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      • KCI등재
      • SCOPUSKCI등재

        Serum 2,3,7,8-Tetrachlorodibenzo-p-dioxin Levels and Their Association With Age, Body Mass Index, Smoking, Military Record-based Variables, and Estimated Exposure to Agent Orange in Korean Vietnam Veterans

        Yi, Sang-Wook,Ohrr, Heechoul,Won, Jong-Uk,Song, Jae-Seok,Hong, Jae-Seok The Korean Society for Preventive Medicine 2013 Journal of Preventive Medicine and Public Health Vol.46 No.5

        Objectives: The aim of this study was to examine the levels of serum 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and evaluate their association with age, body mass index, smoking, military record-based variables, and estimated exposure to Agent Orange in Korean Vietnam veterans. Methods: Serum levels of TCDD were analyzed in 102 Vietnam veterans. Information on age, body mass index, and smoking status were obtained from a self-reported questionnaire. The perceived exposure was assessed by a 6-item questionnaire. Two proximitybased exposures were constructed by division/brigade level and battalion/company level unit information using the Stellman exposure opportunity index model. Results: The mean and median of serum TCDD levels was 1.2 parts per trillion (ppt) and 0.9 ppt, respectively. Only 2 Vietnam veterans had elevated levels of TCDD (>10 ppt). The levels of TCDD did not tend to increase with the likelihood of exposure to Agent Orange, as estimated from either proximity-based exposure or perceived self-reported exposure. The serum TCDD levels were not significantly different according to military unit, year of first deployment, duration of deployment, military rank, age, body mass index, and smoking status. Conclusions: The average serum TCDD levels in the Korean Vietnam veterans were lower than those reported for other occupationally or environmentally exposed groups and US Vietnam veterans, and their use as an objective marker of Agent Orange exposure may have some limitations. The unit of deployment, duration of deployment, year of first deployment, military rank, perceived self-reported exposure, and proximity-based exposure to Agent Orange were not associated with TCDD levels in Korean Vietnam veterans. Age, body mass index and smoking also were not associated with TCDD levels.

      • SCOPUSKCI등재

        Low Systolic Blood Pressure and Mortality From All Causes and Vascular Diseases Among Older Middle-aged Men: Korean Veterans Health Study

        Yi, Sang-Wook,Ohrr, Heechoul The Korean Society for Preventive Medicine 2015 Journal of Preventive Medicine and Public Health Vol.48 No.2

        Objectives: Recently, low systolic blood pressure (SBP) was found to be associated with an increased risk of death from vascular diseases in a rural elderly population in Korea. However, evidence on the association between low SBP and vascular diseases is scarce. The aim of this study was to prospectively examine the association between low SBP and mortality from all causes and vascular diseases in older middle-aged Korean men. Methods: From 2004 to 2010, 94 085 Korean Vietnam War veterans were followed-up for deaths. The adjusted hazard ratios (aHR) were calculated using the Cox proportional hazard model. A stratified analysis was conducted by age at enrollment. SBP was self-reported by a postal survey in 2004. Results: Among the participants aged 60 and older, the lowest SBP (<90 mmHg) category had an elevated aHR for mortality from all causes (aHR, 1.9; 95% confidence interval [CI], 1.2 to 3.1) and vascular diseases (International Classification of Disease, 10th revision, I00-I99; aHR, 3.2; 95% CI, 1.2 to 8.4) compared to those with an SBP of 100 to 119 mmHg. Those with an SBP below 80 mmHg (aHR, 4.5; 95% CI, 1.1 to 18.8) and those with an SBP of 80 to 89 mmHg (aHR, 3.1; 95% CI, 0.9 to 10.2) also had an increased risk of vascular mortality, compared to those with an SBP of 90 to 119 mmHg. This association was sustained when excluding the first two years of follow-up or preexisting vascular diseases. In men younger than 60 years, the association of low SBP was weaker than that in those aged 60 years or older. Conclusions: Our findings suggest that low SBP (<90 mmHg) may increase vascular mortality in Korean men aged 60 years or older.

      • SCOPUSKCI등재

        Agent Orange Exposure and Prevalence of Self-reported Diseases in Korean Vietnam Veterans

        Yi, Sang-Wook,Ohrr, Heechoul,Hong, Jae-Seok,Yi, Jee-Jeon The Korean Society for Preventive Medicine 2013 Journal of Preventive Medicine and Public Health Vol.46 No.5

