일부 농촌지역 사망신고자료에 기재된 사인에 관한 연구 -사망신고사인과 조사사인의 비교-

남해성,박경수,선병환,신준호,손석준,최진수,김병우,Nam, Hae-Sung,Park, Kyeong-Soo,Sun, Byeong-Hwan,Shin, Jun-Ho,Sohn, Seok-Joon,Choi, Jin-Su,Kim, Byong-Woo 대한예방의학회 1996 예방의학회지 Vol.29 No.2

This study was conducted to evaluate the accuracy of the official death registry in rural area. The base data used for the study was 379 deaths registered during the period of 1993 and 1994 in 4 rural townships of Chonnam province. The interview survey for cause-of-death was performed on the next of kin and/or neighbor. Additional medical informations were collected from hospitals and medical insurance associations for the purpose of verification. The underlying cause-of-death of 278 cases presumed by the survey was compared to the cause on official death registry. There was a prominent disagreement of cause-of-death between the survey data and the registry data(agreement rate: $38.9\sim44.6%$, according to disease classification method). These results may be caused by extremely low rates of physicians' certification, which were mostly confined to the poisoning and injury. Symptoms, signs, and ill defined conditions on death registry could be classified into circulatory disease(32.3%), neoplasm(21.2%), digestive disease(7.1%), injury and poisoning(7.1%) and so on. These results suggest that careful attention and verification be required on utilization of death registry data in rural area.

일부 농촌지역 시설노인의 건강상태

남해성(Hae-Sung Nam),박경수(Kyeong-Soo Park),이정애(Jung-Ae Rhee) 한국농촌의학 지역보건학회 1999 농촌의학·지역보건 Vol.24 No.2

농촌지역과 어촌지역 주민들의 건강행태 비교

남해성(Hae-Sung Nam),이정애(Jung-Ae Rhee),신준호(Jun-Ho Shin),손명호(Myong-Ho Son),권순석(Sun-Seok Kweon),나백주(Baeg-Ju Na),김순영(Soon-Young Kim) 한국농촌의학 지역보건학회 2002 농촌의학·지역보건 Vol.27 No.1

남원지역 고연령 인구에서 당뇨병의 유병률

김상국(Sang Guk Kim),양승원(Seung Won Yang),박상후(Sang Hoo Park),이경록(Kyung Rok Lee),박재홍(Jae Hong Park),장안수(An Soo Jang),서정평(Jeong Pyeong Seo),이숭(Soong Lee),남해성(Hae Sung Nam),손명호(Myung Ho Sun),신명근(Myung Geun S 대한내과학회 2001 대한내과학회지 Vol.60 No.6

N/A Background : Significant ethnic and geographic differences exist in the prevalence of diabetes mellitus, which has increased dramatically in South Korea. But a few population-based studies were performed in South Korea. The purpose of this study was to determine the prevalence of diabetes mellitus, impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) by the World Health Organization (WHO) and the American Diabetic Association (ADA) diagnostic categories, and to investigate their associated risk factors. Methods : Between march 22, 1999 and July 14, 1999, a random sampling of 1445 residents over 40 year of age in five villages in the Namwon county of South Korea was carried out. Among these subjects, 665 (46.0%) participants completed 75 g OGTT. WHO and ADA diagnostic criteria were used for the diagnosis of diabetes mellitus, IGT and IFG. Detailed questionnaire were performed and anthropometric data were collected. Results : After age-adjustment for population projection for Korea (1999), the prevalence of diabetes and IGT were 13.7% and 13.8% with WHO criteria, while the prevalence of diabetes, IGT and IFG were 15.8%, 12.8% and 5.7% with ADA criteria. The age-adjusted prevalence of previously diagnosed diabetes was 5.8%. The level of agreement between WHO and ADA diagnostic criteria except IFG was high (κ=0.94; p<0.001). The ROC curve analysis determined FSG of 114.5 mg/dL (6.4 mmol/L) to yield optimal sensitivity and specificity corresponding to a PP2SG 200 mg/dL (11.1 mmol/L). The prevalence of diabetes and IGT with ADA diagnostic criteria rose with increasing age (p<0.05). The difference in the prevalence of diabetes, IGT and IFG by BMI was not significant. The prevalence of diabetes rose with increase in the waist-hip ratio. The prevalence of diabetes was increased in subjects with dyslipidemia (Odds ratio 2.29, 95% CI: 1.16-3.49).

