• 한국환경보건학회지
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• 제38권1호
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• pp.31-41
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• 2012

Objectives: Biomonitoring is used to assess human environmental exposures. Urinary biomonitoring data are typically adjusted to a constant creatinine concentration to correct for variable dilutions among spot samples. Our objective was to investigate urinary creatinine concentrations by region, gender, age and lifestyle. Methods: We studied urinary creatinine concentrations in 6,286 Koreans aged 20 years old and older who participated the fourth Korea National Health and Nutrition Survey (KNHANES IV) in 2009. Urinary creatinine concentration analysis used the Jaffe method. Results: The average urinary creatinine concentration of 6,286 Koreans was 158.99 mg/dl. The urinary creatinine concentration was significantly higher among men (184.97 mg/dl) than women (130.02 mg/dl). In both men and women, urinary creatinine concentrations were significantly different according to age group (p < 0.01). Whereas the urinary creatinine concentration of men significantly differed with smoking in adjusted comparison analysis, that of women significantly differed by education level. Ninety-two percent of urinary creatinine concentration was included within WHO guidelines effective range(30 mg/dl ${\leq}$ urinary creatinine concentration ${\leq}$ 300 mg/dl). In multiple regression analysis, creatinine was influenced by gender, age and body mass index (BMI). Conclusions: The urinary creatinine value obtained from representative samples of adult Koreans aged 20 year and older in KNHANES IV 2009 could be used as a reference value for other nationally studied surveys, such as abandoned metal mine surveys and surveys for industrial complexes.

• 보건교육건강증진학회지
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• 제28권1호
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• pp.69-80
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• 2011

Objectives: This study aims to identify the factors associated with colorectal cancer screening behaviors. Methods: The nation-wide representative samples of 2,928 adults aged ${\geq}50$ years for colorectal cancer screening were derived from the fourth Korea National Health and Nutrition Examination Survey (KNHANES IV). This study investigated socio-demographic, health behavioral and contextual factors associated with colorectal cancer screening using descriptive statistics and multivariate logistic regression analysis. Results: In terms of socio-demographic factors, gender, age, marital status, occupation, monthly income, and resident region were significantly different between screening group and non-screening group. Among health behavioral and contextual factors, regular physical checkup, weight control, physical activity, smoking, drinking and having other cancers were significantly different. From the multivariate logistic regression analysis, marital status, education level, regular physical checkup and weight control were associated with colorectal cancer screening behavior. Conclusions: It is necessary to understand the importance of early detection and cancer screening. Appropriate health education and active promotion about the cancer screening should be developed based on the study findings in order to motivate people to have cancer screening. Also, these findings should be reflected in the health policy.

• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.3773-3779
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• 2012

Objective: Despite government efforts to increase participation in gastric cancer screening, the rate is still suboptimal in Korea. Therefore, we explored barriers to and predictors of gastric cancer screening participation among a nationally representative sample. Methods: We used the Health Interview Survey sub-dataset derived from the Fourth Korean National Health and Nutrition Examination Survey 2008 (KNHANES IV) to evaluate participation in gastric cancer screening and factors associated with attendance in individuals age ${\geq}40$ years. We enrolled 4,464 subjects who completed the questionnaire and were not previously diagnosed with gastric cancer. Four groups of factors were considered potential predictors of gastric cancer screening in a multivariate analysis: sociodemographic, health behavior, psychological and cognitive, and dietary factors. Results: Overall, 41.3% complied with the gastric cancer screening recommendations. Younger age, lower education level, living without a spouse, frequent binge drinker, and current smoker were significantly associated with less participation in gastric cancer screening. Conclusions: To improve participation in gastric cancer screening, more focused interventions should be directed to vulnerable populations, such as groups with low socioeconomic status or unhealthy behavior. In addition, there should be new promotional campaigns and health education to provide information targeting these vulnerable populations.

• Tuberculosis and Respiratory Diseases
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• 제83권4호
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• pp.268-275
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• 2020

