Epidemiology and Health

Original article

The association between the consumption of raw Kudoa septempunctata–infected farmed Paralichthys olivaceus and gastrointestinal symptoms: Jihye An, En-Joo Jung, Soon-Ok Lee, Jong-Hoon Choi, Jung Hee Kim, Sung-Jong Hong, Sung-Hee Hong, Jung-Wong Ju, Hyungjun Kim, Kwang-Pil Ko; Epidemiol Health. 2026;e2026003. Published online January 19, 2026; DOI: https://doi.org/10.4178/epih.e2026003 [Accepted]

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Abstract PDF: Abstract
OBJECTIVES
Kudoa septempunctata has been identified as the causative agent of food poisoning following the consumption of raw farmed Paralichthys olivaceus. However, cohort studies providing robust evidence for an association between K. septempunctata and gastrointestinal symptoms remain limited. This prospective cohort study investigated the association between the consumption of K. septempunctata–infected farmed P. olivaceus and the occurrence of gastrointestinal symptoms.
METHODS
Individuals who purchased raw farmed P. olivaceus between 2020 and 2021 were selected as the study population. Study data included 2 rounds of questionnaire surveys administered before and after consumption, 2 muscle specimens obtained from each purchased fish, and human biological specimens collected from individuals who developed gastrointestinal symptoms within 24 hours after consumption. Data were analyzed using the chi-square test and t-test, and the association between consumption of K. septempunctata–infected farmed P. olivaceus and gastrointestinal symptoms was evaluated using relative risk estimates between exposure groups.
RESULTS
The relative risk of gastrointestinal symptoms associated with exposure to K. septempunctata–infected P. olivaceus ranged from 71.2 (95% CI, 27.0–178.6) to 124.5 (95% CI, 43.5–355) across the 2 case definitions. A strong and statistically significant association was observed between exposure to K. septempunctata–infected P. olivaceus and the development of acute gastrointestinal symptoms.
CONCLUSIONS
These findings indicate both an association and a causal relationship between consumption of K. septempunctata–infected farmed P. olivaceus and the onset of gastrointestinal symptoms.; Summary

Original Articles

Dental implant removal rates and related factors in older adults in Korea: a cross-sectional study using National Health Insurance Sharing Service database: Hyang-Ah Park, A-Rang Lim, Jae-In Ryu; Epidemiol Health. 2025;47:e2025064. Published online December 3, 2025; DOI: https://doi.org/10.4178/epih.e2025064

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Abstract Summary PDF: Abstract
OBJECTIVES
Dental implants have been covered by the National Health Insurance for older adults in Korea since 2014. As the number of implant treatments has increased, the occurrence of related complications has also grown. While many clinical studies have examined mechanical and biological complications, few epidemiological studies using national data have identified population-level risk factors. This study aimed to determine the dental implant removal rate and related factors among older adults based on the Andersen Behavioral Model.
METHODS
A cross-sectional analysis was conducted using the National Health Insurance Service–National Sample Cohort. Logistic regression analyses were performed to identify factors associated with implant removal. Unadjusted and stepwise cumulative models were applied for predisposing, enabling, and need factors. All analyses were conducted using SPSS version 26.0, with statistical significance set at α=0.05.
RESULTS
The overall dental implant removal rate among older adults was approximately 0.4%. Higher removal rates were observed among males, those aged 65-69, current smokers, individuals with diabetes, and the self-employed group with higher income levels. Current smokers had 1.75 times higher odds of implant removal (95% confidence interval, 1.39 to 2.22) than non- smokers or former smokers.
CONCLUSIONS
Targeted education, management, and preventive interventions for high-risk groups, including smokers and patients with diabetes, are necessary to improve implant success and reduce complications. These findings provide population- based evidence to inform public health strategies that promote successful implant outcomes among older adults.; Summary

Korean summary
이 연구는 국가 단위의 빅데이터 코호트를 이용해 치과 임플란트 제거에 관해 시행한 선행 연구가 없었기 때문에 국가 빅데이터를 활용해 치과 임플란트 제거율과 관련 요인을 파악하기 위해 Anderson Model을 기반으로 다요인 분석을 실시하였다. 전체 치과 임플란트 제거율은 약 0.4%였으며, 남성, 젊은 연령, 건강보험 가입자, 상위 소득분위 자영업자, 당뇨병, 흡연, 유산소 신체 활동 실천자에서 더 높게 나타났다. 특히 현재 흡연자인 경우 치과 임플란트 제거율을 경험할 확률이 1.8배 높았다. 따라서, 치과 임플란트 시술의 성공률을 높이기 위해서는 위험요인에 대해 명시한 가이드라인 제작이 필수적이다.

Key Message
This study conducted a multifactorial analysis based on the Andersen model to identify factors associated with dental implant removal using national big data, addressing the lack of prior studies that examined these determinants sufficiently. The dental implant removal rate among all subjects was approximately 0.4%, and higher removal rates were observed among men, younger individuals, those receiving medical benefits, the self-employed group with higher income quintiles, and individuals with diabetes, smoking habits, or engagement in aerobic physical activity. Current smokers had a 1.8-fold higher probability of implant removal. These findings reinforce the importance of developing and implementing guidelines to increase the success rate of dental implants.

Personal, community, and societal factors associated with mukbang viewing among adolescents: findings from the Korea Youth Risk Behavior Survey: Cynthia Yursun Yoon, Seungha Shin, Haemi Jun, Hyeeun Park, Minseo Kim; Epidemiol Health. 2025;47:e2025055. Published online September 30, 2025; DOI: https://doi.org/10.4178/epih.e2025055

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Mukbang refers to livestreamed videos in which hosts consume large amounts of energy-dense, nutrient-poor foods while interacting with viewers. Mukbang is widely viewed by Korean adolescents and has been associated with adverse health outcomes. To inform efforts to prevent excessive engagement with mukbang content among Korean adolescents, this study examined personal, community, and societal factors associated with excessive mukbang viewing (≥7 times/wk) and explored gender differences in these associations.
METHODS
Data were drawn from the 2022 Korea Youth Risk Behavior Survey (n=36,990; mean age, 15.1±1.7 years; 48.6% girls; 53.2% attending middle school). Self-reported measures included personal (e.g., perceived health, weight, stress, depression, anxiety), community (e.g., living arrangement), and societal factors (e.g., socioeconomic status) and mukbang viewing frequency. Logistic and modified Poisson regression models were used to examine associations with excessive mukbang viewing and to evaluate differences by gender.
RESULTS
Intrapersonal factors—namely perceived health, weight, stress, depression, and anxiety—were associated with excessive mukbang viewing (adjusted prevalence ratios, 1.18 to 1.44), with more pronounced relationships among girls. A community-level factor—living arrangement—displayed a significant association in boys but not in girls. Boys living on campus had 1.42 times the prevalence of excessive mukbang viewing than boys residing with family members (95% confidence interval, 1.08 to 1.88) after adjustment. Further mutual adjustment attenuated estimates toward the null. Societal factors were not significantly associated with excessive mukbang viewing among adolescents.
CONCLUSIONS
Personal and community factors were associated with excessive mukbang viewing. Future research should investigate the mechanisms underlying these associations.; Summary

Korean summary
- 건강 인식 저하, 스트레스, 우울, 불안 등 개인적인 요인은 과도한 먹방 시청과 관련이 있었으며, 특히 여학생에게서 두드러져, 정서적 어려움이 먹방을 정서 조절이나 사회적 연결의 수단으로 활용할 가능성을 시사한다 - 기숙사에 거주하는 남학생이 가족과 거주하는 남학생보다 과도하게 먹방을 시청할 가능성이 높았으며, 이는 또래 영향과 지역사회의 환경이 먹방 시청에 중요한 역할을 함을 보여준다 - 사회경제적 수준은 과도한 먹방 시청과 유의한 관련은 없었으며, 이는 모든 청소년을 대상으로 정서적 건강과 건강한 미디어 사용을 촉진하는 보편적 예방 전략이 필요함을 시사한다

Key Message
- Personal factors such as poor perceived health, stress, depression, and anxiety were strongly related to excessive mukbang viewing, particularly among girls, suggesting that emotional distress may drive girls to engage with mukbang as a form of coping or personal connection - Among boys, those living on campus were more likely to view mukbang excessively than those living with family, indicating that community environment and peer influence may contribute to higher engagement in mukbang - Socioeconomic status was not significantly associated with excessive mukbang viewing, implying that prevention efforts should address emotional well-being and healthy media use across all adolescents, regardless of the background

Risk of non-cancer respiratory diseases attributed to humidifier disinfectant exposure in Koreans: age-period-cohort and differences-in-difference analyses: Jaiyong Kim, Kyoung Sook Jeong, Seungyeon Heo, Younghee Kim, Jungyun Lim, Sol Yu, Suejin Kim, Sun-Kyoung Shin, Hae-Kwan Cheong, Mina Ha, Epidemiology Expert Committee for Reviewing the Epidemiological Correlations between Humidifier Disinfectant Exposure and Health Effects; Epidemiol Health. 2025;47:e2025006. Published online February 22, 2025; DOI: https://doi.org/10.4178/epih.e2025006

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Humidifier disinfectants (HDs) were sold in Korea from 1994 until their recall in 2011. We examined the incidence patterns of 8 respiratory diseases before and after the HD recall and estimated the attributable risk in the Korean population.

METHODS

Using National Health Insurance data from 2002 to 2019, we performed age–cohort–period and differences-in-diffference analyses (comparing periods before vs. after the recall) to estimate the population-attributable fraction and the excess number of episodes. The database comprised 51 million individuals (99% of the Korean population). The incidence of 8 diseases—acute upper respiratory infection (AURI), acute lower respiratory infection (ALRI), asthma, pneumonia, chronic sinusitis (CS), interstitial lung disease (ILD), bronchiectasis, and chronic obstructive pulmonary disease (COPD)—was defined by constructing episodes of care based on patterns of medical care and the clinical characteristics of each disease.

RESULTS

The relative risks (RRs) for AURI, ALRI, asthma, pneumonia, CS, and ILD were elevated among younger individuals (with an RR as high as 82.18 for AURI in males), whereas chronic conditions such as bronchiectasis, COPD, and ILD showed higher RRs in older individuals. During the HD exposure period, the population-attributable risk percentage ranged from 4.6% for bronchiectasis to 25.1% for pneumonia, with the excess number of episodes ranging from 6,218 for ILD to 3,058,861 for CS. Notably, females of reproductive age (19-44 years) experienced 1.1-9.2 times more excess episodes than males.

CONCLUSIONS

This study provides epidemiological evidence that inhalation exposure to HDs affects the entire respiratory tract and identifies vulnerable groups.

Summary

Korean summary
- 2002년부터 2012년까지 가습기살균제 흡입 노출은 한국 인구의 호흡기 질환 중 4~25%에 기여했으며, 특히 천식, 폐렴, 간질성폐질환이 젊은 연령층에서 더 큰 영향을 보였다. - 기관지확장증과 간질성폐질환 같은 만성질환에서는 고령층에서 초과 발생 사례 수가 더 많았다. - 어린이, 노인, 가임기 여성이 취약집단으로 확인되었다.

Key Message
- From 2002 to 2012, humidifier disinfectant inhalation exposure contributed to 4–25% of respiratory diseases in Korea, with greater effects among younger people, especially for asthma, pneumonia, and interstitial lung disease. - Older individuals showed more excess episodes for chronic conditions like bronchiectasis and interstitial lung disease. - The young, the elderly, and reproductive-age women were identified as vulnerable groups in association with humidifier disinfectant exposure.

Citations

Citations to this article as recorded by

Association of respiratory diseases with humidifier disinfectants exposure and its latency: A study of health damage reporter cohort in South Korea
Jaiyong Kim, Kyoung Sook Jeong, Seungyeon Heo, Youngmee Lee, Taksoo Kim, Hye-Jin Kim, Suejin Kim, Hae-Kwan Cheong, Mina Ha
Ecotoxicology and Environmental Safety.2026; 309: 119552. CrossRef

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

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Abstract 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/m2 (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

A prospective association between dietary mushroom intake and the risk of type 2 diabetes: the Korean Genome and Epidemiology Study–Cardiovascular Disease Association Study: Yu-Mi Kim, Hye Won Woo, Min-Ho Shin, Sang Baek Koh, Hyeon Chang Kim, Mi Kyung Kim; Epidemiol Health. 2024;46:e2024017. Published online January 8, 2024; DOI: https://doi.org/10.4178/epih.e2024017

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Mushrooms, known for their nutritious and functional components, are considered healthy and medicinal. This study investigated the prospective association between dietary mushroom consumption and the incidence of type 2 diabetes among Korean adults aged ≥40 years.

METHODS

In total, 16,666 participants who were not taking anti-diabetic medication or insulin and had normal fasting blood glucose (FBG; <126 mg/dL) were included. We used the cumulative average dietary consumption of mushrooms as an exposure metric, calculated from food frequency questionnaires at every follow-up, along with covariates collected during a baseline survey. To estimate incidence rate ratios (IRRs) for type 2 diabetes, a modified Poisson regression model with a robust error estimator was applied.

RESULTS

In multivariable models, dietary mushroom consumption was inversely associated with type 2 diabetes incidence in both genders (men: IRR, 0.65; 95% confidence interval [CI], 0.47 to 0.90; plinearity=0.043 in the highest quartile (Q4) vs. the lowest quartile (Q1); women: IRR, 0.70; 95% CI, 0.54 to 0.93; plinearity=0.114 in Q4 vs. Q1). The inverse association remained after adjustment for dietary factors instead of dietary quality index, the baseline FBG, and the exclusion of incidence within the first year. Additionally, no significant interaction was found regarding the risk of type 2 diabetes between dietary mushroom consumption and participants’ gender or other factors.

CONCLUSIONS

Dietary mushroom consumption was inversely linked with the risk of type 2 diabetes incidence in both genders, indicating the beneficial role of mushrooms in preventing the disease.

Summary

Korean summary
- 흔히 사용하는 버섯의 식이 섭취량이 증가함에 따라 한국 40세 이상 성인에서 제2형 당뇨병 발생 위험이 낮았다. - 이러한 역관계는 성별과 다양한 식이 배경에서도 일관성을 유지하였고, 이는 버섯이 제2형 당뇨병 예방에 있어 잠재적인 식이요소로서의 가능성을 보여주는성을 보여주는 보여주는 결과이다.

Key Message
• Increased dietary consumption of commonly used mushrooms is associated with a lower risk of type 2 diabetes incidence among adults aged 40 years or older in Korea. • This inverse relationship remains consistent across genders and various dietary backgrounds, underscoring the potential of mushrooms as a preventive dietary component against.

Citations

Citations to this article as recorded by

Integrative Roles of Functional Foods, Microbiotics, Nutrigenetics, and Nutrigenomics in Managing Type 2 Diabetes and Obesity
Hong Nhung Lam, Shih-Ping Lin, Dang Hien Ngan Nguyen, Chiao-Ming Chen, Chien-Tien Su, Te-Chao Fang, Sing-Chung Li
Nutrients.2025; 17(4): 608. CrossRef
Protective Properties of the White Button Mushroom, Agaricus bisporus, in a Mouse Model of Colitis
Elaine Dempsey, Aaron M. Walsh, Supriya Yadav, Jude Wilson, Frederick J. Sheedy, Sinead C. Corr
Molecular Nutrition & Food Research.2025;[Epub] CrossRef
Underappreciated Health Benefits of Edible Mushrooms in the Dietary Management of Chronic Kidney Disease
Mona S. Calvo, Jaime Uribarri
Journal of Renal Nutrition.2025;[Epub] CrossRef

COVID-19: Original Article

The bounds of meta-analytics and an alternative method: Ramalingam Shanmugam, Mohammad Tabatabai, Derek Wilus, Karan P. Singh; Epidemiol Health. 2024;46:e2024016. Published online January 7, 2024; DOI: https://doi.org/10.4178/epih.e2024016

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Meta-analysis is a statistical appraisal of the data analytic implications of published articles (Y), estimating parameters including the odds ratio and relative risk. This information is helpful for evaluating the significance of the findings. The Higgins I2 index is often used to measure heterogeneity among studies. The objectives of this article are to amend the Higgins I2 index score in a novel and innovative way and to make it more useful in practice.

METHODS

Heterogeneity among study populations can be affected by many sources, including the sample size and study design. They influence the Cochran Q score and, thus, the Higgins I2 score. In this regard, the I2 score is not an absolute indicator of heterogeneity. Q changes by bound as Y increases unboundedly. An innovative methodology is devised to show the conditional and unconditional probability structures.

RESULTS

Various properties are derived, including showing that a zero correlation between Q and Y does not necessarily mean that they are independent. A new alternative statistic, S2, is derived and applied to mild cognitive impairment and coronavirus disease 2019 vaccination for meta-analysis.

CONCLUSIONS

A hidden shortcoming of the Higgins I2 index is overcome in this article by amending the Higgins I2 score. The usefulness of the proposed methodology is illustrated using 2 examples. The findings have potential health policy implications.

Summary

Key Message
An approach to overcome the hidden shortcomings of Higgens I2 in meta-analysis. The approach has potential health policy implications.

