농촌지역의 B형, C형 간염에 관한 혈청역학적 연구

신해림,김준연,송주복,서병성,김정만,이부옥,김수량,양무관,이채언,전진호,유근영,안윤옥,Shin, Hai-Rim,Kim, Joon-Youn,Song, Jue-Bok,Suh, Byung-Seong,Kim, Jung-Man,Lee, Bu-Ok,Kim, Su-Yang,Ryang, Mu-Guan,Lee, Chae-Un,Chun, Jin-Ho,Yoo, Keun-You 대한예방의학회 1997 Journal of Preventive Medicine and Public Health Vol.30 No.1

To estimate the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection and to determine associated risk factors, a population-based seroepidemiologic study was carried out. In 1993, a health examination survey of the population was carried out in rural area known to have a high incidence of liver cancer. The study population were those who volunteered to participate in a health survey over 10 years of age. Examinees were interviewed by specially trained staffs. Sera from 1,033 study subjects were tested for hepatitis B surface antigen (HBsAg) by .everse passive hemagglutinin (RPHA) estimation and for hepatitis C virus antibody (anti-HCV) by 2nd generation passive hemagglutinin (PHA) estimation. The age and sex standardized prevalence of HBsAg was 6.3% which was similar to national average, but that of anti-HCV was 5.1% which was 4 to 5 times higher than that of blood donors or other health examinees in Korea. In a multivariate analysis, transfusion history, surgical operative history, and acupuncture history were not associated with HBsAg positivity. In contrast, acupuncture history (adjusted odds ratio[OR]=2.2 : 95% Confidence interval[CI] 1.0-4.7) and surgical operative history(adjusted OR=2.0 : 95% CI 1.0-4.1) were associated with anti-HCV positivity. The present study suggest that there is an highly endemic area of HCV infection in Korea and probably this endemicity is associated with a parenteral source of HCV infection other than blood transfusion.

연폭로 지표들의 정상치에 관한 연구

신해림,김준연,Shin, Hai-Rim,Kim, Joon-Youn 대한예방의학회 1986 Journal of Preventive Medicine and Public Health Vol.19 No.2

For the purpose of determinating the normal values of some parameters relevant to lead exposure, a study was carried out from April 1 to June 30, 1986 on 258 healthy Korean adults who have had no apparant lead exposure. The lead indices subjected to this study were as follows; blood lead (PbB), hemoglobin (Hb), zinc protoporphyrin in blood (ZPP), delta-aminolevulinic acid dehydratase (ALAD) activity in blood, coproporphyrin in urine (CPU), delta-aminolevulinic acid in urine (ALAU). 1) The mean value of PbB was $17.17{\pm}7.87{\mu}g/100ml$, and there was no statistically significant difference by age & sex. The distribution of PbB fitted to the log-normal distribution ($x^2=7.38$, p>0.1). 2) The mean value of Hb in male ($15.17{\pm}1.56g/100ml$) was higher than in female ($13.22{\pm}1.51g/100ml$)(p<0.01). The distribution of Hb fitted to the normal distribution ($x^2=9.40$, p>0.1). 3) The mean value of ZPP was $32.61{\pm}8.78{\mu}g/100ml$, and there was no statistically significant difference by age & sex. The distribution of ZPP fitted to the normal distribution ($x^2=13.93$, p>0.05). The correlation of ZPP & ALAD (r=-0.229), CPU (r=0.183) was statistically significant respectively. 4) The mean value of ALAD was $30.20{\pm}10.96{\mu}mol$ ALA/min/L of R.B.C., and there was no statistically significant difference by age & sex. The distribution of ALAD activity did not fit to the normal distribution. The correlation between ALAD & PbB (r=-0.219) was statistically significant 5) The mean value of CPU was $36.10{\pm}24.54{\mu}g/L$, and there was no statistically significant difference by age & sex. The distribution of CPU did not fit to the normal distribution. The correlation between CPU & PbB (r=0.185), ZPP (r=0.183) was statistically signinificant respectively. 6) The mean value of ALAU was $1.94{\pm}0.96mg/L$, and there was no statistically significant difference by age & sex. The distribution of ALAU fitted to the normal distribution ($x^2=9.76$, p>0.1).