        Objectives: The aim of this study was to evaluate the association between Agent Orange exposure and self-reported diseases in Korean Vietnam veterans. Methods: A postal survey of 114 562 Vietnam veterans was conducted. The perceived exposure to Agent Orange was assessed by a 6-item questionnaire. Two proximity-based Agent Orange exposure indices were constructed using division/brigade-level and battalion/ company-level unit information. Adjusted odds ratios (ORs) for age and other confounders were calculated using a logistic regression model. Results: The prevalence of all self-reported diseases showed monotonically increasing trends as the levels of perceived self-reported exposure increased. The ORs for colon cancer (OR, 1.13), leukemia (OR, 1.56), hypertension (OR, 1.03), peripheral vasculopathy (OR, 1.07), enterocolitis (OR, 1.07), peripheral neuropathy (OR, 1.07), multiple nerve palsy (OR, 1.14), multiple sclerosis (OR, 1.24), skin diseases (OR, 1.05), psychotic diseases (OR, 1.07) and lipidemia (OR, 1.05) were significantly elevated for the high exposure group in the division/brigade-level proximity-based exposure analysis, compared to the low exposure group. The ORs for cerebral infarction (OR, 1.08), chronic bronchitis (OR, 1.05), multiple nerve palsy (OR, 1.07), multiple sclerosis (OR, 1.16), skin diseases (OR, 1.05), and lipidemia (OR, 1.05) were significantly elevated for the high exposure group in the battalion/company-level analysis. Conclusions: Korean Vietnam veterans with high exposure to Agent Orange experienced a higher prevalence of several self-reported chronic diseases compared to those with low exposure by proximity-based exposure assessment. The strong positive associations between perceived self-reported exposure and all self-reported diseases should be evaluated with discretion because the likelihood of reporting diseases was directly related to the perceived intensity of Agent Orange exposure.

      • SCIESCOPUSKCI등재
      • KCI등재

        한국인에서 고엽제 관련 노출과 건강영향 및 보상정책

        이상욱,오희철,임현술,Yi, Sang-Wook,Ohrr, Heechoul,Lim, Hyun-Sul 한국환경보건학회 2013 한국환경보건학회지 Vol.39 No.3

        Several US veterans stationed in Korea have told the press that around 250 fifty-five gallon drums of herbicides, including Agent Orange, were buried at Camp Carroll in 1978. Joint Korean-US Agent Orange investigation and environmental and health studies were started in July 2011. Korean soldiers and military personnel who served in Vietnam during 1964-1973 or near the demilitarized zone in Korea during 1967-1970 were exposed to dioxincontaminated Agent Orange. The joint Korean-US Agent Orange investigation team found that herbicides, pesticides, solvents and other chemicals -not Agent Orange- were buried at Camp Carroll. However, there remains the possibility that Agent Orange was stored and buried at Camp Carroll or other military camps in Korea. Adverse health effects have not been clearly explained despite a number of health studies among veterans in Korea with potential Agent Orange exposure. Although the Korean government has been compensating veterans and military personnel with 18 presumptive-service-connected-diseases and their offspring with three diseases, there are many veterans, military personnel and civilians who require the government°Øs support. The environmental study on contaminated sites and health studies among veterans and civilians were initiated three or four decades after possible Agent Orange contamination and exposure. Several toxic chemicals, including dioxin-contaminated Agent Orange, could remain in the environment and could have hazardous effects on the health of exposed people for more than several decades. Further environmental investigations and health studies are needed to ensure public safety and health, and government support should be guaranteed for people potentially exposed to these toxic chemicals.

      • SCISCIESCOPUS

        Low Systolic Blood Pressure and Vascular Mortality Among More Than 1 Million Korean Adults

        Yi, Sang-Wook,Mok, Yejin,Ohrr, Heechoul,Yi, Jee-Jeon,Yun, Young Duk,Park, Jihwan,Jee, Sun Ha American Heart Association 2016 Circulation Vol.133 No.24

        <P>Background-The association between low systolic blood pressure (SBP) and vascular disease is unclear, especially in nonclinical populations. Methods and Results-We studied 1 235 246 individuals who participated in routine medical examinations between 1992 and 1995. The hazard ratios (HRs) were adjusted for potential confounders. During 22.7 million person-years of follow-up, 34 816 individuals died of atherosclerotic vascular diseases. An increase in SBP was directly related to an increase in vascular mortality at SBP above approximate to 100 mmHg. The group with the lowest SBP (<90 mm Hg) had a higher HR for mortality from atherosclerotic vascular disease (HR, 1.53; 95% confidence interval, 1.15-2.03) in comparison with those with an SBP of 90 to 99 mm Hg. The HR associated with the lowest SBP was 2.54 (95% confidence interval, 1.51-4.29) for ischemic heart disease and 1.21 (95% confidence interval, 0.79-1.85) for stroke. Regarding stroke subtype, mortality from hemorrhagic stroke (HR per 10 mm Hg increase, 0.53; 95% confidence interval, 0.29-0.96), rather than mortality from ischemic stroke (HR per 10 mm Hg increase, 1.00; 95% confidence interval, 0.51-1.97), was inversely associated with SBP when SBP fell to <100 mm Hg. Even when excluding the first 5 years of follow-up, the HRs associated with the lowest SBP did not decrease. The inverse association between SBP and vascular mortality in the range <100 mm Hg tended to be apparent in people aged 60 to 95 years in comparison with individuals aged 30 to 59 years. Conclusions-J-curve associations exist between SBP and vascular mortality, which reach a nadir at approximate to 100 mm Hg. SBP of <90 mm Hg may portend death from vascular disease, particularly from ischemic heart disease.</P>