Citations

Citations to this article as recorded by

Practicing Meta-Analytics with Rectification
Ramalingam Shanmugam, Karan P. Singh
Publications.2025; 13(1): 2. CrossRef
A New Measure for an Acceptable Level of Homogeneity in Meta-Informatics
Ramalingam Shanmugam, Karan P. Singh
Mathematics.2025; 13(9): 1364. CrossRef

Original Articles

Smoking-attributable mortality among Korean adults in 2019: Yeun Soo Yang, Keum Ji Jung, Heejin Kimm, Sunmi Lee, Sun Ha Jee; Epidemiol Health. 2024;46:e2024011. Published online December 19, 2023; DOI: https://doi.org/10.4178/epih.e2024011

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Abstract Summary PDF: Abstract
OBJECTIVES
Tobacco use ranks among the leading preventable causes of death worldwide. This study was conducted to calculate the mortality rate attributable to smoking in Korea for 2019 and to highlight the importance of tracking and monitoring smoking-related deaths for public health purposes.
METHODS
Population attributable risk (PAR) was used to estimate the number of deaths related to smoking in 2019. PAR percentages were applied to the estimated mortality figures for various diseases, with PAR determined based on relative risk (RR). Levin’s formula was used to calculate PAR, and RR was adjusted for age and alcohol consumption using Cox proportional hazards regression model to derive disease-specific regression coefficients. The analysis incorporated previously determined smoking rates from 1985, and use rates of novel tobacco products were not considered.
RESULTS
The findings revealed a total of 67,982 smoking-attributable deaths in Korea in 2019, 56,993 of which occurred in men and 11,049 in women. The PAR of smoking for various causes of death in adult men was highest for lung cancer at 74.9%, followed by pneumonia (29.4%), ischemic heart disease (42.3%), and stroke (30.2%). For women, the PAR for smoking-related death was highest for lung cancer (19.9%), followed by stroke (7.6%), pneumonia (5.7%), and ischemic heart disease (9.1%).
CONCLUSIONS
In countries experiencing rapid fluctuations in smoking rates, including Korea, regular studies on smoking-related mortality is imperative. Furthermore, it is necessary to investigate smoking-related deaths, including the prevalence of novel tobacco product use, to accurately gauge the risks associated with emerging tobacco products.; Summary

Korean summary
이 연구는 2019년 한국에서 흡연으로 인한 사망률을 계산하고 공중 보건 목적을 위한 흡연 관련 사망추적 및 모니터링의 중요성을 강조합니다. 연구 결과, 2019년 한국에서 흡연으로 인해 총 67,982명이 사망했으며, 이 중 남성이 56,993명, 여성이 11,049명이었습니다. 특히 남성의 경우 폐암(74.9%), 여성의 경우 폐암(19.9%)에서 흡연으로 인한 사망 위험이 가장 높게 나타났습니다.

Key Message
This study analyzed deaths attributable to smoking in Korea in 2019, revealing that a total of 67,982 individuals lost their lives due to smoking. Among these, 56,993 were men and 11,049 were women, with the highest smoking-related mortality rate observed in men due to lung cancer at 74.9%, and in women due to lung cancer at 19.9%. Through these findings, this research emphasizes the importance of tracking and monitoring smoking-related deaths for public health.

Risk factors for early-onset lung cancer in Korea: analysis of a nationally representative population-based cohort: Jihun Kang, Taeyun Kim, Kyung-Do Han, Jin-Hyung Jung, Su-Min Jeong, Yo Hwan Yeo, Kyuwon Jung, Hyun Lee, Jong Ho Cho, Dong Wook Shin; Epidemiol Health. 2023;45:e2023101. Published online November 21, 2023; DOI: https://doi.org/10.4178/epih.e2023101

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
We examined the associations of socioeconomic factors, health behaviors, and comorbidities with early-onset lung cancer.

METHODS

The study included 6,794,287 individuals aged 20-39 years who participated in a Korean national health check-up program from 2009 to 2012. During the follow-up period, 4,684 participants developed lung cancer. Multivariable Cox regression analysis was used to estimate the independent associations of potential risk factors with incident lung cancer.

RESULTS

Older age (multivariable hazard ratio [mHR], 1.13; 95% confidence interval [CI], 1.12 to 1.14) and female sex (mHR, 1.62; 95% CI, 1.49 to 1.75) were associated with increased lung cancer risk. Current smoking was also associated with elevated risk (<10 pack-years: mHR, 1.12; 95% CI, 1.01 to 1.24; ≥10 pack-years: mHR, 1.30; 95% CI, 1.18 to 1.45), but past smoking was not. Although mild alcohol consumption (<10 g/day) was associated with lower lung cancer risk (mHR, 0.92; 95% CI, 0.86 to 0.99), heavier alcohol consumption (≥10 g/day) was not. Higher income (highest vs. lowest quartile: mHR, 0.86; 95% CI, 0.78 to 0.94), physical activity for at least 1,500 metabolic equivalent of task-min/wk (vs. non-exercisers: mHR, 0.83; 95% CI, 0.69 to 0.99) and obesity (vs. normal weight: mHR, 0.89; 95% CI, 0.83 to 0.96) were associated with lower lung cancer risk, whereas metabolic syndrome was associated with increased risk (mHR, 1.13; 95% CI, 1.03 to 1.24).

CONCLUSIONS

In young adults, age, female sex, smoking, and metabolic syndrome were risk factors for early-onset lung cancer, while high income, physical activity, and obesity displayed protective effects.

Summary

Korean summary
나이, 여성, 흡연, 그리고 대사 증후군은 조기 발생 폐암의 위험도 증가와 연관이 있었다. 반면에 높은 소득, 신체 활동, 비만은 젊은 성인에서 폐암 발생의 위험도 감소와 연관성을 나타내었다.

Key Message
Age, female sex, smoking, and metabolic syndrome were risk factors for early-onset lung cancer. While, high income, physical activity, and obesity displayed protective effects on the development of lung cancer in young adults.

Citations

Citations to this article as recorded by

Comprehensive characterization of early-onset lung cancer, in Chinese young adults
Ye Tian, Rui Ma, Wenchang Zhao, Shumin Wang, Chuanjiang Zhou, Weibing Wu, Bo Yang, Hua Xin, Hongyan Wang, Pengfei Li, Ranhua Li, Changhong Liu, Yao Lu, Qian Yu, Chengyang Song, Han Zhang, Ruipu Liang, Lei Zhang, Di Zhou, Xitong Zhao, Zhuo Wu, Yafei Qi, Ru
Nature Communications.2025;[Epub] CrossRef
Early-onset lung cancer in Asia: a narrative review
Roselle B. De Guzman
Frontiers in Oncology.2025;[Epub] CrossRef
Emerging Trends in Global Lung Cancer Burden
Lynn Y.-W. Shong, David C.-L. Lam
Seminars in Respiratory and Critical Care Medicine.2025; 46(05): 409. CrossRef
Association between long-term exposure to a mixture of ambient air pollutants and the incidences of bladder and kidney cancers
Chung Ho Kim, Seyoung Kim, Yoon-Hee Kang, Soontae Kim, Byungmi Kim, Bomi Park
Environmental Research.2025; 285: 122667. CrossRef

Trends in the effects of socioeconomic position on physical activity levels and sedentary behavior among Korean adolescents: Hunju Lee, Hyowon Choi, Sang Baek Koh, Hyeon Chang Kim; Epidemiol Health. 2023;45:e2023085. Published online September 8, 2023; DOI: https://doi.org/10.4178/epih.e2023085

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Abstract

OBJECTIVES
We examined trends in physical activity and sedentary behavior in Korean adolescents, and their association with socioeconomic position (SEP).

METHODS

We used data from the Korea Youth Risk Behavior Survey, a nationwide study involving students aged 12-19 conducted between 2009 and 2021. SEP was assessed based on economic status, parental education attainment, and urbanization. Physical activity was categorized into vigorous physical activity, moderate physical activity, and muscle training, and sedentary time was also measured. We conducted the log-binomial regression to calculate prevalence ratios (PRs) and prevalence differences.

RESULTS

Our analysis included a total of 593,896 students. We observed an increasing trend in physical activity, but a worsening trend in sedentary behavior. A positive association was found between an adolescent’s physical activity and SEP indicators, except for urbanization. Adolescents with higher economic status engaged in more vigorous physical activity (high: PR, 1.26; 95% confidence interval [CI], 1.25 to 1.28; middle: PR, 1.03; 95% CI, 1.02 to 1.04). Similar associations were observed for father’s education (tertiary or above: PR, 1.11; 95% CI, 1.09 to 1.13; upper secondary: PR, 1.05; 95% CI, 1.03 to 1.07) and mother’s education (tertiary or above: PR, 1.17; 95% CI, 1.15 to 1.20; upper secondary: PR, 1.06; 95% CI, 1.04 to 1.08). Adolescents with higher economic status also showed a higher compliance rate with the guideline restricting sedentary time to 2 hours per day (high: PR, 1.28; 95% CI, 1.25 to 1.30; middle: PR, 1.03; 95% CI, 1.01 to 1.05).

CONCLUSIONS

Adolescents with higher SEP exhibited more physical activity and less sedentary time than those with lower SEP.

Summary

Korean summary
본 연구는 2009년부터 2021년까지 청소년의 사회경제적 지위가 신체활동과 좌식생활습관에 미치는 영향을 분석하였다. 청소년의 경제적 상태, 아버지와 어머니의 교육수준이 높을수록 청소년의 신체활동이 증가하고 좌식생활이 감소하였다. 그러나 청소년이 사는 지역의 도시화 정도는 영향을 미치지 않았다.

Key Message
This article analyzes the effects of an adolescent's socio-economic position on their physical activity and sedentary behavior from 2009 to 2021. The higher the adolescent's economic status, father's education, or mother's education, the more they engaged in physical activity and the less time they spent in sedentary behaviors. However, the level of urbanization in the area where the adolescent resided had no effect.

Citations

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Global trends in importance of 24-hour movement behaviors to pediatric health: implications for South Korea
Eun-Young Lee, Reyana Jayawardena, Seiyeong Park, Justin Y Jeon, Yeon-Soo Kim, Mark S. Tremblay
Clinical and Experimental Pediatrics.2025; 68(1): 16. CrossRef
Socioeconomic disparities in depression risk: Limitations of the moderate effect of physical activity changes in Korea
Su Kyoung Lee, Yong Jin Kwon, Zulkarnain Jaafar
PLOS ONE.2025; 20(2): e0314930. CrossRef
Trends in overweight and socioeconomic inequality among children and adolescents aged 7–18 years in China from 2010 to 2020
Zhidong Zhou, Jianhua Zhang, Chengyue Li, Yi Wan, Jianwu Liu, Tao He
BMC Public Health.2025;[Epub] CrossRef
Physical exercise and adolescent mental toughness: mediating effects of family support and socioeconomic status
Weihan Yuan, Guihong Wang, Zixian Wang
Frontiers in Psychology.2025;[Epub] CrossRef
Association Between Sedentary Behavior and Body Image Distortion Among Korean Adolescents Considering Sedentary Purpose
Suin Park, Heesoo Lee, Wanhyung Lee, Mi-Jeong Lee
Children.2025; 13(1): 20. CrossRef
Gender Differences in the Association Between Sedentary Behavior and Mental Health Among Korean Adolescents: Analysis of the 2021 Korea Youth Risk Behavior Survey
Kyong Sil Park
Journal of Korean Public Health Nursing.2025; 39(3): 423. CrossRef
Using structural equation modeling to explore the influences of physical activity, mental health, well-being, and loneliness on Douyin usage at bedtime
Hongcheng Luo, Xing Zhang, Songpeng Su, Mingyang Zhang, Mingyue Yin, Siyuan Feng, Rui Peng, Hansen Li
Frontiers in Public Health.2024;[Epub] CrossRef
The Association between Social Isolation and Physical Activity among Korean Adolescents
Sarang Jang, Na-Young Park
Children.2024; 11(8): 1003. CrossRef
Analysis of Nutrition Knowledge After One Year of Intervention in a National Extracurricular Athletics Program: A Cross-Sectional Study with Pair-Matched Controls of Polish Adolescents
Dominika Skolmowska, Dominika Głąbska, Dominika Guzek, Jakub Grzegorz Adamczyk, Hanna Nałęcz, Blanka Mellová, Katarzyna Żywczyk, Krystyna Gutkowska
Nutrients.2024; 17(1): 64. CrossRef

The association between glaucoma and all-cause mortality in middle-aged and elderly Chinese people: results from the China Health and Retirement Longitudinal Study: Xiaoxu Huang, Mengqiao Xu, Minwen Zhou, Wenjia Liu, Xiaohuan Zhao, Xiaodong Sun; Epidemiol Health. 2023;45:e2023066. Published online July 21, 2023; DOI: https://doi.org/10.4178/epih.e2023066

15,848 View
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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This population-based, prospective cohort study investigated the association between glaucoma and mortality in older adults.

METHODS

Participants aged 45 years or older at baseline (47.9% male) were enrolled in 2011 for the China Health and Retirement Longitudinal Study (CHARLS). All-cause mortality was observed during 7 years of follow-up. The baseline data were collected in the 2011 CHARLS, and participants were followed up for 7 years (until 2018). The risk of all-cause mortality was investigated using Cox proportional-hazards regression with age as the time scale, adjusting for significant risk factors and comorbid conditions.

RESULTS

Among the 14,803 participants included, the risk of all-cause death was significantly higher among people with glaucoma than among those without glaucoma, after adjustment for other confounders (hazard ratio [HR], 1.46; 95% confidence interval [CI], 1.04 to 2.03). In a subgroup analysis based on the mean age of death, among those who were 75 years and older (n=1,231), the risk of all-cause death was significantly higher in patients with glaucoma than in those without glaucoma (HR, 1.89; 95% CI, 1.24 to 1.89).

CONCLUSIONS

Participants with glaucoma had a higher risk of all-cause mortality, especially those aged 75 years and above. Our findings revealed potential mechanisms underlying an association between glaucoma and all-cause mortality. They also highlighted the importance of glaucoma management to prevent premature death in middle-aged and older adults.

Summary

Key Message
The present study suggests that glaucoma is associated with a higher rate of mortality in middle-aged and elderly people in China, especially for those aged 75 years and older. This study provides an important reference for the design and evaluation of clinical glaucoma treatment and the management of patients of different ages.

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Exploring association between ambient air pollution and glaucoma in China: a nationwide analysis with predictive modeling based on the China Health and Retirement Longitudinal Study
Xiang Li, Zhan-Yang Luo, Sen Lei, Zhi-Jie Zhang, Jia-feng Tang, Yi-qing Sun
Frontiers in Public Health.2025;[Epub] CrossRef
Estimated glucose disposal rate and its dual role in hyperlipidemia risk and mortality: a secondary analysis of retrospective cohort data from U.S. and Chinese
Shouxin Wei, Sijia Yu, Chuan Qian, Zhengwen Xu, Yindong Jia, Bo Chen
Lipids in Health and Disease.2025;[Epub] CrossRef

Prediction of the 10-year risk of atherosclerotic cardiovascular disease in the Korean population: Sangwoo Park, Yong-Giun Kim, Soe Hee Ann, Young-Rak Cho, Shin-Jae Kim, Seungbong Han, Gyung-Min Park; Epidemiol Health. 2023;45:e2023052. Published online May 12, 2023; DOI: https://doi.org/10.4178/epih.e2023052

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Proper risk assessment is important for the primary prevention of atherosclerotic cardiovascular disease (ASCVD). However, no validated risk prediction tools are currently in use in Korea. This study sought to develop a 10-year risk prediction model for incident ASCVD.

METHODS

Using the National Sample Cohort of Korea, 325,934 subjects aged 20-80 years without previous ASCVD were enrolled. ASCVD was defined as a composite of cardiovascular death, myocardial infarction, and stroke. The Korean atherosclerotic cardiovas cular disease risk prediction (K-CVD) model was developed separately for men and women using the development dataset and validated in the validation dataset. Furthermore, the model performance was compared with the Framingham risk score (FRS) and pooled cohort equation (PCE).

RESULTS

Over 10 years of follow-up, 4,367 ASCVD events occurred in the overall population. The predictors of ASCVD included in the model were age, smoking status, diabetes, systolic blood pressure, lipid profiles, urine protein, and lipid-lowering and blood pressure-lowering treatment. The K-CVD model had good discrimination and strong calibration in the validation dataset (time-dependent area under the curve=0.846; 95% confidence interval, 0.828 to 0.864; calibration χ2=4.73, goodness-of-fit p=0.32). Compared with our model, both FRS and PCE showed worse calibration, overestimating ASCVD risk in the Korean population.

CONCLUSIONS

Through a nationwide cohort, we developed a model for 10-year ASCVD risk prediction in a contemporary Korean population. The K-CVD model showed excellent discrimination and calibration in Koreans. This population-based risk prediction tool would help to appropriately identify high-risk individuals and provide preventive interventions in the Korean population.

Summary

Korean summary
국민건강보험공단 표본 코호트를 이용하여, 한국인 인구에서 10년 죽상경화성 심혈관질환 위험 예측 (K-CVD) 모델을 개발하였다. 한국인 인구집단을 기반으로 개발된 K-CVD 모델은 한국 인구집단에서 판별력과 교정력 측면에서 우수한 성능을 보여주었다. K-CVD 모델은 한국인 집단에서 심혈관질환의 고위험군을 적절하게 식별하고, 예방적 중재를 시행하는데 있어 도움이 될 것으로 생각된다.