일 도시 시설노인들과 지역노인들의 건강관련 삶의 질 비교

박경수,서용길,남해성,손석준,이정애,Park, Kyeong-Soo,Seo, Yong-Gil,Nam, Hae-Sung,Sohn, Seok-Joon,Rhee, Jung-Ae 대한예방의학회 1998 예방의학회지 Vol.31 No.2

The purpose of this study is to compare the level of health-related quality of life and relating factor between institutional elderly and community living elderly. The subjects were 390 from Sanatorium or Nursing home and 467 from the community in Kwangju. The results are followed : 1) A comparison of ADL between two groups, institutional elderly and community living elderly, resulted in that community elderly were more significantly independent in the areas of bathing and transfer than institutional elderly. 2) A comparison of IADL between two groups resulted in that : Community elderly were more independent in the areas of using telephone and transportation, food preparation, house keeping, and doing laundry. Institutional elderly were more independent in the area of handling finances. 3) In the case of poor health-related quality of life, institutional elderly showed 2.4 times in the dimension of physical fitness, 1.8 times in daily activity, 2 times in social activity, 2 times in pain, 26.7 times in social support, and 0.4 times in subjective quality of life higher than community elderly There was no significant differences in the rest of dimensions. 4) In institutional elderly, the analysis of variables related to the health-related quality of life resulted in that; The relating factors were sex, education, and chronic illness in the dimension of physical function. Direct contact with family or significant others in the dimension of social activity. Chronic illness in the dimension of pain and perceived health status. Direct or indirect contact with family or significant others over the phone or through letters in the dimension of social support. 5) The analysis of variables related to the health-related quality of life showed that community elderly has more relating variables in each area than institutional elderly. The relating factors were age, sex, and chronic illness in the dimension of physical function. Education and chronic illness in the dimension of emotional status. Age and chronic illness in the dimension of daily activity and social activity Education and chronic illness in the dimension of pain and perceived health status. Sex, education, family size in the dimension of social support. Education and chronic illness in the dimension of subjective quality-of-life. Throughout general daily activity, community elderly showed more satisfactory results than institutional elderly, but in the subjective area of health-related quality of life, such as subjective quality of life, institutional elderly group showed more positive results. And community elderly had more relating factors than institutional elderly. For the health care of the elderly that focused on quality of life, new approaches considering the characteristics of both group, institutional and community living elderly, are needed.

일개 군 사망신고자료에 기재된 사인의 정확성과 관련요인

신희영,신준호,남해성,류소연,임정수,이정애,정은경,Shin, Hee-Young,Shin, Jun-Ho,Nam, Hae-Sung,Ryu, So-Yeon,Im, Jeong-Soo,Rhee, Jung-Ae,Chung, Eun-Kyung 대한예방의학회 2002 Journal of Preventive Medicine and Public Health Vol.35 No.2

