of sarcopenia and its associated adverse effects in older adults. Our systematic review and meta-analysis showed that protein supplementation combined with resistance exercise is effective in enhancing muscle mass and strength in community-dwelling older adults with sarcopenia.

Citations

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  • The Impact of Protein in Post-Menopausal Women on Muscle Mass and Strength: A Narrative Review
    Katherine Elizabeth Black, Penelope Matkin-Hussey
    Physiologia.2024; 4(3): 266.     CrossRef
Original Article
Combined effect of anemia and chronic rhinitis on hearing loss in Korean adults: a nationwide observational study
Yeong Jun Ju, Woorim Kim, Jina Han, Soon Young Lee
Epidemiol Health. 2024;46:e2024063.   Published online July 15, 2024
DOI: https://doi.org/10.4178/epih.e2024063
  • 1,417 View
  • 73 Download
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Studies have suggested an association between hearing loss and anemia. Hearing loss has also been linked to rhinitis, which is characterized by inflammation of the nasal mucous membranes and sinus mucosa. Few studies have concurrently explored the relationships between hearing loss, anemia, and rhinitis. This study was conducted to investigate the association between hearing loss and anemia and to further analyze the potential role of rhinitis in this relationship.
METHODS
Data were collected from the 2020 Korea National Health and Nutrition Examination Survey. Hearing loss was measured with an audiometer in a soundproof booth and was defined as at least moderate impairment (as indicated by a pure-tone average of ≥41 dB in the better-hearing ear). The association between hearing loss and anemia was analyzed using multivariable logistic regression. The combined effect of anemia and rhinitis on hearing loss was assessed with an interaction term.
RESULTS
Among the 2,772 participants, 477 (17.2%) exhibited hearing loss. Participants with anemia were more likely to experience hearing loss than those without anemia (odds ratio [OR], 1.58; 95% confidence interval [CI], 1.07 to 2.33). Furthermore, the odds of hearing loss were greater in participants with both anemia and rhinitis (OR, 3.79; 95% CI, 1.93 to 7.43) relative to those without either condition.
CONCLUSIONS
Anemia was associated with hearing loss in individuals aged 40 years and older. Based on the analysis of combined effects, participants with anemia and chronic rhinitis were more likely to experience hearing loss than individuals without these conditions.
Summary
Korean summary
빈혈은 흔하고 잠재적으로 가역적인 상태이기 때문에, 이 연관성을 검토하는 것은 조기 및 효과적인 중재의 새로운 기회를 제시할 수 있습니다. 이 연구는 빈혈과 청력 손실 사이의 연관성을 평가하고, 이 관계에서 비염의 역할을 추가적으로 조사하는 것을 목표로 하였습니다. 연구 결과, 빈혈이 있는 개인들은 청력 손실을 겪을 가능성이 더 높다는 것이 확인되었으며, 특히 비염을 동시에 겪고 있는 경우에 두드러지게 나타났습니다. 이를 바탕으로, 청력 손실과 관련된 공중보건 문제를 해결하는 데 있어 빈혈과 비염의 효과적인 관리의 필요성을 강조합니다.
Key Message
Given that anemia is a prevalent and potentially reversible condition, examining this correlation could present novel opportunities for early and effective intervention. This study aimed to evaluate the association between anemia and hearing impairment, while further investigating the role of rhinitis in this relationship. Our findings indicated that individuals with anemia had a higher likelihood of experiencing hearing loss, particularly among those simultaneously affected by chronic rhinitis. Therefore, we emphasize the critical need for effective management of both anemia and rhinitis in addressing public health challenges related to hearing impairment.

Epidemiol Health : Epidemiology and Health
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