Key Message
Using a nationwide cohort, the Korean ASCVD risk prediction (K-CVD) model was developed for 10-year ASCVD risk prediction. The K-CVD model showed excellent discrimination and calibration in a contemporary Korean population. This population-based risk prediction tool would help to appropriately identify high-risk individuals and provide preventive interventions in the Korean population.

Citations

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Increased risk of colorectal cancer in young males with higher cardiovascular risk: A nationwide population-based cohort study
Ji Hyun Song, Su-Yeon Choi, Young Sun Kim, Sun Young Yang, Kyung-Do Han
World Journal of Gastrointestinal Oncology.2025;[Epub] CrossRef
Atherosclerotic Cardiovascular Disease Risk Prediction Models in China, Japan, and Korea
Patricia K. Nguyen, Dong Zhao, Tomonori Okamura, Hyeon Chang Kim, Nathan D. Wong, Eugene Yang
JACC: Asia.2025; 5(3): 333. CrossRef

Association of group-level segregation with cardiovascular health in older adults: an analysis of data from the Korean Social Life, Health, and Aging Project: Sung-Ha Lee, Hyeok-Hee Lee, Kiho Sung, Yoosik Youm, Hyeon Chang Kim; Epidemiol Health. 2023;45:e2023041. Published online April 4, 2023; DOI: https://doi.org/10.4178/epih.e2023041

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The adverse health effects of individual-level social isolation (e.g., perceived loneliness) have been well documented in older adults. However, little is known about the impact of collective-level social isolation on health outcomes. We sought to examine the association of group-level segregation with cardiovascular health (CVH) in older adults.

METHODS

From the prospective Korean Social Life, Health, and Aging Project database, we identified 528 community-dwelling older adults who were aged ≥60 years or were married to those aged ≥60 years. Participants who belonged to smaller social groups separate from the major social group were defined as group-level-segregated. The CVH score was calculated as the number of ideal non-dietary CVH metrics (0-6), as modified from the American Heart Association’s Life’s Simple 7. Using ordinal logistic regression models, we assessed cross-sectional and longitudinal associations between group-level segregation and CVH.

RESULTS

Of the 528 participants (mean age, 71.7 years; 60.0% female), 108 (20.5%) were segregated at baseline. In the crosssectional analysis, group-level segregation was significantly associated with lower odds of having a higher CVH score at baseline after adjusting for socio-demographic factors and cognitive function (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.43 to 0.95). Among 274 participants who completed an 8-year follow-up, group-level segregation at baseline was marginally associated with lower odds of having a higher CVH score at 8 years (OR, 0.49; 95% CI, 0.24 to 1.02).

CONCLUSIONS

Group-level segregation was associated with worse CVH. These findings imply that the social network structure of a community may influence its members’ health status.

Summary

Korean summary
본 연구는 “한국인의 사회적 삶, 건강과 노화에 대한 조사”(Korean Social Life, Health and Aging Project, KSHAP)에서 측정한 한 지역 내의 사회적 연결망 자료를 이용하여 사회적 분리와 심혈관 건강 사이의 관계를 살펴보았다. 그 결과, 사회적 분리는 비만, 고혈압, 콜레스테롤, 흡연, 음주 신체적 활동 등을 종합한 ‘라이프 심플 7’ 지표와 부정적인 관련성을 보였으며, 8년 후 추적 조사에서도 이 패턴이 유지되었다. 본 연구 결과는 사회적, 집단적 분리 현상이 신체적 건강에도 악영향을 초래할 수 있음을 시사한다.

Key Message
Using the prospective Korean Social Life, Health, and Aging Project (KSHAP) database, we discovered that group-level segregation was significantly associated with worse cardiovascular health (CVH). Also, we observed a tendency for baseline group-level segregation to be linked to worse CVH after an 8-year follow-up period. These findings emphasize the significance of group-level segregation as a potential contributing factor in the health outcomes of older adults.

Citations

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Association of social isolation and loneliness with the risk of hypertension in middle aged and older adults: Findings from a national representative longitudinal survey
Shiqi Wang, Hao Zhang, Yiling Lou, Qiqi You, Qingqing Jiang, Shiyi Cao
Journal of Affective Disorders.2024; 349: 577. CrossRef

Clinical traits and systemic risks of familial diabetes mellitus according to age of onset and quantity: an analysis of data from the community-based KoGES cohort study: Ju-Yeun Lee, Kyungsik Kim, Sangjun Lee, Woo Ju An, Sue K. Park; Epidemiol Health. 2023;45:e2023029. Published online February 23, 2023; DOI: https://doi.org/10.4178/epih.e2023029

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The aim of this study was to clarify the clinical trait of familial diabetes mellitus (DM) by analyzing participants’ risk of DM according to the age of DM onset in parents and siblings, and to evaluate individuals’ risk of DM-associated cardiometabolic diseases.

METHODS

Altogether, 211,173 participants aged ≥40 years from the Korean Genome and Epidemiology Study were included in this study. The participants were divided into groups based on the number (1 or 2 relatives) and age of onset (no DM and early, common, or late onset) of familial DM. Participants’ risk of DM was assessed using a Cox regression model with hazard ratios and 95% confidence intervals (CIs). A logistic regression model with odds ratios was used to evaluate associations among the participants’ likelihood of acquiring cardiometabolic diseases such as hypertension, chronic kidney disease (CKD), and cardiovascular disease.

RESULTS

The risk of developing DM was 2.02-fold (95% CI, 1.88 to 2.18) and 2.88-fold (95% CI, 2.50 to 3.33) higher, respectively, in participants with 1 and 2 family members diagnosed with familial DM. It was 2.72-fold (95% CI, 2.03 to 3.66) higher in those with early-onset familial DM. In the early-onset group, the respective risks of hypertension and CKD were 1.87-fold (95% CI, 1.37 to 2.55) and 4.31-fold (95% CI, 2.55 to 7.27) higher than in the control group.

CONCLUSIONS

The risk of DM and related cardiometabolic diseases was positively associated with the number of family members diagnosed with DM and an early diagnosis in family members with DM.

Summary

Korean summary
본 연구는 한국인유전체역학조사사업 역학자료를 이용하여, 당뇨병을 진단받은 가족 구성원 (부모 및 형제)의 수가 많고 당뇨병이 조기에 발생할수록 개인의 당뇨발생 위험도가 높아짐을 보고하였습니다. 또한 당뇨병이 조기에 발생한 가족구성원이 있을 경우 개인의 일부 심대사질환과의 연관성이 있을 수 있음을 설명하였습니다.

Key Message
This study demonstrated that the risk of diabetes in individuals was significantly associated with the quantity and the onset of family members diagnosed with diabetes. We also explained that having a family member with early-onset diabetes can be associated with some cardiometabolic diseases in individuals.

Citations

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Assessing blood sugar measures for predicting new-onset diabetes and cardiovascular disease in community-dwelling adults
Jung-Hwan Kim, Yaeji Lee, Chung-Mo Nam, Yu-Jin Kwon, Ji-Won Lee
Endocrine.2024; 86(2): 528. CrossRef

Nationwide trends in the incidence of tuberculosis among people with disabilities in Korea: a nationwide serial cross-sectional study: Jinsoo Min, So Young Kim, Jong Eun Park, Yeon Yong Kim, Jong Hyock Park; Epidemiol Health. 2022;44:e2022098. Published online October 28, 2022; DOI: https://doi.org/10.4178/epih.e2022098

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Studies on the association between disabilities and tuberculosis (TB) are scarce. We aimed to assess the risk of active TB disease among people with disabilities.

METHODS

We conducted a nationwide serial cross-sectional study using national registry linkage databases from 2008 to 2017. The crude and age-standardized and sex-standardized incidence rates of TB were analyzed for each year according to the presence, type, and severity of disabilities. The crude incidence rate and odds of developing TB disease were examined with a multivariable logistic regression model using data from 2017.

RESULTS

The overall incidence of active TB decreased between 2008 and 2017. The age- and sex-standardized incidence rates of TB disease among people with disabilities were significantly higher than among those without disabilities throughout all observed years (p<0.001). As of 2017, the population with disabilities had a higher crude incidence rate of active TB disease than that without disabilities (119.9/100,000 vs. 48.5/100,000 person-years, p<0.001), regardless of sex, income level, and place of residence. Compared to those without disabilities, those with disabilities had higher odds of active TB (adjusted odds ratio [aOR], 1.19; 95% confidence interval [CI], 1.15 to 1.24). Individuals with mental disabilities (aOR, 1.51; 95% CI, 1.24 to1.84) had the highest odds of active TB incidence, followed by those with developmental disabilities (aOR, 1.30; 95% CI, 1.09 to 1.55).

CONCLUSIONS

People with disabilities are at a greater risk of developing TB disease. Active screening and care for TB cases would be beneficial for people with disabilities.

Summary

Korean summary
장애가 있는 사람은 이차적 건강 문제가 발생할 가능성이 더 높고 그들의 건강결정요인은 결핵 발생 위험 요인과 겹친다. 장애인은 비장애인에 비해 연령과 성별에 관계없이 활동성 결핵 발병률이 현저히 높았으며, 장애 유형 중 정신장애와 발달장애가 결핵에 더 취약한 것으로 나타났다. 장애인과 같이 결핵 감염 위험이 있는 취약계층을 파악하고 이들에게 결핵진단 및 항결핵치료의 어려움을 극복할 수 있도록 다학제적 지원을 제공하는 것이 중요하겠다.

Key Message
People with disabilities are more likely to develop secondary health conditions and their social determinants of health overlap with the risk factors for developing TB disease. We found that compared to people without disabilities, a markedly higher incidence of active TB disease among people with disabilities regardless of age and sex, and mental and developmental disabilities among types of disability were more prone to TB disease. It is critical to identify the vulnerable populations, such as people with disabilities, at risk of developing TB infection and provide them with multidisciplinary support to overcome any barriers during TB diagnosis and anti-TB treatment.

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Long-Term Mortality After Tuberculosis Among People With Disabilities in Korea
Jinsoo Min, So Young Kim, Jong Eun Park, Yeon Yong Kim, Hee Soo Yang, Bo Hui Park, Seong Woo Jeon, Yu Jin Kim, Bumhee Yang, Kyoung Eun Yeob, Jong Hyock Park
Journal of Korean Medical Science.2026;[Epub] CrossRef
People with disabilities are at risk of osteoporotic fractures: a population-based study in South Korea
Ji Hyoun Kim, So Young Kim, Jong Eun Park, Yo Han Im, Hyunjeong Cho, Yeon Yong Kim, Jong-Hyock Park
Journal of Public Health.2025; 47(4): 858. CrossRef
HIV knowledge and access to testing for people with and without disabilities in low‐ and middle‐income countries: evidence from 37 Multiple Indicator Cluster Surveys
Sara Rotenberg, Shanquan Chen, Jill Hanass‐Hancock, Calum Davey, Lena Morgon Banks, Hannah Kuper
Journal of the International AIDS Society.2024;[Epub] CrossRef
The Korea National Disability Registration System
Miso Kim, Wonyoung Jung, So Young Kim, Jong Hyock Park, Dong Wook Shin
Epidemiology and Health.2023; 45: e2023053. CrossRef
Nationwide Trends in Osteoporosis in Koreans With Disabilities From 2008 to 2017
Ji Hyoun Kim, So Young Kim, Jong Eun Park, Hyo Jong Kim, Hyun Jeong Jeon, Yeon Yong Kim, Jong‐Hyock Park
JBMR Plus.2023;[Epub] CrossRef
Growing disparity in the prevalence of chronic obstructive pulmonary disease between people with and without disabilities: a Korean nationwide serial cross-sectional study
Jinsoo Min, Jong Eun Park, So Young Kim, Yeon Yong Kim, Jong Hyock Park
Scientific Reports.2023;[Epub] CrossRef

Prediction of cancer survivors’ mortality risk in Korea: a 25-year nationwide prospective cohort study: Yeun Soo Yang, Heejin Kimm, Keum Ji Jung, Seulji Moon, Sunmi Lee, Sun Ha Jee; Epidemiol Health. 2022;44:e2022075. Published online September 13, 2022; DOI: https://doi.org/10.4178/epih.e2022075

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study aimed to investigate the factors affecting cancer survival and develop a mortality prediction model for Korean cancer survivors. Our study identified lifestyle and mortality risk factors and attempted to determine whether health-promoting lifestyles affect mortality.

METHODS

Among the 1,637,287 participants in the Korean Cancer Prevention Study (KCPS) cohort, 200,834 cancer survivors who were alive after cancer diagnosis were analyzed. Discrimination and calibration for predicting the 10-year mortality risk were evaluated. A prediction model was derived using the Cox model coefficients, mean risk factor values, and mean mortality from the cancer survivors in the KCPS cohort.

RESULTS

During the 21.6-year follow-up, the all-cause mortality rates of cancer survivors were 57.2% and 39.4% in men and women, respectively. Men, older age, current smoking, and a history of diabetes were high-risk factors for mortality, while exercise habits and a family history of cancer were associated with reduced risk. The prediction model discrimination in the validation dataset for both KCPS all-cause mortality and KCPS cancer mortality was shown by C-statistics of 0.69 and 0.68, respectively. Based on the constructed prediction models, when we modified exercise status and smoking status, as modifiable factors, the cancer survivors’ risk of mortality decreased linearly.

CONCLUSIONS

A mortality prediction model for cancer survivors was developed that may be helpful in supporting a healthy life. Lifestyle modifications in cancer survivors may affect their risk of mortality in the future.

Summary

Korean summary
현재 암 생존자의 사망 위험을 평가하는 데 유용한 한국형 암 생존자 사망률 예측 모델은 없습니다. 본 연구에서는 고령, 남성, 현재 흡연, 당뇨병 병력을 포함한 생활양식 요인이 사망의 고위험 요인인 반면, 운동 습관 및 암의 가족력은 사망 위험을 감소시키는 것으로 나타났습니다. 현재 흡연과 운동 습관은 사망 위험에 영향을 미치는 수정 가능한 두 가지 요소로써, 이러한 생활습관 요인으로 구성된 예측모형은 생활습관 교정을 통해 우리나라 암 생존자의 사망률을 낮출 수 있음을 시사합니다.

Key Message
Currently, there is no Korean mortality prediction model for cancer survivors that would be useful in evaluating their risk of mortality. The present study showed that lifestyle factors, including older age, male sex, current smoking, and history of diabetes were high-risk factors for mortality, while exercise habits and a family history of cancer reduced the risk of mortality. Current smoking and exercise habits are the two modifiable factors that affected the risk of mortality. The prediction model comprising these lifestyle factors implies that the risk of mortality of cancer survivors in Korea can be reduced through lifestyle modification.

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A comparative study of health behaviors in adult male cancer survivors and the general male population in Korea: from the Korea national health and nutrition examination survey VII-VIII (2016–2021)
Hyein Jung, Yoonjoo Choi, Byungmi Kim
Supportive Care in Cancer.2025;[Epub] CrossRef
Sex Disparity in Cancer and Non-cancer Mortality among Korean Cancer Survivors
Ansun Jeong, Soyeoun Kim, Somin Jeon, Boyoung Park
Journal of Cancer Prevention.2025; 30(4): 196. CrossRef
COVID-19 Mortality and Severity in Cancer Patients and Cancer Survivors
Jae-Min Park, Hye Yeon Koo, Jae-ryun Lee, Hyejin Lee, Jin Yong Lee
Journal of Korean Medical Science.2024;[Epub] CrossRef
Weight maintenance and gain were significantly associated with lower risk of all-cause and cancer-related mortality in Korean adults who were newly diagnosed with cancer based on the Korean NHIS-HEALS cohort
Yong-June Kim, Seung Park, Won Tae Kim, Yoon-Jong Bae, Yonghwan Kim, Hee-Taik Kang
Medicine.2023; 102(47): e36184. CrossRef

Local-level spatiotemporal dynamics of COVID-19 transmission in the Greater Seoul Area, Korea: a view from a Bayesian perspective: Youngbin Lym, Hyobin Lym, Ki-Jung Kim; Epidemiol Health. 2022;44:e2022016. Published online January 13, 2022; DOI: https://doi.org/10.4178/epih.e2022016

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Abstract Summary PDF

Abstract

OBJECTIVES
The purpose of this study was to enhance the understanding of the local-level spatiotemporal dynamics of COVID-19 transmission in the Greater Seoul Area (GSA), Korea, after its initial outbreak in January 2020.

METHODS

Using the weekly aggregates of coronavirus disease 2019 (COVID-19) cases of 77 municipalities in the GSA, we examined the relative risks of COVID-19 infection across local districts over 50 consecutive weeks in 2020. To this end, we employed a spatiotemporal generalized linear mixed model under the hierarchical Bayesian framework. This allowed us to empirically examine the random effects of spatial alignments, temporal autocorrelation, and spatiotemporal interaction, along with fixed effects. Specifically, we utilized the conditional autoregressive and the weakly informative penalized complexity priors for hyperparameters of the random effects.

RESULTS

Spatiotemporal interaction dominated the overall variability of random influences, followed by spatial correlation, whereas the temporal correlation appeared to be small. Considering these findings, we present dynamic changes in the spread of COVID-19 across local municipalities in the GSA as well as regions at elevated risk for further policy intervention.