Objectives : To evaluate the accuracy of the registered cause of death in a county and its related factors. Methods : The data used in this study was based on 504 cases, in a county of Chonnam province, registered between January and December 1998. Study subjects consisted of 388 of the 504 cases, and their causes of death were established by an interview survey of the next of kin or neighbor and medical record surveys. We compared the registered cause of death with the confirmed cause of death, determined by surveys and medical records, and evaluated the factors associated with the accuracy of the registered cause of death. Results : 62.6% of the deaths were concordant with 19 Chapters classification of cause of death. external causes of mortality, endocrine, nutritional and metabolic diseases, neoplasms and diseases of the circulatory system showed the good agreement between the registered cause of death and the confirmed cause of death. The factors relating to the accuracy of the registered cause of death were the doctors' diagnosis for the cause of death (adjusted Odds Ratio: 2.67, 95% Confidence Interval: 1.21-5.89) and the grade of the public officials in charge of the death registry (adjusted Odds Ratio: 0.30, 95% CI=0.12-0.78). Conclusions : The accuracy of the registered cause of death was not high. It could be improved by using the doctors' diagnosis for death and improving the job specification for public officials who deal with death registration. 전라남도의 일개 군에서 1998년 1월 1일부터 1998년 12월 31일까지 사망으로 신고된 건수는 총 504건이었으며, 이중 설문조사와 의무기록조사로 확인사인의 추정이 가능했던 388건을 연구대상으로 하였다. 확인사인을 신고사인과 비교하고 사망자와 사망관련 변수, 신고자의 특성 그리고 사망신고담당 공무원의 특성에 따른 양자간의 일치율을 통해 신고사인의 정확성과 관련된 인자를 파악하였다. 신고사인과 확인사인의 전체적 일치율은 19대 분류상 62.6%을 보였다. 19대 분류에 의한 사인별 일치율을 보면 손상, 중독 및 사망의 외인이 가장 높았고, 그 다음으로는 내분비, 영양 및 대사질환, 신생물, 순환기계질환 순이었다. 반면에 낮은 일치율을 보인 질환은 피부 및 피하조직의 질환, 근골격계 질환, 정신 및 행동장애 이었다. 사망자 및 사망관련변수에 따른 확인사인과 신고사인의 일치율은 사망자가 남자일 때, 사망 연령이 50대와 60대일 때, 그리고 사망원인 진단자가 의사일 때 높았다. 신고자의 특성별로는 신고자의 연령이 증가함에 따라 일치율이 감소하였으며, 신고자의 교육 정도와 직업과도 유의한 관련성이 있었다. 또한 사망신고 담당 공무원의 특성에 따라서는 공무원의 직급이 6급인 경우 7급 이상인 경우에 비해 일치율이 높았다. 확인사인과 신고사인의 일치여부를 종속변수로 하여 단변량분석을 실시한 후 통계적으로 의미 있는 변수에 대한 로지스틱 회귀분석의 결과를 보면, 사망원인 진단자가 의사인 경우 비차비 2.67(95% 신뢰구간: 1.21-5.89)로 높았으며, 사망신고담당 공무원의 직급이 7급 이상인 경우 비차비 0.30(95%신뢰구간: 0.12-0.78)로 낮았다. 사망신고자료에 기재된 신고사인의 정확성과 관련된 요인에 대한 결과를 종합하여 볼 때 무엇보다 중요한 일은 사망을 의사로 하여금 진단하게 하는 일이다. 또한 사망신고담당 공무원의 업무를 명확히 해야 하며 이들을 대상으로 하는 정기적이며 강화된 교육도 강조되어야 할 것이다.

2019년 충남지역에서 발생한 식중독 현황과 원인분석

이현아(Hyunah Lee),남해성(Hae-Sung Nam),최지혜(Jihye Choi),박성민(Seongmin Park),박종진(Jongjin Park),김현민(Hyeonmin Kim),천영희(Younghee Cheon),박준혁(Junhyuk Park) 한국환경보건학회 2020 한국환경보건학회지 Vol.46 No.2

Objectives: This study was performed to analyze cases of food poisoning outbreaks reported in Chungcheongnam-do Province in 2019 and report it as effective data for preventing food poisoning in the future. Methods: Food poisoning outbreaks were analyzed to detect virus, bacteria, and protozoa according to the Manual for Detection of Foodborne Pathogens in Outbreaks to clarify the causes of food poisoning that occurred in Chungcheongnam-do Province in 2019. Results: Among the 79 cases of food poisoning outbreaks, 59 cases (74.7%) were in general restaurants, 15 cases (19.0%) in food service institutions, three cases at banquets, and two cases in take-out food. The 42 cases at general seafood restaurants made up the majority of food poisoning in Chungcheongnam-do. Food poisoning pathogens were shown in 13 cases (86.7%) out of the 15 cases at food service institutions, and 10 cases were related to Norovirus. Among the 79 cases, food-borne pathogens were identified in 35 cases of outbreaks, accounting for 44.3%. The confirmed pathogens were as follows: bacteria (24 cases), Norovirus (12 cases) and Kudoa septempunctata. (five cases). The food-borne bacteria were pathogenic E. coli (12 cases), Staphylococcus aureus (six cases), Salmonella spp. (two cases), Campylobacter jejuni, Bacillus cereus, Clostridium perfringens, and Vibrio parahaemolyticus (one case). Conclusions: To prevent food poisoning, it is necessary to analyze regional characteristics and environments and to hold a campaign for the prevention of food poisoning based on that analysis. In addition, when food poisoning occurs, the results of analyzing its cause and spread based on accurate epidemiological survey need to be shared.