암등록과 암관리사업의 최신 국제 경향 및 우리나라 암발생 통계

신해림,Shin, Hai-Rim 대한예방의학회 2008 예방의학회지 Vol.41 No.2

The World Health Organization (WHO) reported that cancer killed 7.6 million people in the world in 2005, and that 40% of all cancer deaths can be prevented. According to the WHO Global Action Plan Against Cancer (GAPAC), monitoring of cancer patients is the essential part of cancer control, and should be conducted through cancer registration. Originally, cancer registries were primarily concerned with the description of cancer patterns, trends of cancer occurrence, and etiology of cancer. In the last 20 years, cancer registries provided not only information on the incidence and characteristics of specific cancers, but also supplied the source of cancer control planning and evaluation and the care of individual cancer patients with survival. Cancer Incidence in Five Continents (CI5) presents incidence data from populations all over the world every five year. Volume IX in the series (data for 1998-2002) has recently (November 2007) been published online at International Agency for Research on Cancer (IARC). Nine data from Korea Central Cancer Registry (National data), Seoul, Busan, Daegu, Gwangju, Incheon, Daejeon, Usan, Jejudo regional cancer registries were included in that volume. In this paper, the editorial process, the characteristics of national data, and quality indices in CI5 IX are being described. In addition, cancer control activities related to cancer registration in some selected countries are also presented.

톨루엔 폭로 근로자들의 요중 마뇨산 배설량

이채언,신해림,조병만,문덕환,손혜숙,조규일,김성천,김용완,Lee, Chae-Un,Shin, Hai-Rim,Cho, Byung-Mann,Moon, Deog-Hwan,Shon, Hae-Sook,Cho, Kyu-Il,Kim, Sung-Chun,Kim, Yong-Wan 대한예방의학회 1988 Journal of Preventive Medicine and Public Health Vol.21 No.2

In order to prepare the fundamental data for preventing the hazardous effects at toluene exposure in many kinds of industry, the authors determined the level of urinary hippuric acid on 592 toluene exposed women(exposed group) and 102 unexposed women(control group) in Pusan area, from April. 1 to October 31, 1986. Hippuric acid was measured by high performance liquid chromatography. The results were summarized as follows; 1. The mean value of urinary hippuric acid concentration of the control group was $0.44{\pm}0.21g/l$(0.11-0.89g/l). The distribution of urinary hippuric acid concentration of the control group was not fit to the normal distribution. 2. The mean value of urinary hippuric acid concentration of the exposed group was $1.56{\pm}0.95g/l$(0.44-4.57g/l). The distribution of urinary hippuric acid concentration of control group was not fit to the normal distribution. 3. The urinary hippuric acid concentration by age group was not statistically significant in the control group, but in the exposed group the urinary hippuric acid concentration was highest in women between 20-29 years old($1.71{\pm}0.95g/l$) and was statistically significant(p<0.01). 4. The urinary hippuric acid concentration by duration of working hours was not statistically significant (p>0.1).

출생신고자료를 이용한 우리 나라 조산아 출생률의 계절변동

마상혁,신해림,이덕희,Ma, Sang-Hyeok,Shin, Hai-Rim,Lee, Duk-Hee 대한예방의학회 2000 예방의학회지 Vol.33 No.4

Objectives : To investigate possible seasonal patterns of pre-term birth in Korea. Methods : A total number of 2,669,357 single live births reported to the National Statistical Office from 1995 to 1998 were analyzed. Composite monthly cohorts of ongoing pregnancies were constructed for each month of the year and the probability of pre-term birth was estimated. Results : Increases in the probability of a pre-term birth occurred during winter for the birth of first child and during summer for the birth of second or later child. This seasonal variation was similar among groups divided by sex, residency, age of mother, and education of mother. Conclusions : These findings suggests that some environmental factors related to season may partially explain the incidence of premature births.

국가 암조기검진사업 참여에 영향을 미치는 인구사회학적 요인

성나영,박은철,신해림,최귀선,Sung, Na-Young,Park, Eun-Cheol,Shin, Hai-Rim,Choi, Kui-Son 대한예방의학회 2005 예방의학회지 Vol.38 No.1