CONCLUSIONS

The outcomes of this study can contribute to advancing our understanding of the local-level COVID-19 spread dynamics within densely populated regions in Korea throughout 2020 from a different perspective, and will contribute to the development of regional safety planning against infectious diseases.

Summary

Korean summary
본 논문은 수도권 지역에서 코로나바이러스가 처음 발생한 2020년 1월 이후 12월 말까지 총 50주 동안 수도권 내 지자체 수준에서의 코로나 19 전염병에 대한 시공간적 확산 역동성을 파악하기 위한 연구이다. 데이터 기반의 실증분석을 위한 계층적 베이지언 기법 기반의 시공간 일반화 선형 혼합모형의 결과에 따르면, 확률효과 중 시공간적 상호작용의 영향성이 가장 크게 나타났고, 다음으로는 공간자기상관에 의한 영향 순으로 나타난 반면, 시간에 의한 확률효과는 상대적으로 적게 도출되었다. 연구의 결과를 종합하여, 본 연구에서는 지도 기반의 코로나 19 위험 및 그 위험의 시공간적 변화를 제시하고, 향후 전염병에 대한 정책대응에 활용될 수 있도록 하였다.

Key Message
This study investigates the local-level spatiotemporal dynamics of COVID-19 transmission in the Greater Seoul Area, Korea, after its initial outbreak in January 2020. We adopt a flexible hierarchical Bayesian method so as to account for latent influences of space and time along with the fixed effects by covariates. The results suggest that spatiotemporal interaction dominates the overall variability of random influences, followed by spatial correlation, while the temporal effect appears to be small. Based on these findings, we present maps that depict dynamic changes of COVID-19 infection as well as regions of elevated risks for further policy consideration.

Citations

Citations to this article as recorded by

Yearly Spatiotemporal Patterns of COVID-19 During the Pandemic Period: An In-Depth Analysis of Regional Trends and Risk Factors in the Republic of Korea
Chiara Achangwa, Jung-Hee Park, Moo-Sik Lee
COVID.2025; 5(3): 40. CrossRef
A mobility-adjusted framework for regional Rt estimation: enhancing spatial interpretation of transmission dynamics
Young Kim, Junwoo Jo, Byul Nim Kim, Arsen Abdulali, Gerardo Chowell, Sunmi Lee
BMC Infectious Diseases.2025;[Epub] CrossRef
A Review of Bayesian Spatiotemporal Models in Spatial Epidemiology
Yufeng Wang, Xue Chen, Feng Xue
ISPRS International Journal of Geo-Information.2024; 13(3): 97. CrossRef

The predictive value of resting heart rate in identifying undiagnosed diabetes in Korean adults: Korea National Health and Nutrition Examination Survey: Dong-Hyuk Park, Wonhee Cho, Yong-Ho Lee, Sun Ha Jee, Justin Y. Jeon; Epidemiol Health. 2022;44:e2022009. Published online January 3, 2022; DOI: https://doi.org/10.4178/epih.e2022009

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The purpose of this study was (1) to examine whether the addition of resting heart rate (RHR) to the existing undiagnosed diabetes mellitus (UnDM) prediction model would improve predictability, and (2) to develop and validate UnDM prediction models by using only easily assessable variables such as gender, RHR, age, and waist circumference (WC).

METHODS

Korea National Health and Nutrition Examination Survey (KNHANES) 2010, 2012, 2014, 2016 data were used to develop the model (model building set, n=19,675), while the data from 2011, 2013, 2015, 2017 were used to validate the model (validation set, n=19,917). UnDM was defined as a fasting glucose level ≥126 mg/dL or glycated hemoglobin ≥6.5%; however, doctors have not diagnosed it. Statistical package for the social sciences logistic regression analysis was used to determine the predictors of UnDM.

RESULTS

RHR, age, and WC were associated with UnDM. When RHR was added to the existing model, sensitivity was reduced (86 vs. 73%), specificity was increased (49 vs. 65%), and a higher Youden index (35 vs. 38) was expressed. When only gender, RHR, age, and WC were used in the model, a sensitivity, specificity, and Youden index of 70%, 67%, and 37, respectively, were observed.

CONCLUSIONS

Adding RHR to the existing UnDM prediction model improved specificity and the Youden index. Furthermore, when the prediction model only used gender, RHR, age, and WC, the outcomes were not inferior to those of the existing prediction model.

Summary

Korean summary
당뇨병 미인지 또는 미진단은 적절한 치료 시작 시기를 늦추고 당뇨병 합병증 발생의 위험을 높이기 때문에, 각국은 당뇨병 예측 모형을 개발하여 당뇨병을 조기에 예측하고, 치료 시기를 앞당기기 위해 노력하고 있다. 본 연구는 기존의 한국인 당뇨병 예측 모형에 안정시심박수를 추가 변수로 포함시켜, 예측 모형의 성능이 일부개선되는 것을 확인하였고, 더 나아가 나이, 허리 둘레, 그리고 안정시심박수를 포함하여 예측 모형을 개발하고, 그 성능을 확인하였다. 본 연구에서는 간단하게 측정이 가능한 허리 둘레와 안정시심박수 그리고 나이만 포함한 예측 모형이 기존의 예측 모형과 비교해 성능이 열등하지 않은 것을 확인하였다.

Key Message
Higher RHR is associated with increased risk of diabetes. When RHR is added to the Korean undiagnosed diabetes risk score model (Age, Family history of diabetes, Hypertension, Waist circumference, Smoking, Alcohol consumption), the model somewhat increased its predictability of undiagnosed diabetes. Furthermore, the prediction model developed only using age, waist circumference and RHR, which anyone can easily measure or access, had similar predictability to the previous undiagnosed diabetes risk prediction model. The results of this study may help develop future strategies or applications for predicting early undiagnosed diabetes.

Citations

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Improving T2D machine learning-based prediction accuracy with SNPs and younger age
Cynthia AL Hageh, Andreas Henschel, Hao Zhou, Jorge Zubelli, Moni Nader, Stephanie Chacar, Nantia Iakovidou, Haralampos Hatzikirou, Antoine Abchee, Siobhán O’Sullivan, Pierre A. Zalloua
Computational and Structural Biotechnology Journal.2025; 27: 2772. CrossRef
Comparisons of the prediction models for undiagnosed diabetes between machine learning versus traditional statistical methods
Seong Gyu Choi, Minsuk Oh, Dong–Hyuk Park, Byeongchan Lee, Yong-ho Lee, Sun Ha Jee, Justin Y. Jeon
Scientific Reports.2023;[Epub] CrossRef
Factors related to undiagnosed diabetes in Korean adults: a secondary data analysis
Bohyun Kim
Journal of Korean Biological Nursing Science.2023; 25(4): 295. CrossRef

Late eating, blood pressure control, and cardiometabolic risk factors among adults with hypertension: results from the Korea National Health and Nutrition Examination Survey 2010-2018: Jee-Seon Shim, Hyeon Chang Kim; Epidemiol Health. 2021;43:e2021101. Published online November 24, 2021; DOI: https://doi.org/10.4178/epih.e2021101

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Abstract

OBJECTIVES
Despite growing concerns regarding the timing of eating, little is known about the association between late eating and health. This study aimed to investigate whether late eating is associated with blood pressure (BP) control and cardiometabolic risk factors among Korean adults with hypertension.

METHODS

Data from the Korea National Health and Nutrition Examination Survey 2010-2018 were used. Adults with hypertension aged 30-79 years (n=13,361) were included in this study. Dietary intake and information on meal timing were assessed using 1-day 24-hour recall. Late eating was defined as after the median midpoint between the times of the first and the last eating episode during the recall day. Logistic and linear regression models were used to estimate the associations of late eating with BP control and cardiometabolic risk factors.

RESULTS

Among late eaters, there were more men than women. Compared to early eaters, late eaters were younger, had a higher body mass index (BMI) and unhealthier habits, and their overall dietary quality score was lower. A negative association between late eating and BP control was found in a univariate model (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.94 to 1.12), but this association disappeared after adjustment for confounders (OR, 1.03; 95% CI, 0.94 to 1.12). Late eating was independently associated with higher BMI (p=0.03) and blood triglyceride concentration (p<0.01).

CONCLUSIONS

Our results do not support a link between late eating and BP control among adults with hypertension, but suggest that late eating is associated with cardiometabolic risk factors.

Summary

Korean summary
식사시간이 건강에 미치는 영향에 대한 관심이 증가하고 있지만, 이에 대한 근거는 많지 않다. 이 연구는 국민건강영양조사 자료를 활용하여 고혈압이 있는 성인의 늦은 식사와 혈압 조절, 심장대사 위험인자의 연관성을 분석하였다. 늦은 식사와 혈압 조절의 독립적 연관성은 찾지 못했지만, 늦은 식사는 높은 체질량지수, 혈중 지질 농도와 연관성을 보여 식사 시간 조정이 고혈압 환자의 예후 개선을 위한 유용한 대책이 될 수 있으리라는 근거를 지지한다.

Key Message
This study investigated whether late eating is associated with blood pressure (BP) control and cardiometabolic risk factors among Korean adults with hypertension using data from the Korea National Health and Nutrition Examination Survey 2010–2018. We did not find an independent association between late eating and BP control among Korean adults with hypertension, but found that late eating was significantly associated with higher BMI and a higher blood concentration of triglycerides, independent of potential confounders. Our findings support the suggestion that a time-based dietary approach can be used as a useful strategy to improve the prognosis of adults with hypertension.

Citations

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The combination of physical activity and late-time-restricted eating improves eating behavior, cognitive performance and cardiovascular parameters in women living with excess body weight
Sarra Miladi, Omar Hammouda, Samar J. Miladi Trabelsi, Sirine C. Miladi, Ranya Ameur, Tarak Driss
Physiology & Behavior.2026; 306: 115200. CrossRef
Later eating timing in relation to an individual internal clock is associated with lower insulin sensitivity and affected by genetic factors
Janna Vahlhaus, Beeke Peters, Silke Hornemann, Anne-Cathrin Ost, Michael Kruse, Andreas Busjahn, Andreas F.H. Pfeiffer, Olga Pivovarova-Ramich
eBioMedicine.2025; 116: 105737. CrossRef
Chronotype-specific associations of meal timing patterns with cardiometabolic health in women: a cross-sectional study
Azadeh Lesani, Neda Soveid, Cain C. T. Clark, Bahar Barkhidarian, Fatemeh Gholami, Mansooreh Sadat Mojani-Qomi
Nutrition & Metabolism.2025;[Epub] CrossRef
The Prevalence of Normal Weight Obesity in Slovak Young Adults and Its Relationship with Body Composition and Lifestyle Habits
Darina Falbová, Simona Sulis, Paulína Oravská, Alexandra Hozaková, Petra Švábová, Radoslav Beňuš, Lenka Vorobeľová
Bratislava Medical Journal.2025; 126(10): 2698. CrossRef
Late-eating adolescents consume more energy, make poorer dietary choices, and are more likely to have excess weight: An analysis of the Brazilian Household Budget Survey (2008–2009)
Maria Carliana Mota, Laura Cristina Tibiletti Balieiro, Luana Thomazetto Rossato, Claudia Roberta de Castro Moreno, Cibele Aparecida Crispim
Chronobiology International.2025; : 1. CrossRef
Eating patterns in Korean adults, 1998–2018: increased energy contribution of ultra-processed foods in main meals and snacks
Sukyoung Jung, Jee Young Kim, Sohyun Park
European Journal of Nutrition.2024; 63(1): 279. CrossRef
Association between time-of-day for eating, exercise, and sleep with blood pressure in adults with elevated blood pressure or hypertension: a systematic review
Thomas Keiser, Sarah Katz, Shannon M. Robson, Jody L. Greaney, Sean Healy, Susan K. Malone, Vahid Farrahi, Freda Patterson
Journal of Hypertension.2024; 42(6): 951. CrossRef
Relationship between omitting breakfast and late eating with obesity and metabolic disorders: a review focusing on chrononutrition
Gabriel da Silva Almeida, Manoela Oliveira De Souza, Leonardo Matthew Ribeiro Nunes Pereira
Journal Archives of Health.2023; 4(2): 466. CrossRef

Cohort Profile

The Dehgolan Prospective Cohort Study (DehPCS) on non-communicable diseases in a Kurdish community in the west of Iran: Farhad Moradpour, Ebrahim Ghaderi, Ghobad Moradi, Mojdeh Zarei, Amjad Mohamadi Bolbanabad, Bakhtiar Piroozi, Azad Shokri; Epidemiol Health. 2021;43:e2021075. Published online October 1, 2021; DOI: https://doi.org/10.4178/epih.e2021075

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Abstract

The Dehgolan Prospective Cohort Study (DehPCS) was conducted to examine and identify risk factors for the most prevalent non-communicable diseases (NCDs). In addition, in order to examine participants’ health status, socioeconomic status, behavioral factors, nutritional status, and environmental exposures, the DehPCS collected, analyzed, and stored blood, urine, nail, and hair samples to conduct genetic studies and identify biomarkers and other biological determinants of NCDs. In total, 3,996 adults aged 35 to 70 from the general population participated in the study from February 2018 to March 2019. Of them, 43.7% were women. The first follow-up wave was conducted with 3,995 participants. Information on a wide range of variables was collected, including on socioeconomic status, lifestyle, nutritional status, habits, physical examination findings, medication use, and medical history. Proxy variables such as body mass index, metabolic equivalent task score, wealth index, and macronutrients and micronutrients were calculated. The most common self-reported diseases in descending order were kidney stones, hypertension, and fatty liver. The prevalence of diabetes and hypertension was 9.3% and 33.4%, respectively. All data, samples, and measurements will be collected again at 5-year intervals. Thus, it will be possible to examine time-dependent changes in the risk factors of NCDs. The DehPCS can be used to study the relationships among genetics, lifestyle, socioeconomic status, and environmental risk factors and the most prevalent NCDs in case-cohort studies using a nested case-control design that will be applied to the cohort infrastructure. Researchers can also submit pre-proposals via the following web address: http://c.ddrc.ac.ir/persianaccess/Account/Login.

Summary

Key Message
• The DehPCS was designed to examine NCDs among the Kurdish population, who are located in a wide area between the northwest of the Zagros Mountains and the eastern Taurus Mountains covering Turkey, Iraq, Iran, and Syria. • In total, 3,996 adults aged 35 to 70 from the general population participated in the study. • All data, samples, and measurements from the registration phase will be collected again at 5-, 10-, and 15-year intervals. • After labeling, aliquots were placed in a freezer at -70°C to enable ongoing studies of the samples in the future.

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BMC Public Health.2025;[Epub] CrossRef
Diagnostic Performance of the TyG Index in Detecting Metabolic Syndrome: A Cross-Sectional Study from Western Iran
Maziar Afshar, Maryam Afraie, Mobin Azami, Kamran Zamani, Farhad Moradpour, Yousef Moradi
The Open Public Health Journal.2025;[Epub] CrossRef
Prevalence of urolithiasis in adults of the Eastern Mediterranean region: A systematic review and meta-analysis
Mohammed Alhakamy, Ismaeel AlShoaibi, Basheer Abdo, Mohammed Abdullah, Khaled Alzanen, Nabil Albadani, Faisal Ahmed, Khalil Al-Naggar, Nabil Aljuma’ai, Ibrahim Alnadhari, Abdulghani Al-Hagri, Fadhl Alareefi
Urological Science.2025; 36(4): 176. CrossRef
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Zahra Ghanbari, Yousef Moradi, Negin samiee, Farhad Moradpour
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Validity of self‐reported hypertension and related factors in the adult population: Preliminary results from the cohort in the west of Iran
Negar Piri, Yousef Moradi, Reza Ghanei Gheshlagh, Mahsa Abdullahi, Eghbal Fattahi, Farhad Moradpour
The Journal of Clinical Hypertension.2023; 25(2): 146. CrossRef
The association between nutrients and occurrence of COVID‐19 outcomes in the population of Western Iran: A cohort study
Dana Vaisi, Farhad Moradpour, Shadieh Mohammadi, Daem Roshani, Yousef Moradi
The Clinical Respiratory Journal.2023; 17(6): 589. CrossRef
Prevalence of metabolic syndrome and its association with oral health: First results from the Kurdish cohort study
Farhad Moradpour, Zahra Karimi, Zeinab Fatemi, Yousef Moradi, Mohammad Rastegar Khosravi, Azad Shokri, Mohammad Karimzadeh
Health Science Reports.2023;[Epub] CrossRef
Socioeconomic inequalities in metabolic syndrome and its components in a sample of Iranian Kurdish adults
Pardis Mohammadzadeh, Farhad Moradpour, Bijan Nouri, Farideh Mostafavi, Farid Najafi, Ghobad Moradi
Epidemiology and Health.2023; 45: e2023083. CrossRef
Socio-demographic correlates of diabetes self-reporting validity: a study on the adult Kurdish population
Farhad Moradpour, Negar Piri, Hojat Dehghanbanadaki, Ghobad Moradi, Mahdiyeh Fotouk-Kiai, Yousef Moradi
BMC Endocrine Disorders.2022;[Epub] CrossRef
Prevalence of prediabetes, diabetes, diabetes awareness, treatment, and its socioeconomic inequality in west of Iran
Farhad Moradpour, Satar Rezaei, Bakhtiar Piroozi, Ghobad Moradi, Yousef Moradi, Negar Piri, Azad Shokri
Scientific Reports.2022;[Epub] CrossRef

Original Articles

The classification capability of the Asia Pacific Colorectal Screening score in Korea: an analysis of the Cancer Screenee Cohort: Xuan Quy Luu, Kyeongmin Lee, Jeongseon Kim, Dae Kyung Sohn, Aesun Shin, Kui Son Choi; Epidemiol Health. 2021;43:e2021069. Published online September 16, 2021; DOI: https://doi.org/10.4178/epih.e2021069

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study aimed to validate a simple risk assessment tool for estimating the advanced colorectal neoplasia (ACN) risk at colonoscopy screenings and potential factors relevant for implementing this tool in the Korean population.