지역사회건강조사에서 EQ-5D index의 지역간 변이와 관련 요인: 사회심리적 요인의 중요성

김은수(Eunsu Kim),남해성(Hae-Sung Nam) 한국농촌의학 지역보건학회 2020 농촌의학·지역보건 Vol.45 No.4

이 연구는 생태학적 연구로서 EQ-5D index로 측정되는 건강수준의 시군구 단위 변이를 파악하고 지역사회건강조사 지표에서 이러한 변이를 설명하는 요인을 탐색하고자 하였다. 2017년도 지역사회건강조사자료에서 산출되는 전국 229개 시군구의 EQ-5D index 변이는 EQ(격차비) 1.1배, CV(변이계수) 1.0으로 지역 간 변이는 연구에 포함된 독립변수들에 비해 상대적으로 작았다. EQ-5D index 값이 전국 하위 25%에 속하는 시군구 비중이 높은 광역시도는 전라북도(9개 시군, 64.3%)와 충청남도(7개 시군, 46.7%)이었다. 다중 선형회귀분석 결과 지역 간 변이의 주요 요인으로 우울감 경험률, 스트레스 인지율, 자살생각률, 관절염진단 경험률 등이 도출되었다. 지역간 건강수준의 격차를 줄이기 위해서는 사회심리적 요인들을 포함한 상기 요인들의 개선에 우선순위를 두어야 할 것으로 사료된다. Objectives: As an ecological study, this study was performed to identify the community-level variation of health related quality-of-life (HRQOL), and to explore the factors that explain the variation, using 2017 Korean Community Health Survey (KCHS) data. Methods: Community health indicators of KCHS, which are correlated with the EQ-5D index of Si-gun-gu districts, were selected as independent variables. Multiple linear regression model was used to derive factors that explain regional variations in the EQ-5D index. Results: The EQ-5D index variation in 229 districts nationwide was 1.1 times for extremal quotient (EQ) and 1.0 for coefficient of variance (CV). The Si-gun-gu districts with the EQ-5D index in the lower 25% were more distributed in the province (27.7%) than in the metropolitan area (20.3%). As a result of multiple linear regression analysis, the depressed mood experience rate, perceived stress rate, suicide ideation rate, and physician diagnosed arthritis rate were derived as major factors of the variation. Conclusions: In order to reduce the gap in HRQOL between the districts, the priority of local health policies should be placed on the above factors including psychosocial factors.

일부 농촌지역주민에서 Bioelectric Impedance로 측정한 체지방비율에 대한 고찰

나백주,박요섭,선병환,남해성,신준호,손석준,최진수,Na, Baeg-Ju,Park, Yo-Sub,Sun, Byung-Hwan,Nam, Hae-Sung,Shin, Jun-Ho,Sohn, Seok-Joon,Choi, Jin-Su 대한예방의학회 1997 예방의학회지 Vol.30 No.1

Obesity usually is defined as the presence of and abnormally amount of adipose tissue. In many epidemiologic study, obesity as a health risk factor has been estimated by Body Mass Index(BMI) in general. This study was conducted to review of body fat percent measured by Bioelectric impedance analyzer as a estimator of obesity in a rural adult population. The study subjects were 421 men and 664 women who reside in the area on the Juam lake. They were sampled by multistage cluster sampling. Their mean age was 59 years old. Body fat percent increased with age, but BMI decreased with age in this study. Body fat percent was more larger at female and elder on the same BMI. The correlation coefficient between with body fat percent and body mass index was low (r=0.4737). Body fat percent was explained by not only BMI but also sex and age $(r^2=0.63)$. The result suggested that it is inadequate for BMI only to estimate obesity about elderly person who reside in the rural community. The relation of body fat percent and body mass index of this study agreed with the preceding know-ledges and studies in general.