Background : Cancer is the leading cause of death and one of the largest burdens of disease in Korea. In 1996, the Ten year Plan for Cancer Control was formulated and the government then adopted the plan as a national policy. As part of this plan, the National Cancer Screening Program (NCSP) for Medicaid recipients was formulated, and the government adapted this in 1999. For low-income beneficiaries of the National Health Insurance Corporation (NHIC), the screening program has been in place since 2002. In 2002, the target cancers of NCSP were stomach, breast and cervical cancer. This study was conducted to examine the relationships between the participation rate, the abnormal screening rate and the socio-demographic factors associated with participation in the screening program. Methods : To analyze the participation rate and abnormal rate for the NCSP, we used the 2002 NCSP records. The information on the socio-demographic factors was available from the database of the beneficiaries in the NHIC and Medicaid. Results : The participation rate of the Medicaid beneficiaries for the stomach, breast and cervical cancer screening were 9.2%, 15.5% and 15.0%, respectively, and 11.3% and 12.5%, except cervical cancer which wasn't be included in the NCSP, for the beneficiaries of the NHIC. The abnormal rate of stomach, breast and cervical cancer screening were 25.7%, 11.2% and 21.0%, respectively, for the beneficiaries of Medicaid and 42.6% and 19.4% for the beneficiaries of the NHIC. On the multiple logistic regression analysis, gender, age and place of residence were significantly associated with participation rates of the NCSP. For stomach cancer, women participated in the NCSP more than men. The participation rate was higher among people in their fifties and sixties than for those people in their forties and those people over seventy years in age. For the breast and cervical cancer, people in their fifties were more likely to participate in the NCSP than people in their forties and people over sixty. For the place of residence, people in the rural areas participated more than those people in any other places. Conclusions : The above results show that the participation rate and abnormal rate were significantly associated with the socio-demographic factors. To improve the participation rate for the NCSP, more attention should be given to the underserved groups.

한국인 일반 여성의 HPV 감염 유병율 -부산지역 일반 여성에서의 HPV DNA 및 항 VLPs 항체 양성 빈도 -

홍숙희,이덕희,신해림,Hong, Sook-Hee,Lee, Duk-Hee,Shin, Hai-Rim 대한세포병리학회 2004 대한세포병리학회지 Vol.15 No.1

To investigate a population-based survey of the prevalence of human papillomavirus (HPV) infection in South Korea, we performed Papanicolaou smears and tests for HPV DNA and anti-HPV antibody detection in 909 sexually active general women (age range; 20-74 years, median 44 years) who were randomly selected residents from S district of Busan City. The presence of DNA of 36 different HPV types was detected by means of a GP 5+/6+ primer-mediated PCR enzyme immunoassay in cervical exfoliated cells, and IgG antibodies against L1 virus-like particles (anti-VLPs) of 5 HPV types 16, 18, 31, 33, and 58 were tested by means of enzyme linked immunoassay. The incidence of cytologic abnormality was 5.2% in Pap smear. The positive rate of HPV DNA was 10.4%, high in young women younger than 35 years old and proportionally increased according to the cytologic grades. The most often found HPV type was HPV 70, followed by HPV 16 and 33, and high-risk HPV types were more frequent in women younger than 35 years old. The most common HPV type in abnormal cytologic smears was HPV 16, followed by HPV 58 and 66. Anti-VLPs was positive in 19.7% and the frequent anti-VLPs type was against HPV 18, followed by HPV 31 and 16. The concordance between the markers for each specific HPV type was noted in 10 women and HPV 16 was the most frequent one. The incidence of multiple HPV infection was 18.9% and that of multiple anti-VLPs antibodies was 31%. Among 103 self-reported virgins, 4.9% had anti-VLP antibodies.

농촌지역 주민의 건강관련 행위와 질병이환과의 관계

송주복,이부옥,신해림,정갑열,김준연,Song, Jue-Bok,Rhee, Boo-Ouk,Shin, Hai-Rim,Jung, Kap-Yeol,Kim, Joon-Youn 대한예방의학회 1997 Journal of Preventive Medicine and Public Health Vol.30 No.2

This research was carried out to determine the performance rate of health related practices, to measure the agreement between morbidity by doctor's diagnosis and morbidity by subject' self-reported and the degree of association between health related practices and morbidity rate by doctor's diagnosis, to identify their effects on morbidity among rural area populations. The data were gathered by volunteer residents (over the age of 20) of Haman Myeon, Haman Gun, Kyeongsangnam Do in Korea, from June 10, 1993 to June 12, 1993 (369 male and 516 female). Face to face interview, lab, chest P-A, EKG and physical examination were completed. Descriptive statistics, agreement analysis and multiple logistic regression procedures were employed for analyses. The results of the study were summarized as follows : 1) Age adjusted morbidity rates by doctor's diagnosis and self-reported were 38.5% (male:37.3%, female:36.5%), 26.4% (male:33.3%, female:27.5%), respectively. Kappa coefficient between morbidity by doctor's diagnosis and morbidity by self-reported was 0.21 (male:0.21, female:0.22). 2) The frequency of disease by doctor's diagnosis was as follows: hypertension(15.3%), gastritis (9.6%), diabetes mellitus (8.5%), live. disease (8.1%), and degenerative arthritis (6.2%) in the study population. 3) Order of health practice performance rate was as follows: Males-normal body weight (62.1%), non-heavy alcohol consumption (57.5%), 7-8 hours of sleeping (50.1%), non-smoking (21.7%), and exercise (19.8%). Females- non-heavy alcohol consumption (97.3%), non-smoking (84.7%), normal body weight (57.8%), 7-8 hours of sleeping (45.0%), and exercise (9.9%). 4) There was no significant relationship between health related practice and morbidity except exercise among health related practices. 5) Health related practice index which was recategorized by high, medium, and low had effects on the probability of developing morbidity.