METHODS

Our study analyzed data from the Cancer Screenee Cohort Study conducted by the National Cancer Center in Korea. The risk level was assessed using the Asia Pacific Colorectal Screening (APCS) score developed by the Asia-Pacific Working Group on Colorectal Cancer. Logistic regression models were used to examine the associations between colorectal-related outcomes and the risk level by APCS score. The discriminatory performance of the APCS score for various colorectal-related outcomes was assessed using C-statistics.

RESULTS

In 12,520 individuals, 317 ACN cases and 4,528 adenoma cases were found. The APCS tool successfully classified the study population into different risk groups, and significant differences in the ACN rate and other outcomes were observed. The APCS score demonstrated acceptable discrimination capability with area under the curve values ranging from 0.62 to 0.65 for various outcomes. The results of the multivariate logistic regression model revealed that the high-risk group had a 3.1-fold higher risk of ACN (95% confidence interval, 2.08 to 4.67) than the average-risk group. Body mass index (BMI) was identified as a significant predictor of ACN in both multivariate and subgroup analyses.

CONCLUSIONS

Our study highlighted significant differences in colorectal-related screening outcomes by colorectal risk level measured using the APCS score, and BMI could be used to improve the discriminatory capability of the APCS score.

Summary

Korean summary
검진의 위해성을 줄이면서 동시에 이득을 최대화할 수 있는 최적의 검진 프로그램은 암 발생 위험도를 고려하는 것이다. 이 연구는 Asia-Pacific Working Group on Colorectal Cancer에서 제안한 “Asia Pacific Colorectal Screening Score (APCS)”가 한국인에서 대장암 발생 위험도를 선별적으로 잘 구분해 낼 수 있음을 보여주었다. 나아가 대장암의 위험도 점수를 산출하는데 체질량지수가 중요한 예측 변수라는 것을 확인하였고, 한국인에서 대장암 발생 위험도의 변별력을 향상시키기 위해 기존의 APCS에 체질량지수를 추가할 것을 제안하였다.

Key Message
This study highlighted that the Asia Pacific Colorectal Screening Score by the Asia-Pacific Working Group on Colorectal Cancer could successfully classify Korean screenees into different risk groups with acceptable discriminatory capability. Furthermore, our study results also suggest that BMI is a significant predictor of colorectal-related health outcomes, which could be potentially added to the original APCS score for improving its discriminatory power.

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Deborah Jael Herrera, Daiane Maria Seibert, Karen Feyen, Marlon van Loo, Guido Van Hal, Wessel van de Veerdonk
Gastrointestinal Disorders.2025; 7(2): 26. CrossRef
Advancements in the colorectal cancer screening, a Euro-Asian perspective
Nadim Hussein Malibary
Asian Journal of Surgery.2025; 48(6): 3487. CrossRef
Modified predictive model incorporating the waist-to-hip ratio for advanced colorectal neoplasia: A step toward precision screening
Zong-Xian Zhao, Zong-Ju Hu
World Journal of Clinical Oncology.2025;[Epub] CrossRef
Assessing the Feasibility and Acceptability of a Colorectal Cancer Risk Prediction Tool in Primary Care to Increase Screening Uptake in Singapore: A Multi-Methods Pilot Study
Rose Wai-Yee Fok, Sze Wern Lim, Dhana Letchimy, Jianbang Chiang, Jeanette Yuen, Tiffany Qing Lim, Zi Yang Chua, Shun Zi Liong, Grace Meijuan Yang, Ngiap Chuan Tan, Eng Sing Lee, Joanne Ngeow
Journal of Primary Care & Community Health.2025;[Epub] CrossRef
Performance of the Asia–Pacific Colorectal Screening score in stratifying the risk of advanced colorectal neoplasia: A meta‐analysis and systematic review
Mai Ngoc Luu, Nhi Ai Trinh, Truc Le Thanh Tran, Thinh Phuong Dang, Toru Hiyama, Duc Trong Quach
Journal of Gastroenterology and Hepatology.2024; 39(6): 1000. CrossRef
Developing a Nomogram for Predicting Colorectal Cancer and Its Precancerous Lesions Based on Data from Three Non-Invasive Screening Tools, APCS, FIT, and sDNA
Yuan Ze, Hui-Ming Tu, Yuan-Yuan Zhao, Lin Zhang
Journal of Multidisciplinary Healthcare.2024; Volume 17: 2891. CrossRef
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Sarah Tsz Yui Yau, Chi Tim Hung, Eman Yee Man Leung, Ka Chun Chong, Albert Lee, Eng Kiong Yeoh
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A Comparison of Single and Combined Schemes of Asia-Pacific Colorectal Screening, Faecal Immunochemical and Stool Deoxyribonucleic Acid Testing for Community Colorectal Cancer Screening
Yuan Ze, Huiming Tu, Lin Zhang, Yu Bai, Yilin Ren, Xin Chen, Yuzheng Xue, Renjuan Sun, Yuling Yang, Jie Yang, Xuan Zhou, Li Liu
Journal of Multidisciplinary Healthcare.2023; Volume 16: 571. CrossRef
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Gastrointestinal Disorders.2023; 5(4): 549. CrossRef
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J. M. Cairns, S. Greenley, O. Bamidele, D. Weller
Cancer Causes & Control.2022; 33(5): 653. CrossRef

Preventable causes of cancer in Texas by race/ethnicity: tobacco smoking: Franciska J. Gudenkauf, Aaron P. Thrift; Epidemiol Health. 2021;43:e2021046. Published online July 13, 2021; DOI: https://doi.org/10.4178/epih.e2021046

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Abstract Summary PDF: Abstract
OBJECTIVES
Tobacco smoking is classified as carcinogenic to humans (International Agency for Research on Cancer Group 1). We aimed to estimate the percentage and number of incident cancer cases diagnosed in Texas in 2015 that were attributable to tobacco smoking, and we examined differences in the proportions of smoking-attributable cancers between the major racial/ethnic subgroups of the population.
METHODS
We calculated population-attributable fractions for cancers attributable to tobacco smoking using prevalence data from the Texas Behavioral Risk Factor Surveillance System and relative risks associated with smoking status from pooled analyses of cohort studies or meta-analyses. Cancer incidence data were collected from the Texas Cancer Registry.
RESULTS
We estimated that 19,000 excess cancer cases or 18.4% of all cancers diagnosed in 2015 in Texans aged ≥ 25 years were caused by tobacco smoking. Males had a higher overall proportion of cancers attributable to tobacco smoking than females (male, 23.3%, 11,993 excess cases; female, 13.5%, 7,006 cases). Approximately 20% of cancer cases in non-Hispanic Whites and non-Hispanic Blacks were attributable to tobacco smoking compared to 12.8% among Hispanics.
CONCLUSIONS
Despite ongoing public health campaigns combatting tobacco use, this preventable behavior still contributes significantly to cancer incidence in Texas. Racial/ethnic differences in smoking prevalence and smoking-attributable cancer incidence should be considered when designing cancer prevention programs.; Summary

Key Message
Tobacco smoking remains a major contributor to cancer burden in the United States, particularly among men, non-Hispanic whites and non-Hispanic Blacks due to historically higher smoking rates.

Cohort Profile

Cohort profile: the Ewha Birth and Growth Study: Hye Ah Lee, Bohyun Park, Jungwon Min, Eun Jeong Choi, Ui Jeong Kim, Hyun Jin Park, Eun Ae Park, Su Jin Cho, Hae Soon Kim, Hwayoung Lee, Young Ju Kim, Young Sun Hong, Eui-Jung Kim, Eun Hee Ha, Hyesook Park; Epidemiol Health. 2021;43:e2021016. Published online February 22, 2021; DOI: https://doi.org/10.4178/epih.e2021016

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Abstract

With the introduction of life-course epidemiology, researchers realized the importance of identifying risk factors in early life to prevent chronic diseases. This led to the establishment of the Ewha Birth and Growth Study in 2001; the study is a prospective birth cohort designed to provide evidence of early life risk factors for a child’s growth and health. Participants were recruited from those who visited Ewha Womans University Mokdong Hospital (a tertiary hospital in southwest Seoul, Korea) for prenatal care at 24-28 weeks of gestation. In total, 891 mothers enrolled in this study between 2001 and 2006 and their offspring (n=940) were followed-up. Regular check-up examinations of offspring were conducted at 3 years, 5 years, and 7 years of age and every year thereafter. To consider age-related health issues, extensive data were collected using questionnaires and measurements. In 2021, the study subjects will reach 19 years of age, and we are planning a check-up examination for early adulthood. About 20 years have passed since the cohort data were collected, and we have published results on childhood health outcomes associated with prenatal and birth characteristics, genetic and epigenetic characteristics related to childhood metabolism, the effects of exposure to endocrine disruptors, and dietary patterns in childhood. Recently, we started reporting on topics related to adolescent health. The findings will facilitate identification of early life risk factors for chronic diseases and the development of interventions for diseases later in life.

Summary

Korean summary
이화영아성장코호트는 만성질환 예방을 위한 생애초기 위험인자에 대한 근거를 제공하기 위해 2001년에 시작되었습니다. 이화영아성장코호트는 국내에서 선도적인 장기 추적관찰 연구로, 소아기 건강과 관련된 산전 및 출생 시 특징, 소아기 대사와 관련된 유전적 혹은 후성학적 특성, 내분비 장애물질 노출에 따른 영향, 소아기의 식이패턴과 같은 다양한 연구결과들을 발표하였습니다. 추후 청년기의 자료 수집을 계획하고 있으며, 우리의 연구결과는 만성질환 예방을 위한 중재 개발에 기여할 것으로 기대됩니다.

Key Message
To provide evidence of early life risk factors for the prevention of chronic diseases, the Ewha Birth and Growth Study was started in 2001. The Ewha Birth and Growth cohort is a leading long-term follow-up study in Korea, and we have published results on childhood health outcomes associated with prenatal and birth characteristics, genetic and epigenetic characteristics related to childhood metabolism, the effects of exposure to endocrine disruptors, and dietary patterns in childhood. We are planning to collect data for early adulthood, and our findings will contribute to the development of interventions to prevent chronic diseases.

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Prospective association between handgrip strength in childhood and the metabolic syndrome score and insulin resistance indices in adolescence: an analysis based on the Ewha Birth and Growth Study
Seunghee Jun, Hyunjin Park, Hyelim Lee, Hye Ah Lee, Young Sun Hong, Hyesook Park
Epidemiology and Health.2025; 47: e2025001. CrossRef
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Diego Augusto Santos Silva, Tiago Rodrigues de Lima, Francisco de Assis Guedes de Vasconcelos, Katia Vergetti Bloch, Felipe Vogt Cureau, Mark Stephen Tremblay
BMC Public Health.2025;[Epub] CrossRef
Keun Lee (October 10, 1942 – May 14, 2024): a pioneering pediatrician in the field of developmental screening tests in Korea and a beloved teacher at Ewha Womans University College of Medicine
Su Jin Cho
The Ewha Medical Journal.2024;[Epub] CrossRef
Prospective association between phthalate exposure in childhood and liver function in adolescence: the Ewha Birth and Growth Cohort Study
Seonhwa Lee, Hye Ah Lee, Bohyun Park, Hyejin Han, Young Sun Hong, Eun Hee Ha, Hyesook Park
Environmental Health.2023;[Epub] CrossRef
BMI trajectory and inflammatory effects on metabolic syndrome in adolescents
Ui-Jeong Kim, Eun Jeong Choi, Hyunjin Park, Hye Ah Lee, Bohyun Park, Jungwon Min, Eun Ae Park, Su Jin Cho, Hae Soon Kim, Hwayoung Lee, Young Ju Kim, Young Sun Hong, Eun Hee Ha, Seungyoun Jung, Hyesook Park
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Hyunjin Park, Seunghee Jun, Hye-Ah Lee, Hae Soon Kim, Young Sun Hong, Hyesook Park
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Synergistic effect of serum uric acid and body mass index trajectories during middle to late childhood on elevation of liver enzymes in early adolescence: Findings from the Ewha Birth and Growth Study
Sung Hee Lee, Eun Jeong Choi, Ui Jeong Kim, Hyunjin Park, Bomi Park, Hye Ah Lee, Hyesook Park, Linglin Xie
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BMC Public Health.2023;[Epub] CrossRef
The Mediating Effect of Inflammation between the Dietary and Health-Related Behaviors and Metabolic Syndrome in Adolescence
Ui-Jeong Kim, Eun-Jeong Choi, Hyunjin Park, Hye-Ah Lee, Bomi Park, Haesoon Kim, Youngsun Hong, Seungyoun Jung, Hyesook Park
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Original Articles

Strongyloides stercoralis and other intestinal parasites in patients receiving immunosuppressive drugs in northern Iran: a closer look at risk factors: Leila Mirzaei, Keyhan Ashrafi, Zahra Atrkar Roushan, Mohammad Reza Mahmoudi, Irandokht Shenavar Masooleh, Behnaz Rahmati, Farshid Saadat, Hamed Mirjalali, Meysam Sharifdini; Epidemiol Health. 2021;43:e2021009. Published online January 20, 2021; DOI: https://doi.org/10.4178/epih.e2021009

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Abstract

OBJECTIVES
The objective of this study was to evaluate the prevalence of Strongyloides stercoralis and other intestinal parasites in patients receiving immunosuppressive drugs in northern Iran and to investigate related risk factors.

METHODS

This cross-sectional study was conducted among 494 patients receiving immunosuppressive drugs, including cancer patients undergoing chemotherapy (n=188) and those treated with prolonged corticosteroid administration (n=306). All fresh fecal samples were examined using the direct wet-mount, formalin ethyl acetate concentration, and agar plate culture techniques.

RESULTS

In total, 16.8% of patients were positive for at least 1 intestinal parasite; the helminthic and protozoan infection rates were 5.1% and 12.3%, respectively. The infection rate was significantly higher in corticosteroid-treated individuals (19.6%) than cancer patients (12.2%) (p<0.05). The prevalence rate of S. stercoralis among patients receiving chemotherapy and those treated with corticosteroids were 4.3% and 5.2%, respectively. The prevalence rate of S. stercoralis infection was significantly higher in older patients (p<0.05).

CONCLUSIONS

Strongyloidiasis is one of the most common parasites among patients receiving immunosuppressive drugs in northern Iran. Early diagnosis and proper treatment of these patients are necessary to minimize the complications of severe strongyloidiasis.

Summary

Key Message
This study showed strongyloidiasis is one of the most common parasitic diseases among patients receiving immunosuppressive drugs in northern Iran and early diagnosis before chemotherapy or steroid therapy is necessary.

Citations

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Human Strongyloides stercoralis infection
Ruibing Yang, Meiyining Xu, Lichao zhang, Yao Liao, Yuheng Liu, Xiaoyan Deng, Lifu Wang
Journal of Microbiology, Immunology and Infection.2025; 58(2): 164. CrossRef
Evaluation of strongyloidiasis prevalence in immunocompromised patients referred to hospitals: a case study of Iran’s capital
Zahra Arab-Mazar, Tahereh Kanani, Mahdi Toulabi, Arian Karimi Rouzbahani, Shirzad Fallahi, Anahita Behzadi, Maysam Yousefi, Seyyed Javad seyyed tabaei
BMC Infectious Diseases.2025;[Epub] CrossRef
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Joel H. Elizondo-Luévano, Abelardo Chávez-Montes, Antonio Muro, Belén Vicente-Santiago, Miroslava Kačániová, David G. García-Hernández, Aldo F. Bazaldúa-Rodríguez, Horacio Larqué-García, Uziel Castillo-Velázquez, Julio López-Abán
Parasitologia.2025; 5(2): 18. CrossRef
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In Vitro Anthelmintic Effect of Mexican Plant Extracts and Partitions Against Trichinella spiralis and Strongyloides venezuelensis
Nancy E. Rodríguez-Garza, Ricardo Gomez-Flores, Ramiro Quintanilla-Licea, Joel H. Elizondo-Luévano, César I. Romo-Sáenz, Miguel Marín, Javier Sánchez-Montejo, Antonio Muro, Rafael Peláez, Julio López-Abán
Plants.2024; 13(24): 3484. CrossRef
Seropositivity Rates of Strongyloides stercoralis Antibody in the Southeastern Region of Republic of Korea: A Single-Center Retrospective Study
Taehwa Kim, Seungjin Lim
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The Coexistence of Blastocystis spp. in Humans, Animals and Environmental Sources from 2010–2021 in Asia
Adedolapo Aminat Rauff-Adedotun, Farah Haziqah Meor Termizi, Nurshafarina Shaari, Ii Li Lee
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Mehdi Pandi, Meysam Sharifdini, Keyhan Ashrafi, Zahra Atrkar Roushan, Behnaz Rahmati, Nayereh Hajipour
Frontiers in Cellular and Infection Microbiology.2021;[Epub] CrossRef

Renal hyperfiltration, fatty liver index, and the hazards of all-cause and cardiovascular mortality in Finnish men: Mounir Ould Setti, Ari Voutilainen, Tomi-Pekka Tuomainen; Epidemiol Health. 2021;43:e2021001. Published online December 24, 2020; DOI: https://doi.org/10.4178/epih.e2021001

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Abstract

OBJECTIVES
Renal hyperfiltration (RHF) and fatty liver are separately associated with adverse health outcomes. In this study, we investigated the mortality hazard of coexisting RHF and fatty liver.