대전 양치교실사업 30개월 경과시점의 구강병 예방효과

박후섭 ( Hoo Seob Park ),남해성 ( Hae Sung Nam ),최유경 ( Yu Kyoung Choi ),송은주 ( Eun Joo Song ),황수정 ( Soo Jeong Hwang ) 한국치위생과학회 2011 치위생과학회지 Vol.11 No.2

본 연구는 대전 양치교실사업의 2년 6개월경과 시점에서 구강병 예방효과를 추구조사연구로 보고자 하였다. 조사대상은 2008년부터 2010년 5월 현재 양치교실이 설치되어 있는 대전 동구 D초등학교 5학년 학생 70명을 실험군으로 선정하였으며 대조군으로는 지리적, 경제적 상태, 학교 규모가 비슷할 것으로 예측되며 학교장의 협조를 얻을수 있었던 대전 동구 S초등학교 5학년 학생 70명을 선정하였다. 조사방법은 구장검사로 치면세균막검사, 치아우식증검사를 양치교실 경과 6개월 시점, 18개월 시점, 30개월 시점에 실시하였으며, 30개월 시점에서는 치은지수검사, 치은열구액 수집을 추가하여 치은열구액 내 MMP-9 을 분석하였으며, 구강보건지식도 및 행위 도를 분석하였다. 1. 치아우식증 관련지수에 있어서 2년 6개월 경과함에 따른 양치교실군과 대조군의 유의한 차이가 없었다. 2. 치면세균막지수는 양치교실군이 대조군에 비해 유의하게 낮았다. 3. 치주질환 관련지수인 치은지수, 치석지수는 양치교실 군과 대조군의 유의한 차이가 없었다. 4. 치은열구액 내 MMP-9의 농도에 있어서 양치교실군이 대조군에 비해 낮았으나 유의한 차이가 없었다. 5. 구강보건지식에 있어서 양치교실군이 대조군에 비해 지식상태가 높은 것으로 나타났다. 6 구장보건행위도, 1일 잇솔질 횟수, 교내 양치도구 준비에 있어서 양치교실군과 대조군의 유의한 차이가 없었다. 결론적으로 양치교실사업에 있어 치연세균막제거의 효 과는 검증할 수 있었으나 치아우식증예방 치주질환예방효과는 불분명하며 행위도나 양치도구 구비 여부를 보았을 때 현재 대전 D초의 양치교실사업이 효율적으로 운용되고 있지 않은 것으로 판단되기 때문에 양치교실사업의 효과를 보기 위해서는 양치교실 설치 뿐 아니라 적절한 응용프로그램과 운용에 대한 책임 소재, 학교측과 학부모의 관심이 있어야 할 것으로 사료되었다. The aim of this study was to investigate the prevention effect of oral disease on the school-based toothbrushing program(SBTBP) in Daejeon in 30 months. The experimental subjects were the 5th grade`s 70 students who have gone to school with the school-based toothbrushing program since the 3th-grade. The control school was located in close geographical area with similar economical status. The questionnaire about oral health knowledge and behavior was done by self-recording. After one dentist examined the dental caries and periodontal status, the gingival crevicular fluid(GCF) was collected with #25 paperpoint for 1 miniutes. Matrix Metalloproteinase(MMP)-9 in GCF was analyzed by ELISA. The SBTBP group had the upper oral health knowledge than the control significantly(p<0.001), but, the SBTBP group had no difference of the oral health behavior from the control. Although the SBTBP group had the lower plaque index than the control significantly(p=0.02), the SBTBP group had no difference of the gingival index, calculus index and the concentration of MMP-9 in GCF from the control. In conclusion, The SBTBP had the effect to reduce the dental plaque and to improve the oral health knowledge. On the other hand, the effect to prevent dental caries and periodontal disease of SBTBP was not clear.