Background: It is not evident that the attributable risk of smoking on mortality in Korea has decreased. We investigated the impact of smoking on all-cause mortality and estimated the attributable risk of smoking in Korean adults. Methods: Those aged ≥20 years with smoking history in the Korean National Health and Nutrition Examination Surveys (KNHANES) 2007-2015 were enrolled. We categorized the participants into three groups as follows: never smoker, <20 pack-years (PY) smokers, and ≥20 PY smokers. We applied inverse probability weighting using propensity scores to control various confounders between the groups. All-cause mortality risks were compared between the groups using the Kaplan-Meier log-rank test. The effects of smoking-attributable risks (ARs) on mortality were also calculated. Results: A total of 50,458 participants were included. Among them, 19,334 (38.3%) were smokers and 31,124 (61.7%) were never smokers. Those with a smoking history of 20 PY or more (≥20 PY smokers), those with a smoking history of less than 20 PY (<20 PY smokers), and never smokers were 18.1%, 20.2%, and 61.7%, respectively, of the study population. Smokers had a higher risk of all-cause mortality compared to never smokers (log-rank test p<0.01). The ARs of smoking were 21.8% (95% confidence interval [CI], 5.7%-37.9%) and 9.0% (95% CI, 6.1%-12.0%) in males and females, respectively. ARs decreased from 24.2% to 19.5% in males and from 9.5% to 4.1% in females between 2007-2010 and 2011-2015. Conclusion: Our study using KNHANES IV-VI data demonstrated that smoking increased the risk of all-cause mortality in a dose-response manner and the ARs of smoking on mortality were 21.8% in males and 9.0% in females during 2007-2015. This suggests that the ARs of smoking on mortality have decreased since around 2010.

• Preventive Nutrition and Food Science
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• 제19권4호
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• pp.333-342
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• 2014

Limited epidemiologic data is available regarding the cardiovascular effects of mercury exposure. The purpose of this study was to determine the relationship between mercury exposure from fish consumption and cardiovascular disease in a nationally representative sample of Korean adults using the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV 2008~2009). Survey logistic regression models accounting for the complex sampling were used to estimate the odds ratios (OR) adjusted for fish consumption frequency, age, education, individual annual income, household annual income, body mass index (BMI), waist circumference (WC), alcohol consumption status, and smoking status. The mean blood mercury level in the population was $5.44{\mu}g/L$. Trends toward increased blood mercury levels were seen for increased education level (P=0.0011), BMI (P<0.0001), WC (P<0.0001), and fish (i.e., anchovy) consumption frequency (P=0.0007). The unadjusted OR for hypertension in the highest blood mercury quartile was 1.450 [95% confidential interval (CI): 1.106~1.901] times higher than that of the lowest quartile. The fish consumption-adjusted OR for hypertension in the highest blood mercury quartile was 1.550 (95% CI: 1.131~2.123) times higher than that of the lowest quartile, and the OR for myocardial infarction or angina in the highest blood mercury quartile was 3.334 (95% CI: 1.338~8.308) times higher than that of the lowest quartile. No associations were observed between blood mercury levels and stroke. These findings suggest that mercury in the blood may be associated with an increased risk of hypertension and myocardial infarction or angina in the general Korean population.

• Nutrition Research and Practice
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• 제15권4호
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• pp.528-540
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• 2021

BACKGROUND/OBJECTIVES: In a healthy person, from 35 years of age, there is an annual loss of muscle mass at the rate of 1-2% and is associated with a decline in the quality of life. This study aimed to identify the particular dietary patterns associated with the risk of lower lean muscle mass in Korean postmenopausal women. SUBJECTS/METHODS: The Korea National Health and Nutrition Examination Survey (KNHANES) is a population-based, continuous cross-sectional annual survey. The participants of the KNHANES IV (2008-2009) and V (2010-2011) were considered for this study. The study sample consisted of 1548 postmenopausal women, aged 45-86 years. Lower lean muscle mass was defined as having appendicular skeletal muscle mass corrected for body weight less than 1 standard deviation of the young reference group aged 20 to 39 years in KNHANES IV and V. To identify the dietary pattern using factor analysis, 24-h recall data was used. RESULTS: The prevalence of lower lean muscle mass was 31.3% in this study population. Four dietary patterns were identified by factor analysis; 'Diverse', 'Western', 'Traditional', and 'Snacks and beverages'. The 'Western' pattern, highest factor loadings for flour and bread, potatoes, red meat, processed meat, eggs, and cheese, was significantly associated with a high (60%) risk of lower lean muscle mass (odds ratio [95% confidence interval] = 1.60 [1.07-2.39], P for trend = 0.01) after adjustments for potential covariates. The other 3 dietary patterns were not associated with lower lean muscle mass. CONCLUSIONS: The study findings suggest that the 'Western' dietary pattern that includes flour and bread, potatoes, red meat, processed meat, eggs, and cheese, may be associated with a higher risk of lower lean muscle mass in Korean postmenopausal women.