METHODS

Middle-aged men from the Kuopio Ischaemic Disease Risk Factor Study (n=1,552) were followed up for a median of 29 years. Associations among RHF, fatty liver index (FLI) score, age, body mass index, smoking status, alcohol consumption, and hypertension status were assessed using logistic regression. Cox proportional hazards models were used to determine the hazard ratios (HRs) for all-cause and cardiovascular disease (CVD) mortality with respect to RHF and fatty liver.

RESULTS

Of the men, 5% had RHF (n=73), whereas a majority had fatty liver (n=848). RHF was associated specifically with smoking, and fatty liver was associated specifically with overweight. The all-cause mortality hazard was highest (HR, 1.96; 95% confidence interval [CI], 1.27 to 3.01) among men with RHF and fatty liver (n=33). Among men with RHF but normal FLI (n=40), the HR of all-cause mortality was 1.67 (95% CI, 1.15 to 2.42). Among men with fatty liver but a normal estimated glomerular filtration rate (n=527), the HR of all-cause mortality was 1.35 (95% CI, 1.09 to 1.66). CVD mortality hazard was associated with RHF, but not fatty liver. We detected no interaction effect between RHF and fatty liver for all-cause (synergy index, 0.74; 95% CI, 0.21 to 2.67) or CVD (synergy index, 0.94; 95% CI, 0.34 to 2.60) mortality.

CONCLUSIONS

RHF and fatty liver are independently associated with all-cause and CVD mortality

Summary

Key Message
Both prevalent, underdiagnosed, and commonly coexisting, renal hyperfiltration and fatty liver are two notable independent risk factors of all-cause and cardiovascular disease mortality.

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Sex-specific association of body mass index and fatty liver index with prevalence of renal hyperfiltration: a cross sectional study using Japanese health check-up data
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Brief Communication

Testosterone levels and cause-specific mortality in the older French men without metabolic syndrome: Nasser Laouali, Sylvie Brailly-Tabard, Catherine Helmer, Marie-Laure Ancelin, Christophe Tzourio, Alexis Elbaz, Anne Guiochon-Mantel, Marianne Canonico; Epidemiol Health. 2020;42:e2020036. Published online June 1, 2020; DOI: https://doi.org/10.4178/epih.e2020036

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Abstract PDF Supplementary Material

Abstract

OBJECTIVES
Previous studies have reported controversial findings regarding the association of testosterone with mortality in older men. This heterogeneity might be partially explained by comorbidities and the presence of metabolic syndrome, as well as differential associations according to causes of death.

METHODS

We used data from a random subsample of the Three-City study, in which hormone levels were measured in 338 men ≥65 years without metabolic syndrome who were followed-up for 12 years. Vital status was determined for all participants from different sources. We used inverse-probability-weighted Cox regression to estimate the hazard ratios (HRs) of cause-specific mortality and 95% confidence intervals (CIs).

RESULTS

Over the follow-up period, 130 men died (30 from cardiovascular disease, 45 from cancer, 55 from other causes). The association of testosterone with mortality showed significant heterogeneity across causes of death (p=0.027 and p=0.022 for total and bioavailable testosterone, respectively). Higher testosterone levels were associated with increased cardiovascular mortality (HR for 1-standard deviation increase, 1.86; 95% CI, 1.28 to 2.71 and 1.50; 95% CI, 1.04 to 2.17 for total and bioavailable testosterone, respectively). By contrast, there were no significant associations of testosterone with mortality from cancer and other causes.

CONCLUSIONS

Our data suggest that the association of testosterone with mortality in men without metabolic syndrome might be differential according to the cause of death. These findings may partially explain the heterogeneity across studies on the relationship between testosterone levels and mortality.

Summary

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Endogenous Sex Steroid Hormones, Sex Hormone-Binding Globulin, and Risk of All-Cause and Cause-Specific Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies
Hamidreza Raeisi-Dehkordi, Mojgan Amiri, Sara Beigrezaei, Hugo G Quezada-Pinedo, Farnaz Khatami, Fadi Alijla, Marinka Steur, Beatrice Minder, Angeline Chatelan, Trudy Voortman, Yvonne T van der Schouw, Oscar H Franco, Taulant Muka
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Testosterone, atherosclerosis and cardiovascular risks
Anastasia V. Makarova, Sergey B. Shustov, Yuri S. Khalimov, Sergey V. Gaiduk, Viktor P. Kitsyshin, Dmitry S. Frolov
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Original Article

Trends in prediabetes and diabetes prevalence and associated risk factors in Vietnamese adults: That Thanh Ton, Anh Thi Ngoc Tran, Ich Thanh Do, Hoa Nguyen, Thi Thanh Binh Nguyen, Minh Tu Nguyen, Van Anh Bao Ha, Anh Quoc Tran, Huu Khoi Hoang, Binh Thang Tran; Epidemiol Health. 2020;42:e2020029. Published online May 11, 2020; DOI: https://doi.org/10.4178/epih.e2020029

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Abstract PDF Supplementary Material

Abstract

OBJECTIVES
The prevalence of diabetes mellitus is rapidly increasing in Vietnam, particularly among adults aged over 45 years. This study estimated trends in diabetes and prediabetes prevalence and determined risk factors in Vietnamese adults (over 45 years).

METHODS

A cross-sectional study was conducted based on data from an annual diabetes screening program among people aged 45-69 years in an urban city in central Vietnam (Da Nang). Joinpoint regression analyses were performed to calculate the annual percentage change and ptrend-values. Multinomial logistic regression analysis was used to determine risk factors.

RESULTS

In total, 3,765 men and 9,149 women were included in this analysis. The age-adjusted prevalence of diabetes and prediabetes in 2017 was 11.4% and 52.9%, respectively. The prevalence of diabetes was higher in men (15.1%) than in women (10.3%), but that of prediabetes was similar in both genders (53.4% vs. 52.8%). The prevalence of prediabetes significantly increased during the study period, whereas no upward or downward trend for diabetes was observed. The prevalence of obesity, abdominal obesity, hypertension, and dyslipidemia showed no obvious trend. Obesity, a high waist-to-hip ratio, hypertension, more severe abdominal obesity, and dyslipidemia were significantly associated with a higher risk of diabetes and prediabetes.

CONCLUSIONS

Diabetes and prediabetes were more prevalent among people aged over 45 years than in the general population. Da Nang has experienced a marked increase in the prevalence of prediabetes. These findings have significant implications regarding the need for nationwide public health interventions and management aiming at diabetes prevention and control.

Summary

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Methods

Equivalence model: A new graphical model for causal inference: Jalal Poorolajal; Epidemiol Health. 2020;42:e2020024. Published online April 9, 2020; DOI: https://doi.org/10.4178/epih.e2020024

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Abstract PDF

Abstract

Although several causal models relevant to epidemiology have been proposed, a key question that has remained unanswered is why some people at high-risk for a particular disease do not develop the disease while some people at low-risk do develop it. The equivalence model, proposed herein, addresses this dilemma. The equivalence model provides a graphical description of the overall effect of risk and protective factors at the individual level. Risk factors facilitate the occurrence of the outcome (the development of disease), whereas protective factors inhibit that occurrence. The equivalence model explains how the overall effect relates to the occurrence of the outcome. When a balance exists between risk and protective factors, neither can overcome the other; therefore, the outcome will not occur. Similarly, the outcome will not occur when the units of the risk factor(s) are less than or equal to the units of the protective factor(s). In contrast, the outcome will occur when the units of the risk factor(s) are greater than the units of the protective factor(s). This model can be used to describe, in simple terms, causal inferences in complex situations with multiple known and unknown risk and protective factors. It can also justify how people with a low level of exposure to one or more risk factor(s) may be affected by a certain disease while others with a higher level of exposure to the same risk factor(s) may remain unaffected.

Summary

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Systematic Review

Risk factors for stomach cancer: a systematic review and meta-analysis: Jalal Poorolajal, Leila Moradi, Younes Mohammadi, Zahra Cheraghi, Fatemeh Gohari-Ensaf; Epidemiol Health. 2020;42:e2020004. Published online February 2, 2020; DOI: https://doi.org/10.4178/epih.e2020004

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Abstract PDF Supplementary Material

Abstract

OBJECTIVES
This report provides information on 14 behavioral and nutritional factors that can be addressed in stomach cancer prevention programs.

METHODS

PubMed, Web of Science, and Scopus were searched through December 2018. Reference lists were also screened. Observational studies addressing the associations between stomach cancer and behavioral factors were analyzed. Between-study heterogeneity was investigated using the χ2, τ2, and I2 statistics. The likelihood of publication bias was explored using the Begg and Egger tests and trim-and-fill analysis. Effect sizes were expressed as odds ratios (ORs) with 95% confidence intervals (CIs) using a random-effects model.

RESULTS

Of 52,916 identified studies, 232 (including 33,831,063 participants) were eligible. The OR (95% CI) of factors associated with stomach cancer were as follows: Helicobacter pylori infection, 2.56 (95% CI, 2.18 to 3.00); current smoking, 1.61 (95% CI, 1.49 to 1.75); former smoking 1.43 (95% CI, 1.29 to 1.59); current drinking, 1.19 (95% CI, 1.10 to 1.29); former drinking, 1.73 (95% CI, 1.17 to 2.56); overweight/obesity, 0.89 (95% CI, 0.74 to 1.08); sufficient physical activity, 0.83 (95% CI, 0.68 to 1.02); consumption of fruits ≥3 times/wk, 0.48 (95% CI, 0.37 to 0.63); consumption of vegetables ≥3 times/wk, 0.62 (95% CI, 0.49 to 0.79); eating pickled vegetables, 1.28 (95% CI, 1.09 to 1.51); drinking black tea, 1.00 (95% CI, 0.84 to 1.20); drinking green tea, 0.88 (95% CI, 0.80 to 0.97); drinking coffee, 0.99 (95% CI, 0.88 to 1.11); eating fish ≥1 time/wk 0.79 (95% CI, 0.61 to 1.03); eating red meat ≥4 times/wk 1.31 (95% CI, 0.87 to 1.96), and high salt intake 3.78 (95% CI, 1.74 to 5.44) and 1.34 (95% CI, 0.88 to 2.03), based on two different studies.

CONCLUSIONS

This meta-analysis provided a clear picture of the behavioral and nutritional factors associated with the development of stomach cancer. These results may be utilized for ranking and prioritizing preventable risk factors to implement effective prevention programs.

Summary

Citations

Citations to this article as recorded by

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Original Articles

Factors associated with mortality from tuberculosis in Iran: an application of a generalized estimating equation-based zero-inflated negative binomial model to national registry data: Fatemeh Sarvi, Abbas Moghimbeigi, Hossein Mahjub, Mahshid Nasehi, Mahmoud Khodadost; Epidemiol Health. 2019;41:e2019032. Published online July 9, 2019; DOI: https://doi.org/10.4178/epih.e2019032

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Abstract PDF

Abstract

OBJECTIVES
Tuberculosis (TB) is a global public health problem that causes morbidity and mortality in millions of people per year. The purpose of this study was to examine the relationship of potential risk factors with TB mortality in Iran.

METHODS

This cross-sectional study was performed on 9,151 patients with TB from March 2017 to March 2018 in Iran. Data were gathered from all 429 counties of Iran by the Ministry of Health and Medical Education and Statistical Center of Iran. In this study, a generalized estimating equation-based zero-inflated negative binomial model was used to determine the effect of related factors on TB mortality at the community level. For data analysis, R version 3.4.2 was used with the relevant packages.

RESULTS

The risk of mortality from TB was found to increase with the unemployment rate (βˆ=0.02), illiteracy (βˆ=0.04), household density per residential unit (βˆ=1.29), distance between the center of the county and the provincial capital (βˆ=0.03), and urbanization (βˆ=0.81). The following other risk factors for TB mortality were identified: diabetes (βˆ=0.02), human immunodeficiency virus infection (βˆ=0.04), infection with TB in the most recent 2 years (βˆ=0.07), injection drug use (βˆ=0.07), long-term corticosteroid use (βˆ=0.09), malignant diseases (βˆ=0.09), chronic kidney disease (βˆ=0.32), gastrectomy (βˆ=0.50), chronic malnutrition (βˆ=0.38), and a body mass index more than 10% under the ideal weight (βˆ=0.01). However, silicosis had no effect.

CONCLUSIONS

The results of this study provide useful information on risk factors for mortality from TB.

Summary

Citations

Citations to this article as recorded by

Tuberculosis disease characteristics associated with mortality, severe morbidity and unsuccessful treatment in people living with HIV treated for tuberculosis – a secondary analysis of the ANRS 12300 Reflate TB2 trial
Robert Akpata, Jean-Baptiste Ntakpe, Eugène Messou, Nathalie De Castro, Corine Chazallon, Isabel Timana, Rodrigo Escada, Sandra Wagner Cardoso, Nilesh Bhatt, Celso Khosa, Didier Laureillard, Giang Do Chau, Frédéric Ello Nogbou, Donald Diomande Glao, Valdi
BMC Infectious Diseases.2025;[Epub] CrossRef
Regional deprivation and cause-specific mortality in Russian adults in 2006–2022
Anastasia Zelenina
Global Health Journal.2024; 8(4): 190. CrossRef

Risk factors associated with the recent cholera outbreak in Yemen: a case-control study: Fekri Dureab, Albrecht Jahn, Johannes Krisam, Asma Dureab, Omer Zain, Sameh Al-Awlaqi, Olaf Müller; Epidemiol Health. 2019;41:e2019015. Published online April 21, 2019; DOI: https://doi.org/10.4178/epih.e2019015

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Abstract PDF

Abstract

OBJECTIVES
The cholera outbreak in Yemen has become the largest in the recent history of cholera records, having reached more than 1.4 million cases since it started in late 2016. This study aimed to identify risk factors for cholera in this outbreak.

METHODS

A case-control study was conducted in Aden in 2018 to investigate risk factors for cholera in this still-ongoing outbreak. In total, 59 cholera cases and 118 community controls were studied.

RESULTS

The following risk factors were associated with being a cholera case in the bivariate analysis: a history of travelling and having had visitors from outside Aden Province; eating outside the house; not washing fruit, vegetables, and khat (a local herbal stimulant) before consumption; using common-source water; and not using chlorine or soap in the household. In the multivariate analysis, not washing khat and the use of common-source water remained significant risk factors for being a cholera case.

CONCLUSIONS

Behavioural factors and unsafe water appear to be the major risk factors in the recent cholera outbreak in Yemen. In order to reduce the risk of cholera, hygiene practices for washing khat and vegetables and the use and accessibility of safe drinking water should be promoted at the community level.

Summary

Citations

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Bilal Hamamra, Maysa Abuzant, Fayez Mahamid
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Ever Moyo, Sipho Sibanda, Alice Chimhondoro, Senzenia Chakauya, Davidon Jani
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Associations of water quality with cholera in case-control studies: a systematic review and meta-analysis
Thuy Tien Nguyen, Chaelin Kim, Gerard Goucher, Jong-Hoon Kim
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Anastasia A. Asantewaa, Alex Odoom, Godfred Owusu-Okyere, Eric S. Donkor
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Frontiers in Public Health.2023;[Epub] CrossRef
Inadequate Hand Washing, Lack of Clean Drinking Water and Latrines as Major Determinants of Cholera Outbreak in Somali Region, Ethiopia in 2019
Jemal Mussa Challa, Tamirat Getachew, Adera Debella, Melkamu Merid, Genanaw Atnafe, Addis Eyeberu, Abdi Birhanu, Lemma Demissie Regassa
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Determining factors associated with cholera disease in Ethiopia using Bayesian hierarchical modeling
Tsigereda Tilahun Letta, Denekew Bitew Belay, Endale Alemayehu Ali
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Hana Mekonen, Kefyalew Amene, Dr Samrawit Bisrat, Tesfahun Abye
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Abdulqawi Mohammed Qaserah, Mohammed Abdullah Al Amad, Abdulwahed Abduljabbar Al Serouri, Yousef Saleh Khader
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Assessment of the risk factors associated with multidrug-resistant tuberculosis in Sudan: a case-control study: Adel Hussein Elduma, Mohammad Ali Mansournia, Abbas Rahimi Foroushani, Hamdan Mustafa Hamdan Ali, Asrar M A Salam Elegail, Asma Elsony, Kourosh Holakouie-Naieni; Epidemiol Health. 2019;41:e2019014. Published online April 20, 2019; DOI: https://doi.org/10.4178/epih.e2019014

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Abstract PDF

Abstract

OBJECTIVES
The emergence of multidrug-resistant tuberculosis (MDR-TB) is a major challenge for the global control of tuberculosis (TB). The aim of this study was to determine the risk factors associated with MDR-TB in Sudan.