단계적 행위변화 모형을 이용한 자궁경부암 검진행위 관련 요인 분석 - 국가 조기 암검진 대상자들을 중심으로 -

이혜진,정상혁,신해림,오대규,이선희,Lee, Hye-Jean,Jung, Sang-Hyuk,Shin, Hai-Rim,Oh, Dae-Kyu,Lee, Sun-Hee 대한예방의학회 2005 예방의학회지 Vol.38 No.1

Objective : To evaluate the relationships among sociodemographic characteristics, health behaviors, levels of pros and cons and stages of change in Pap testing for uterine cervical cancer. Methods : A questionnaire survey was performed on 560 randomly sampled people who were assigned to participate in a Pap testing program by the National Cancer Screening Project in 2003' between 25 September and 10 October in Gyeonggi, Korea. Data about the behaviors and intentions of Pap testing, sociodemographic characteristics, health behaviors, and levels of acknowledged benefit (pros) and barrier (cons) for Pap testing was collected. The stages of change were grouped according to behaviors and intentions of Pap testing as passive, active, and relapse. Results : Logistic analysis between the passive and active groups showed that city dwellers, 'high' and 'middle' groups in terms of the individual s health belief, those who had undergone a health examination within the past 2 years, and those who had undergone hormone replacement therapy had a higher odds ratios to be in the active group. As the 'benefit' scores increased and the 'Unnecessity' scores decreased, the probabilities to be in the active group increased. According to the logistic analysis results between the active and relapse groups, those who were 60 years or older, members of the National Heath Insurance, and those who had not undergone a health examination within the past 2 years had a higher odds ratio to be in the relapse group. The 'Benefit' scores were not significant in this relationship. The probabilities of being in the relapse group increased as the Unnecessity and 'Shamefulness' scores increased. Conclusions : In conclusion, health planners should inform women in the passive group of the benefits and necessity of Pap testing. It would be better to reduce the barriers to the active group of undergoing Pap smear. This study might be a useful guide for future planning of Pap testing program.

국가 암조기검진사업 성과에 영향을 미치는 요인 - 보건소 및 사업실무자 특성을 중심으로 -

최귀선,양정희,계수연,이선희,신해림,김창민,박은철,Choi, Kui-Son,Yang, Jeong-Hee,Kye, Su-Yeon,Lee, Sun-Hee,Shin, Hai-Rim,Kim, Chang-Min,Park, Eun-Cheol 대한예방의학회 2004 예방의학회지 Vol.37 No.3

Objectives : Cancer is the leading cause of death in Korea. Therefore, a National Cancer Screening Program (NCSP) was launched in 1999. This study planned to evaluate the performance of the NCSP to identifying the influencing factors in relation to characteristic public health centers. Methods : To analyze the performance, the database of the NCSP records for 2002 was used. The performance index was measured by the goal achievement rate, which was defined by the real number of screenees against the expected number of screenees. Also, a survey was conducted by a self-administered questionnaire to identify the factors associated with the goal achievement rate. The questionnaire was divided into two sections. In the first section, the individual characteristics of the program coordinator in each public health center were measured, and second section was comprised of questions about the organizational characteristics associated with the NCSP. A total of 121 subjects from 241 public health centers completed the questionnaire. Results : Of the 121 public health centers (50.2% response rate), the average goal achievement rate was 72.8%. The results of the regression model showed that public health centers located in rural area (parameter estimates=38.2) and had great support from a head of center or province (parameter estimates=0.20) and tended to have higher goal achievement rates. However, the characteristics of the program coordinator, especially their knowledge of and attitude toward cancer screening, were not significantly related to the goal achievement rates. Conclusions : It appears that the most important associated factors to the goal achievement rate in the NSCP were the location of the public health center and the support for the NCSP from the head of the center or province.