• Journal of Nutrition and Health
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• 제44권6호
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• pp.518-526
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• 2011

To determine blood heavy metal concentrations by seafood consumption in Korean adults, blood cadmium, mercury, and lead concentrations in a representative sample of 1,709 Koreans participated in the Fourth Korea National Health and Nutrition Examination Survey (KHANES IV-2) in 2008 were analyzed by age and seafood consumption frequency. The mean blood cadmium, mercury, and lead concentrations were $1.14{\pm}0.73{\mu}g/L$, $5.50{\pm}3.83{\mu}g/L$, and $2.56{\pm}1.22{\mu}g/dL$, respectively. The subjects aged ${\geq}$ 50 years had significantly higher blood cadmium concentrations than the subjects aged 20~39 years. Blood mercury concentrations of the 50's were significantly higher than those of the 20's and 30's (p < 0.05). Approximately, 43% of males and 22% of females had blood mercury concentrations > $5.8{\mu}g/L$ which is a blood mercury level equivalent to the current Reference Dose. Only 2 subjects had lead concentrations > $10{\mu}g/dL$, the standard lead level by the Centers for Disease Control and Prevention, USA. The subjects consuming pollack, mackerel, anchovy, corvina, shellfish, and salted seafood at least once a week had significantly higher mercury concentrations than the subjects consuming those seafoods less than once a month. However, there were no clear relationships between blood cadmium and lead concentrations and seafood consumption frequencies.

• 한국환경보건학회지
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• 제46권3호
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• pp.297-311
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• 2020

Objective: We compared the level of blood cadmium exposure with health impacts by using data from a survey of residents near an abandoned mine and a national health survey. Methods: For this study, we used data from 7,046 individuals who participated in the Health Effects Survey of Abandoned Metal Mines (AMS, 2008-2011) and 6,871 individuals who participated in the Korea National Health and Nutrition Examination Survey IV-VI (KNHANES, 2008-2013). To evaluate the health impacts, the quartiles (S1 to S4) were classified according to blood cadmium concentration, and then the odds ratios of S2 to S4 over S1 for exceeding the reference values of renal function, blood pressure, and bone density were compared. Similarly, the odds ratio of AMS over KNHANES was confirmed. Results: In the AMS, adjusted for general characteristics, the geometric mean of blood cadmium concentration was 1.34 ㎍/L, which was statistically significantly higher than that of the KNHANES 1.22 ㎍/L (p<0.001). In the integrated data of AMS and KNHANES, the estimated odds ratio of S4 over S1 for exceeding the reference value was found to be 1.70 for serum creatinine, 1.71 for hypertension, and a T-score 2.02 for the tarsal bone. They were all statistically significant. Conclusion: Residents around abandoned metal mines had a higher blood cadmium concentration than the general population, and the odds for exceeding the reference values were higher for some health indicators. Continuous biomonitoring should be conducted for vulnerable areas such as around abandoned metal mines, and measures to reduce cadmium exposure and management of chronic diseases are needed.

• 한국지역사회생활과학회지
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• 제22권4호
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• pp.669-678
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• 2011

The purpose of this study were to analyze the staple food consumption trend of Koreans using KNHANES(Korea National Health and Nutrition Examination Survey) data. Nutrient intake of 38,840 participants of 1998~2008 KNHANES, over 6 year old were analyzed. For the analysis of major staple food intakes, twenty four hour recall data was used. The results were analyzed by SAS Program, as follows. Despite westernized diet, ranking in the primary energy source of food showed similar patterns. But total calory intake was reduced over the past 11 years and percentage of carbohydrate intake was increased. Relative proportions of protein and fat intake was reduced. The major carbohydrate and protein source of Koreans was rice and grains. Pork and ramen were the major fat source food. Although intake levels were different by gender, age and areas, carbohydrate of rice was primary source of energy in Korea.

• 지역사회간호학회지
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• 제26권2호
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• pp.61-68
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• 2015

Purpose: In this study, we performed a comparative analysis on the quality of life (QoL) in male and female chronic obstructive pulmonary disease (COPD) patients based on the 4th Korea National Health and Nutrition Examination Survey (KNHANES IV) from 2007 to 2010. Methods: We extracted the socio-demographic and clinical data of 1,218 COPD patients including 874 men and 344 women from the KNHANES IV database. Descriptive statistics and correlation test were used to analyze the data. In order to find factors associated with QoL of COPD patients, we conducted multivariate linear regression analysis. Results: Infrequency analysis, the educational level and income were lower in the female COPD patients than in the male ones. The QoL indexes including mobility, self-care, activities of daily living, discomfort, anxiety, and depression were significantly worse in the female of COPD patients than in the male ones (p<.01).Conclusion: Our study indicates that QoL of female COPD patients should be improved on the educational, economic, and healthcare aspects.