METHODS

This case-control study was conducted from May 2017 to February 2019. Patients newly diagnosed with MDR-TB were selected as cases, and controls were selected from TB patients who responded to first-line anti-TB drugs. A questionnaire was designed and used to collect data from study participants. Logistic regression was used to evaluate associations between risk factors and MDR-TB infection. The best multivariate model was selected based on the likelihood ratio test.

RESULTS

A total of 430 cases and 860 controls were selected for this study. A history of previous TB treatment (adjusted odds ratio [aOR], 54.85; 95% confidence interval [CI], 30.48 to 98.69) was strongly associated with MDR-TB infection. We identified interruption of TB treatment (aOR, 7.62; 95% CI, 3.16 to 18.34), contact with MDR-TB patients (aOR, 5.40; 95% CI, 2.69 to 10.74), lower body weight (aOR, 0.89; 95% CI, 0.87 to 0.91), and water pipe smoking (aOR, 3.23; 95% CI, 1.73 to 6.04) as factors associated with MDR-TB infection.

CONCLUSIONS

Previous TB treatment and interruption of TB treatment were found to be the main predictors of MDR-TB. Additionally, this study found that contact with MDR-TB patients and water pipe smoking were associated with MDR-TB infection in Sudan. More efforts are required to decrease the rate of treatment interruption, to strengthen patients’ adherence to treatment, and to reduce contact with MDR-TB patients.

Summary

Citations

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Perspective

Health effects of exposure to radon: implications of the radon bed mattress incident in Korea: Songwon Seo, Wi-Ho Ha, Jin-Kyu Kang, Dalnim Lee, Soojin Park, Tae-Eun Kwon, Young Woo Jin; Epidemiol Health. 2019;41:e2019004. Published online February 12, 2019; DOI: https://doi.org/10.4178/epih.e2019004

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Abstract Summary PDF

Abstract

Radon is a naturally occurring radioactive material formed by the slow decay of uranium and thorium found in the earth’s crust or construction materials. Internal exposure to radon accounts for about half of the natural background radiation dose to which humans are exposed annually. Radon is a carcinogen and is the second leading cause of lung cancer following smoking. An association between radon and lung cancer has been consistently reported in epidemiological studies on mine workers and the general population with indoor radon exposure. However, associations have not been clearly established between radon and other diseases, such as leukemia and thyroid cancer. Radiation doses are assessed by applying specific dose conversion coefficients according to the source (e.g., radon or thoron) and form of exposure (e.g., internal or external). However, regardless of the source or form of exposure, the effects of a given estimated dose on human health are identical, assuming that individuals have the same sensitivity to radiation. Recently, radiation exceeding the annual dose limit of the general population (1 mSv/yr) was detected in bed mattresses produced by D company due to the use of a monazite-based anion powder containing uranium and thorium. This has sparked concerns about the health hazards for mattress users caused by radiation exposure. In light of this event, this study presents scientific information about the assessment of radon and thoron exposure and its human implications for human health, which have emerged as a recent topic of interest and debate in society.

Summary

Korean summary
라돈은 세계보건기구에서 지정한 발암물질로, 흡연 다음으로 폐암을 유발한다. 지난 2018년 5월에 D사 침대 매트리스에서 라돈 및 토론에 의한 일반인의 선량한도 기준치(1 mSv/yr) 이상의 방사선이 검출되었다. 이로 인해 침대 사용자의 방사선 피폭으로 인한 건강영향 우려가 대두되고 있다. 이번 연구에서는 라돈 침대 노출 사고와 관련하여 그 동안 잘 알려지지 않은 라돈 및 토론의 노출평가 및 역학 연구 결과들을 살펴보고, 그 시사점을 고찰한다.

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Editorial

Lessons from radiation epidemiology: Won Jin Lee; Epidemiol Health. 2018;40:e2018057. Published online November 14, 2018; DOI: https://doi.org/10.4178/epih.e2018057

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Abstract Summary PDF Supplementary Material

Abstract

Radiation epidemiology has developed as a specialized field and has unique characteristics compared to the other fields of epidemiology. Radiation exposure assessment is highly quantified and health risk assessment can yield precise risks per unit dose in each organ. At the same time, radiation epidemiology also emphasizes the uncertainty of the estimated doses and risks. More radiation epidemiologists work in radiation societies rather than those of epidemiology. This specialization deepens the research of radiation studies but also results in fragmentation from general epidemiology. In addition to continued involvement with radiation-related sciences, therefore, more efforts to communicate with the other fields of epidemiology are necessary for radiation epidemiology.

Summary

Korean summary
방사선 역학은 역학의 세부 전공분야로서 다른 역학 분야와 구별되는 특성들이 있다. 노출 및 건강영향 평가에서의 정량화된 접근방법을 비롯하여 방사선 역학의 많은 장점들은 다른 역학분야에서도 응용될 필요가 있다. 이러한 전문화는 역학 연구의 내용을 깊게 발전시키는데 큰 역할을 하고 있는 반면, 일반 역학 분야와 분열되는 단점도 있다. 따라서 기존 방사선 관련 학문들과의 지속적인 교류뿐 아니라 다른 역학분야와의 활발한 교류를 통해 방사선 역학 및 전체 역학분야를 발전시키는 것이 중요하다.

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Original Articles

Domestic elder abuse and associated factors in elderly women in Tehran, Iran: Negar Piri, Parisa Taheri Tanjani, Soheila Khodkarim, Koorosh Etemad; Epidemiol Health. 2018;40:e2018055. Published online November 10, 2018; DOI: https://doi.org/10.4178/epih.e2018055

24,769 View
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Abstract PDF

Abstract

OBJECTIVES
Elderly people are often abused in many ways, with serious and lasting consequences. Elder abuse remains one of the most hidden forms of family conflict, and its frequency is anticipated to be rising in many countries that are rapidly experiencing population aging. The purpose of this study was to investigate the status of domestic elder abuse in elderly women in Tehran, Iran and to identify associated factors.

METHODS

This cross-sectional study was conducted in 2017 among 260 women aged 60 and over, selected through multistage random sampling. Information on abuse and its risk factors was collected through interviews with the elderly in their homes. In order to measure domestic elder abuse, the validated Domestic Elderly Abuse Questionnaire was used. The ordinal logistic test was used in Stata version 12 to identify factors related to elder abuse.

RESULTS

Overall, 90.4% of the subjects had experienced at least 1 type of abuse, among which authority deprivation (68.5%) was the most common and rejection (11.2%) the least common. The ordinal logistic analysis showed that the likelihood of experiencing more severe severe abuse was significantly higher in elderly people over 72 than in those aged 60-62 years (odds ratio, 2.07; 95% confidence interval, 1.03 to 4.17).

CONCLUSIONS

Domestic elder abuse was found to be common in older women. Old age was an important risk factor for domestic elder abuse in elderly women in Tehran. Managing and preventing elder abuse is an important issue that needs to be addressed.

Summary

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Substance abuse behaviors among university freshmen in Iran: a latent class analysis: Kourosh Kabir, Ali Bahari, Mohammad Hajizadeh, Hamid Allahverdipour, Mohammad Javad Tarrahi, Ali Fakhari, Hossein Ansari, Asghar Mohammadpoorasl; Epidemiol Health. 2018;40:e2018030. Published online July 2, 2018; DOI: https://doi.org/10.4178/epih.e2018030

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Abstract PDF

Abstract

OBJECTIVES
Substance abuse behaviors among university freshmen in Iran are poorly understood. This study aimed to identify, for the first time, subgroups of university freshmen in Iran on the basis of substance abuse behaviors. Moreover, it examined the effects of socio-demographic characteristics on membership in each specific subgroup.

METHODS

Data for the study were collected cross-sectionally in December 2013 and January 2014 from 4 major cities in Iran: Tabriz, Qazvin, Karaj, and Khoramabad. A total of 5,252 first-semester freshmen were randomly selected using a proportional cluster sampling methodology. A survey questionnaire was used to collect data. Latent class analysis (LCA) was performed to identify subgroups of students on the basis of substance abuse behaviors and to examine the effects of students’ socio-demographic characteristics on membership in each specific subgroup.

RESULTS

The LCA procedure identified 3 latent classes: the healthy group; the hookah experimenter group; and the unhealthy group. Approximately 82.8, 16.1, and 2.1% of students were classified into the healthy, hookah experimenter, and unhealthy groups, respectively. Older age, being male, and having a family member or a close friend who smoked increased the risk of membership in classes 2 and 3, compared to class 1.

CONCLUSIONS

Approximately 2.1% of freshmen exhibited unhealthy substance abuse behaviors. In addition, we found that older age, being male, and having a close friend or family member who smoked may serve as risk factors for substance abuse behaviors.

Summary

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Knowledge, attitudes, and behavioural risk factors regarding zoonotic infections among bushmeat hunters and traders in Nsukka, southeast Nigeria: Kingsley Uchenna Ozioko, Chris Ikem Okoye, Rose Nduka Obiezue, Raymond Awudu Agbu; Epidemiol Health. 2018;40:e2018025. Published online June 16, 2018; DOI: https://doi.org/10.4178/epih.e2018025

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Abstract PDF

Abstract

OBJECTIVES
In light of the dramatic spread of Ebola virus in some parts of Africa and the 2014 outbreak in Nigeria, a study was conducted to evaluate bushmeat dealers’ knowledge and attitudes about zoonotic infections and the risk of transmission to humans.

METHODS

A cross-sectional survey was conducted in a community in Nsukka, southeast Nigeria. Hunters (n=34) and bushmeat traders (n=42) were interviewed. A semi-structured questionnaire was used to generate the data. The Fisher exact test was used to evaluate the significance of differences between these groups.

RESULTS

Only 11.8% of the hunters, as compared to 35.7% of the traders, had no knowledge of possible causes of zoonotic infections (p<0.05). However, 64.7% of the hunters, compared to 38.1% of the traders, were ignorant regarding the responsibility of public health personnel and veterinarians (p<0.05), and 76.5% of the hunters compared to 42.9% of the traders were ignorant regarding the existence of zoonoses in Nigeria (p<0.05). A statistically significant difference was also found between these groups regarding the risk of contracting an infection from ectoparasites (p<0.05). The attitudes of respondents towards zoonotic diseases did not differ significantly between the groups.

CONCLUSIONS

The level of awareness about zoonotic diseases was low in this area, underscoring the need for interventions.

Summary

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Associations between dietary risk factors and ischemic stroke: a comparison of regression methods using data from the Multi-Ethnic Study of Atherosclerosis: Seyed Saeed Hashemi Nazari, Yaser Mokhayeri, Mohammad Ali Mansournia, Soheila Khodakarim, Hamid Soori; Epidemiol Health. 2018;40:e2018021. Published online May 21, 2018; DOI: https://doi.org/10.4178/epih.e2018021

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Abstract PDF

Abstract

OBJECTIVES
We analyzed dietary patterns using reduced rank regression (RRR), and assessed how well the scores extracted by RRR predicted stroke in comparison to the scores produced by partial least squares and principal component regression models.

METHODS

Dietary data at baseline were used to extract dietary patterns using the 3 methods, along with 4 response variables: body mass index, fibrinogen, interleukin-6, and low-density lipoprotein cholesterol. The analyses were based on 5,468 males and females aged 45-84 years who had no clinical cardiovascular disease, using data from the Multi-Ethnic Study of Atherosclerosis.

RESULTS

The primary factor derived by RRR was positively associated with stroke incidence in both models. The first model was adjusted for sex and race and the second model was adjusted for the variables in model 1 as well as smoking, physical activity, family and sibling history of stroke, the use of any lipid-lowering medication, the use of any anti-hypertensive medication, hypertension, and history of myocardial infarction (model 1: hazard ratio [HR], 7.49; 95% confidence interval [CI], 1.66 to 33.69; p for trend=0.01; model 2: HR, 6.83; 95% CI, 1.51 to 30.87 for quintile 5 compared with the reference category; p for trend=0.02).

CONCLUSIONS

Based primarily on RRR, we identified that a dietary pattern high in fats and oils, poultry, non-diet soda, processed meat, tomatoes, legumes, chicken, tuna and egg salad, and fried potatoes and low in dark-yellow and cruciferous vegetables may increase the incidence of ischemic stroke.

Summary

Citations

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Dong Liu, Siyue Tan, Zhengyuan Zhou, Shujun Gu, Hui Zuo
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A comparison of principal component analysis, reduced-rank regression, and partial least–squares in the identification of dietary patterns associated with cardiometabolic risk factors in Iranian overweight and obese women
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Prevalence, awareness, treatment, control, and risk factors of hypertension among adults: a cross-sectional study in Iran: Maryam Eghbali, Alireza Khosravi, Awat Feizi, Asieh Mansouri, Behzad Mahaki, Nizal Sarrafzadegan; Epidemiol Health. 2018;40:e2018020. Published online May 18, 2018; DOI: https://doi.org/10.4178/epih.e2018020

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Abstract PDF

Abstract

OBJECTIVES
Hypertension (HTN) is an important risk factor for cardiovascular disease. Considering the importance of this disease for public health, this study was designed in order to determine the prevalence, awareness, treatment, control, and risk factors of HTN in the Iranian adult population.

METHODS

This cross-sectional study was conducted among 2,107 residents of Isfahan, Iran. Samples were selected through multi-stage random cluster sampling in 2015-2016. The outcome variable was HTN, determined by measuring blood pressure in the right arm via a digital arm blood pressure monitor. Awareness, treatment, and control of HTN were assessed by a validated and reliable researcher-developed questionnaire. Other demographic and clinical variables were assessed via a demographic questionnaire.

RESULTS

The overall prevalence of HTN was 17.3% (18.9 and 15.5% in men and women, respectively). The prevalence of HTN increased in both genders with age. The prevalence of awareness of HTN among people with HTN was 69.2%, of whom 92.4 and 59.9% were taking medication for HTN and had controlled HTN, respectively. Logistic regression identified age, body mass index, having diabetes and hyperlipidemia, and a positive family history of HTN as determinants of awareness of HTN.

CONCLUSIONS

The results showed that HTN was highly prevalent in the community, especially in men and in middle-aged and older adults. Approximately 30.8% of patients were unaware of their disease, and there was less awareness among younger adults. Despite the high frequency of taking medication to treat HTN, it was uncontrolled in more than 40.1% of patients. Health policy-makers should therefore consider appropriate preventive and therapeutic strategies for these high-risk groups.

Summary

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Distribution and larval breeding habitats of Aedes mosquito species in residential areas of northwest Ethiopia: Getachew Ferede, Moges Tiruneh, Ebba Abate, Wondmeneh Jemberie Kassa, Yitayih Wondimeneh, Demekech Damtie, Belay Tessema; Epidemiol Health. 2018;40:e2018015. Published online April 23, 2018; DOI: https://doi.org/10.4178/epih.e2018015

29,777 View
548 Download
64 Web of Science
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Abstract PDF

Abstract

OBJECTIVES
The Aedes mosquito is a vector for transmitting many arboviruses. Knowledge of the breeding habitat of this vector is vital for implementing appropriate interventions. Thus, this study was conducted to determine the breeding habitats and presence of Aedes mosquito species in the study areas.

METHODS

A house-to-house cross-sectional survey of Aedes mosquito breeding habitats was carried out in Metema and Humera, Ethiopia, in August 2017. All available water-holding containers present in and around houses were inspected for the presence of immature stages of Aedes mosquitoes, and they were collected and reared to the adult stage for species identification. In the larval survey, the house index, container index, and Breteau index were computed as risk indices.

RESULTS

Of the 384 houses surveyed for the presence of Aedes mosquito larval breeding, 98 were found to be positive for larvae. During the survey, a total of 566 containers were inspected, of which 186 were found to be infested with Aedes mosquito larvae, with a container index of 32.9, a house index of 25.5, and a Breteau index of 48.4. The most common Aedes mosquito breeding habitats were discarded tires (57.5%), followed by mud pots (30.0%). Of the 1,077 larvae and pupae collected and reared, Aedes aegypti (49.3%), Ae. vittatus (6.5%), and Culex species (44.2%) were identified.

CONCLUSIONS

Discarded tires were the most preferred breeding habitats for Aedes mosquitoes. Moreover, Ae. aegypti, the main vector of dengue and other arboviruses, was identified for the first time in this region, suggesting a high potential for arbovirus transmission in the study areas.

Summary

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Review

Road dust and its effect on human health: a literature review: Raihan K. Khan, Mark A. Strand; Epidemiol Health. 2018;40:e2018013. Published online April 10, 2018; DOI: https://doi.org/10.4178/epih.e2018013

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Abstract PDF

Abstract

The purpose of this study was to determine the effects of road dust on human health. A PubMed search was used to extract references that included the words “road dust” and “health” or “fugitive dust” and “health” in the title or abstract. A total of 46 references were extracted and selected for review after the primary screening of 949 articles. The respiratory system was found to be the most affected system in the human body. Lead, platinum-group elements (platinum, rhodium, and bohrium), aluminum, zinc, vanadium, and polycyclic aromatic hydrocarbons were the components of road dust that were most frequently referenced in the articles reviewed. Road dust was found to have harmful effects on the human body, especially on the respiratory system. To determine the complex mechanism of action of various components of road dust on the human body and the results thereof, the authors recommend a further meta-analysis and extensive risk-assessment research into the health impacts of dust exposure.