      • KCI등재후보
      • Reproductive risk factors for cardiovascular disease mortality among postmenopausal women in Korea: the Kangwha Cohort Study, 1985-2005

        Chang, Hoo Sun,Odongua, Nemekhee,Ohrr, Heechoul,Sull, Jae Woong,Nam, Chung Mo The North American Menopause Society 2011 Menopause Vol.18 No.11

        OBJECTIVE:: The relationship between reproductive factors and the risk of mortality from cardiovascular disease in postmenopausal women is unclear. In this study, we aimed to investigate this relationship in Korean postmenopausal women. METHODS:: Subcohort analysis was carried out using the data of 3,257 postmenopausal women (age, ≥55 y at study entry) from the Kangwha Cohort Study who were followed up from 1985 until 2005. Cox proportional hazards models were used to evaluate the associations between reproductive factors and cardiovascular disease mortality. RESULTS:: The risk of cardiovascular mortality in women who were 20 to 22 years old at first childbirth was 26% lower (95% CI, 0.60-0.92) than that in women younger than 20 years at first childbirth, after adjustment for age at entry, body mass index, hypertension, drinking, smoking, education, and occupation. Early first childbirth was associated with increased cardiovascular disease mortality (P trend = 0.036). The risk of coronary heart disease mortality was 51% lower in women who were 17 to 18 years old at menarche (95% CI, 0.25-0.95) than that in women who were younger than 17 years at menarche. CONCLUSIONS:: An inverse relationship between age at first childbirth and the risk of cardiovascular disease mortality exists. In addition, early menarche may be a reproductive risk factor for coronary heart disease mortality.

      • KCI등재

        우리나라 사산의 위험요인 분석

        한영자 ( Young Ja Han ),이상욱 ( Sang-wook Yi ),오희철 ( Heechoul Ohrr ),김미영 ( Miyong Kim ) 한국보건사회연구원 2004 保健社會硏究 Vol.24 No.2

        태아건강의 중요성에도 불구하고 사산의 원인은 잘 알려져 있지 않고 있으며, 우리나라에서 사산에 관한 연구는 상당히 적은 편이다. 본 연구는 우리나라 사산의 양상과 위험요인을 밝히기 위해 1999년도 출생 코호트의 전체 출생아와 함께 1999~2000년도 전체 사산아의 특성을 분석하였다. 보건 복지부와 한국보건사회연구원은 1999~2000년 발생한 우리나라 전체 사산에 관한 조사를 실시하였으며, 본 연구에서는 이 자료를 사용하였다. 사산아의 비차비(Odds Ratio) 산출을 위해 로짓회귀분석 방법을 사용하였다. 연구결과는 다음과 같다. 단변량분석에서 사산의 비차비는 태아의 재태기간이 짧고, 출생체중이 작으며, 남아, 다태아에서 높았다. 그리고 사산위험은 모연령에 따라 U-shape을 보였다. 다변량 로짓회귀분석 결과 출생체중과 사산의 위험성간에 가장강한 관계를 관찰할 수 있었다(기준군: 출생체중 3,000~3,999g, 출생체중 500~999g 사산아의 비차비: 763.7, 95% 신뢰구간: 586.1~995.2). 짧은 재태기간이 두 번째로 중요한 사산의 위험요인이었다. 다변량분석에서는 단변량분석 결과와 달리 사산의 위험요인은 10대의 여성에서만 높았으며, 35세 이상에서 사산위험이 높지 않은 것으로 분석되었다. 이 부분에 대해서는 추후 연구가 필요하다고 본다. 다태임신 태아의 경우 다변량분석에서는 단변량분석 결과와 달리 사산의 위험이 낮은 것으로 분석되었다. Objectives: In spite of the importance of the health of the fetus, the cause of stillbirth is still unknown and the study on the stillbirth is very rare in Korea. This study was conducted in order to find out the pattern of stillbirth and to investigate the risk factors of stillbirth in Korea. Methods: Total stillbirth cases that occurred during 1999 and 2000 in Korea were collected. The author has analyze the characteristics of the whole live birth of 1999 birth cohort and total stillbirths of 1999 and 2000. Logistic regression model was used to calculate the stillbirth odds ratio. Results and conclusion: The odds ratio(OR) of stillbirth was higher among fetuses of short gestation period, lower birth weight, male fetuses, and multiple pregnancy. The risk of stillbirth showed an U-shape by the age of the mother. Using multiple logistic regression model, the strongest relationship was observed between the birth weight and the risks of stillbirth(birthweight 500~999g group, OR:763.7, 95% Confidence Interval: 586.1~995.2, reference: birth weight 3000~3999g group) Short gestational age was secondly important risk factor. Contrary to the result of univariate analysis, the risk of stillbirth was high only among the teenaged mothers and the risk was not higher among mothers who were 35 years of age or older. The risk of stillbirth was lower among fetuses of multiple pregnancy from the multivariate analysis.

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