Summary

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Original Articles

Income-related inequality in completed suicide across the provinces of Iran: Mohammad Hassan Kazemi-Galougahi, Asieh Mansouri, Samaneh Akbarpour, Mahmood Bakhtiyari, Majid Sartipi, Rahmatollah Moradzadeh; Epidemiol Health. 2018;40:e2018012. Published online April 2, 2018; DOI: https://doi.org/10.4178/epih.e2018012

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Abstract PDF

Abstract

OBJECTIVES
The aim of this study was to measure income-related inequality in completed suicide across the provinces of Iran.

METHODS

This ecological study was performed using data from the Urban and Rural Household Income and Expenditure Survey-2010 conducted by the Iranian Center of Statistics, along with data on completed suicide from the Iranian Legal Medicine Organization in 2012. We calculated the Gini coefficient of per capita income and the completed suicide rate, as well as the concentration index for per capita income inequality in completed suicide, across the provinces of Iran.

RESULTS

The Gini coefficients of per capita income and the completed suicide rate in the provinces of Iran were 0.10 (95% confidence interval [CI], 0.06 to 0.13) and 0.34 (95% CI, 0.21 to 0.46), respectively. We found a trivial decreasing trend in the completed suicide incidence rate according to income quintile. The poorest-to-richest ratio in the completed suicide rate was 2.01 (95% CI, 1.26 to 3.22). The concentration index of completed suicide in the provinces of Iran was -0.12 (95% CI, -0.30 to 0.06).

CONCLUSIONS

This study found that lower income might be considered as a risk factor for completed suicide. Nonetheless, further individual studies incorporating multivariable analysis and repeated cross-sectional data would allow a more fine-grained analysis of this phenomenon.

Summary

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Prevalence of goiter and associated factors among schoolchildren in northeast Ethiopia: Emebet Tigabu, Kindie Bantie Bekele, Berihun Assefa Dachew; Epidemiol Health. 2017;39:e2017055. Published online November 25, 2017; DOI: https://doi.org/10.4178/epih.e2017055

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Abstract PDF

Abstract

OBJECTIVES
Goiter is a major public health problem, especially in developing countries such as Ethiopia. Hence, this study aimed to assess the prevalence and associated factors of goiter among children in Waghimra Zone, northeast Ethiopia.

METHODS

A cross-sectional study was conducted from April 8 to 25, 2015 in northeast Ethiopia. A multistage sampling method was used to select 454 schoolchildren. Data were collected using a pre-tested structured interviewer-administered questionnaire. Children were examined for the presence or absence of goiter based on the criteria of the United Nations Children’s Fund, International Council for the Control of Iodine Deficiency, and the World Health Organization. Salt samples from children’s homes were tested for iodine levels using a rapid iodized salt test kit. Data were entered into EpiInfo version 7 and exported to SPSS version 20 for analysis. Bivariate and multivariate logistic regression models were fitted, and adjusted odds ratio (aOR) with 95% confidence interval (CI) were computed to determine the level of significance.

RESULTS

The prevalence of goiter was 62.1% (95% CI, 57.5 to 66.5%). Being female (aOR, 3.09; 95% CI, 1.57 to 6.08), having a family history of goiter (aOR, 5.18; 95% CI, 2.43 to 11.03), and using non-iodized salt (aOR, 2.20; 95% CI, 1.12 to 4.38) were factors associated with goiter among schoolchildren.

CONCLUSIONS

The prevalence of goiter was high. Being female and having a family history of goiter increased the risk of goiter in children, but using iodized salt was protective. Therefore, we recommend ensuring universal access to iodized salt and increasing the awareness of the community of the importance of iodized salt utilization.

Summary

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Gebremedhin Gebremichael, Melake Demena, Gudina Egata, Berhe Gebremichael
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Muzemil Muktar, Kedir Teji Roba, Bezatu Mengistie, Berhe Gebremichael, Adamu Belay Tessema, Meseret Woldeyohannes Kebede, Sun Young Lee
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Epidemiology and risk factors of voluntary pesticide poisoning in Morocco (2008-2014): Zineb Nabih, Latifa Amiar, Zakaria Abidli, Maria Windy, Abdelmajid Soulaymani, Abdelrhani Mokhtari, Rachida Soulaymani-Bencheikh; Epidemiol Health. 2017;39:e2017040. Published online September 1, 2017; DOI: https://doi.org/10.4178/epih.e2017040

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Abstract PDF

Abstract

OBJECTIVES
To determine the epidemiological profile and risk factors of voluntary poisoning by pesticides.

METHODS

A retrospective analysis was conducted of all cases of voluntary poisoning by pesticides registered at the AntiPoison and Pharmacovigilance Center of Morocco between January 2008 and December 2014.

RESULTS

During the study period, 2,690 cases of acute pesticide poisoning were registered. The region of Rabat-Salé-Zemmour-Zaer accounted for the largest proportion, with 598 cases. The average age of the patients was 24.63±10.29 years. The sex ratio (female-to-male) was 0.45. Adults and teenagers were most affected by this type of poisoning, with 1,667 cases (62.0%) and 806 cases (30.0%), respectively. Suicide attempts accounted for 98.4% of the cases (2,469 cases). Pesticide poisoning occurred more often in urban zones (64.8%). Insecticides were incriminated in 14.0% of cases, with a mortality rate of 4.2%. Among the 1,635 patients for whom the outcomes were known, 154 died, corresponding to a mortality rate of 5.7%.

CONCLUSIONS

Voluntary intoxication by pesticides presents a real scourge that affects public health, and in this study, we developed an epidemiological profile of this phenomenon. Nevertheless, this study has limitations in that it did not evaluate the impact of the socioeconomic and psychological factors that are important contributors to this type of poisoning.

Summary

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Review

Occupational risk factors among Iranian farmworkers: a review of the available evidence: Mahin Ghafari, Zahra Cheraghi, Amin Doosti-Irani; Epidemiol Health. 2017;39:e2017027. Published online July 2, 2017; DOI: https://doi.org/10.4178/epih.e2017027

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Abstract

Farming is one of the most important components of most economies. No comprehensive picture exists of the health status of Iranian farmers and the work-related hazards that affect them. We aimed to determine the gaps in the current knowledge regarding the occupational health of Iranian farmworkers. Electronic databases including Medline, Web of Science, Scopus, and Embase, as well as national databases including the Scientific Information Database, MagIran, and Barakat Knowledge System, were searched for articles published through March 2017. All epidemiologic studies regarding the occupational health of farmworkers in Iran were reviewed, regardless of their design, language, time of publication, and location. Of the 86 retrieved articles, 39 studies were ultimately analyzed. Most studies were conducted in Fars, Kerman, and Mazandaran provinces. According to the results of this review, chemical, physical, and biological hazards, along with work-related injuries, may be the main factors threatening the health of farmworkers. The unsafe use of pesticides was related to male infertility, eye and digestive complications, pesticide poisoning, pesticide absorption, hematological changes, non-Hodgkin lymphoma, and multiple myeloma. Chemical hazards (e.g., the unsafe use of pesticides), physical hazards, injuries, and biological hazards (e.g., work-related infectious diseases) threaten the health of Iranian farmworkers. Moreover, farmworkers lack adequate knowledge about the occupational hazards they face and the relevant risk factors.

Summary

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Perspective

An opposing view on including high school students in a latent tuberculosis infection control program in Korea: Jong-Myon Bae; Epidemiol Health. 2017;39:e2017015. Published online March 31, 2017; DOI: https://doi.org/10.4178/epih.e2017015

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Abstract Summary PDF Supplementary Material

Abstract

The Korea Centers for Diseases Control and Prevention (KCDC) has announced a control program against latent Mycobacterium tuberculosis infection (LTBI), for a “TB-safe country” this year with the goal of a “TB-free Korea” by 2025. The program includes high school students as one target group; however, some school health teachers and parents have expressed their opposition to this. The 2015 World Health Organization guidelines do not recommend inclusion of asymptomatic high school students in LTBI control programs. Based on this guideline, the KCDC should consider excluding this population from the program.

Summary

Korean summary
질병관리본부는 결핵안심국가를 만들기 위하여 고등학교 1학년생을 포함한 잠복결핵감염 검사사업을 2017년 추진하기로 공고하였다. 그러나 2015년에 발표된 WHO 지침에 따르면 해당 대상자들은 검사대상자로 제시되어 있지않다. 근거중심의 보건정책 추진을 위해서 사업 대상 선정을 재검토할 필요가 있다.

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Latent tuberculosis infection: recent progress and challenges in South Korea
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Vitamin D supplementation as a control program against latent tuberculosis infection in Korean high school students
Eun Hee Kim, Jong-Myon Bae
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Review

The criteria for metabolic syndrome and the national health screening and education system in Japan: Kazumasa Yamagishi, Hiroyasu Iso; Epidemiol Health. 2017;39:e2017003. Published online January 6, 2017; DOI: https://doi.org/10.4178/epih.e2017003

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Abstract

Two major definitions of metabolic syndrome have been proposed. One focuses on the accumulation of risk factors, a measure used by the American Heart Association (AHA) and the National Heart, Lung, and Blood Institute (NHLBI); the other focuses on abdominal obesity, a measure used by the International Diabetes Federation (IDF) and the Japanese government. The latter definition takes waist circumference (WC) into consideration as an obligatory component, whereas the former does not. In 2009, the IDF, NHLBI, AHA, and other organizations attempted to unify these criteria; as a result, WC is no longer an obligatory component of those systems, while it remains obligatory in the Japanese criteria. In 2008, a new Japanese cardiovascular screening and education system focused on metabolic syndrome was launched. People undergoing screening are classified into three groups according to the presence of abdominal obesity and the number of metabolic risk factors, and receive health educational support from insurers. This system has yielded several beneficial outcomes: the visibility of metabolic syndrome at the population level has drastically improved; preventive measures have been directed toward metabolic syndrome, which is expected to become more prevalent in future generations; and a post-screening education system has been established. However, several problems with the current system have been identified and are under debate. In this review, we discuss topics related to metabolic syndrome, including (1) the Japanese criteria for metabolic syndrome; (2) metabolic syndrome and the universal health screening and education system; and (3) recent debates about Japanese criteria for metabolic syndrome.

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Indian Journal of Dermatology.2020; 65(3): 228. CrossRef
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Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2020; Volume 13: 1753. CrossRef
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Food Science & Nutrition.2020; 8(7): 3492. CrossRef
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Asia-Pacific Journal of Ophthalmology.2020; 9(1): 14. CrossRef
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Journal of Diabetes Investigation.2020; 11(6): 1511. CrossRef
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Diagnostics.2020; 10(8): 510. CrossRef
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Preventive Medicine.2020; 141: 106301. CrossRef
Lycopene and Metabolic Syndrome: A Systematic Review of the Literature
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Advances in Nutrition.2019; 10(1): 19. CrossRef
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Nutrients.2019; 11(6): 1430. CrossRef
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Journal of Digestive Diseases.2019; 20(10): 557. CrossRef
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Perspective

The effect of smoking on lung cancer: ethnic differences and the smoking paradox: Keum Ji Jung, Christina Jeon, Sun Ha Jee; Epidemiol Health. 2016;38:e2016060. Published online December 20, 2016; DOI: https://doi.org/10.4178/epih.e2016060

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Abstract Summary PDF

Abstract

The objectives of this review were to determine whether the smoking paradox still exists and to summarize possible explanations for the smoking paradox. Based on published data, we compared the risk of cigarette smoking for lung cancer in Western and Asian countries. We extracted data from the relevant studies about annual tobacco consumption, lung cancer mortality rates according to smoking status from each country, and possible explanations for the smoking paradox. A significantly greater risk of lung cancer death was found among current smokers in Asian countries than among nonsmokers, with relative risks (RRs) of 4.0 to 4.6 for Koreans, 3.7 to 5.1 for Japanese, and 2.4 to 6.5 for Chinese. Although a significantly greater risk of lung cancer was present among current smokers in Asian countries, the RRs in Asian countries were much lower than those reported in Western countries (range, 9.4 to 23.2). Possible explanations for the smoking paradox included epidemiologic characteristics, such as the smoking amount, age at smoking initiation, and the use of filtered or mild tobacco. The smoking paradox definitely exists, but may be explained by major epidemiologic characteristics. Therefore, the smoking paradox should not be interpreted as indicating that tobacco is safer or less harmful for Asians.

Summary

Korean summary
흡연이 폐암에 미치는 관련성의 인종 차이 흡연은 폐암의 가장 큰 원인으로 알려져 있다. 그러나 흡연이 폐암에 미치는 관련성의 크기는 영국, 미국 등 서양에서 발표된 연구결과에서 10-20배 정도로 보고되고 있으나 한국, 일본, 중국 등 동양에서 발표된 연구에서 3-5배 정도로 낮게 보고되고 있다. 이러한 차이는 흡연유행, 담배성분, 흡연자 특성, 그리고 유전적인 차이로 일부 설명되고 있으나 아직 완전히 이해되어진 상태는 아니다. 이는 공중보건학적으로 매우 중요한 의미를 가지므로 동서양의 직접적인 비교연구가 필요할 것으로 생각된다.

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MERS-Original Article

Preventive behaviors by the level of perceived infection sensitivity during the Korea outbreak of Middle East Respiratory Syndrome in 2015: Soon Young Lee, Hee Jeong Yang, Gawon Kim, Hae-Kwan Cheong, Bo Youl Choi; Epidemiol Health. 2016;38:e2016051. Published online November 16, 2016; DOI: https://doi.org/10.4178/epih.e2016051

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study was performed to investigate the relationship between community residents’ infection sensitivity and their levels of preventive behaviors during the 2015 Middle East Respiratory Syndrome (MERS) outbreak in Korea.

METHODS

Seven thousands two hundreds eighty one participants from nine areas in Gyeonggi-do including Pyeongtaek, the origin of the outbreak in 2015 agreed to participate in the survey and the data from 6,739 participants were included in the final analysis. The data on the perceived infection sensitivity were subjected to cluster analysis. The levels of stress, reliability/practice of preventive behaviors, hand washing practice and policy credibility during the outbreak period were analyzed for each cluster.

RESULTS

Cluster analysis of infection sensitivity due to the MERS outbreak resulted in classification of participants into four groups: the non-sensitive group (14.5%), social concern group (17.4%), neutral group (29.1%), and overall sensitive group (39.0%). A logistic regression analysis found that the overall sensitive group with high sensitivity had higher stress levels (17.80; 95% confidence interval [CI], 13.77 to 23.00), higher reliability on preventive behaviors (5.81; 95% CI, 4.84 to 6.98), higher practice of preventive behaviors (4.53; 95% CI, 3.83 to 5.37) and higher practice of hand washing (2.71; 95% CI, 2.13 to 3.43) during the outbreak period, compared to the non-sensitive group.

CONCLUSIONS

Infection sensitivity of community residents during the MERS outbreak correlated with gender, age, occupation, and health behaviors. When there is an outbreak in the community, there is need to maintain a certain level of sensitivity while reducing excessive stress, as well as promote the practice of preventive behaviors among local residents. In particular, target groups need to be notified and policies need to be established with a consideration of the socio-demographic characteristics of the community.

Summary

Korean summary
2015년 한국에서 발생한 메르스 유행 시 지역 주민이 인식하는 민감도와 예방행위 수준을 파악하고 연관성을 밝히고자 2015년 경기도 9개 시의 지역사회건강조사 대상자 6,739명을 대상으로 감염 민감도와 예방행위 등을 조사 분석하였다. 감염 민감도는 성별, 연령, 직업, 건강행위와 연관성이 있었으며, 감염에 대한 민감도가 높을수록 스트레스를 많이 받는 한편, 예방행위 실천에 긍정적인 영향을 미침을 알 수 있었다. 따라서 감염병 유행 시 지나친 스트레스는 줄이되 공중보건 위기에 대한 적정 수준의 민감도를 유지하고, 인구사회학적 특성을 고려한 관리정책이 요구된다.

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Original Article

Estimation of the population attributable fraction of road-related injuries due to speeding and passing in Iran: Fatemeh Khosravi Shadmani, Hamid Soori, Kamyar Mansori, Manoochehr Karami, Erfan Ayubi, Salman Khazaei; Epidemiol Health. 2016;38:e2016038. Published online August 29, 2016; DOI: https://doi.org/10.4178/epih.e2016038

25,814 View
288 Download
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Abstract PDF

Abstract

OBJECTIVES
Speeding and passing are considered to be the main human factors resulting in road traffic injuries (RTIs). This study aimed to estimate the population attributeable fraction (PAF) of speeding and passing in RTIs in rural Iran during 2012.

METHODS

The contribution of speeding and passing to RTI-related morbidity and mortality was estimated using the PAF method. The prevalence of speeding and passing was obtained from the national traffic police data registry. A logistic regression model was used to measure the association between the above risk factors and RTIs.

RESULTS

Speeding accounted for 20.96% and 16.61% of rural road-related deaths and injuries, respectively. The corresponding values for passing were 13.50% and 13.44%, respectively. Jointly, the PAF of these factors was 31.63% for road-related deaths and 27.81% for injuries.

CONCLUSIONS

This study illustrates the importance of controlling speeding and passing as a high-priority aspect of public-health approaches to RTIs in Iran. It is recommended that laws restricting speeding and passing be enforced more strictly.

Summary

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