Yousun Ko

Incidence of acute occupational pesticide poisoning among male farmers in South Korea.

BACKGROUND Pesticide poisoning from agricultural labor has been recognized as a major public health problem among farmers worldwide. The objective of this study was to examine the incidence of acute occupational pesticide poisoning among male farmers in South Korea. METHODS A nationwide sampling survey of male farmers was conducted in South Korea. This survey used a stratified multistage probability sampling design and adopted the face-to-face interview method. A total of 1,958 male farmers were interviewed in order to estimate the incidence of acute occupational pesticide poisoning in rural areas in 2010. Based on a self-reported definition, the incidence rate in 2010 and the lifetime hospitalization rate due to acute occupational pesticide poisoning among male farmers were estimated. RESULTS The incidence rate of acute occupational pesticide poisoning was 24.7 (95% CI 22.1-27.2) per 100 male farmers, which corresponds to 209,512 cases across South Korea in 2010. About 12% of the pesticide poisoning cases included either visiting a medical doctor or hospitalization. The lifetime rate of hospitalization due to occupational pesticide poisoning was 6.1 (95% CI 4.9-7.3) among male farmers. Poisoning occurred mainly when farmers were applying pesticides during summer. CONCLUSION Our nationwide sampling survey demonstrated that acute occupational pesticide poisonings are highly prevalent among male South Korean farmers. Intensive intervention efforts to reduce occupational pesticide poisoning are urgently needed in South Korea.

Depressive symptoms and severity of acute occupational pesticide poisoning among male farmers

Objectives Limited evidence suggests the association between severity of acute occupational pesticide poisoning and depressive symptoms in farmers. The aim of this study was to investigate the association between occupational pesticide exposure and depressive symptoms among male farmers in South Korea. Methods A nationwide sampling survey of male farmers was conducted in South Korea. A total of 1958 male farmers were interviewed in 2011. Severity of occupational pesticide poisoning was evaluated according to symptoms, types of treatment and number of pesticide poisonings per individual. Depressive symptoms were assessed using the Geriatric Depression Scale. A survey logistic regression model was used to estimate the multivariate OR and 95% CIs. Results Among total farmers, 10.4% (n=197) reported depressive symptoms. After controlling for potential confounders, occupational pesticide poisoning in the previous year was positively associated with the risk of depressive symptoms (OR=1.61; 95% CI 1.10 to 2.34). Cases of more severe pesticide poisoning, such as moderate- or severe-symptom cases (OR=2.81; 95% CI 1.71 to 4.63), outpatient or hospitalisation cases (OR=2.52; 95% CI 1.15 to 5.53), and multiple poisoning cases (OR=1.82; 95% CI 1.19 to 2.76) showed higher risks of depressive symptoms than did milder cases. Among the pesticides causing the poisonings, paraquat dichloride was found to be a significant predictor of depressive symptoms. No significant association was found with cumulative lifetime pesticide application and depressive symptoms. Conclusions Our findings suggest that the risk of depression appears to be related to the severity of symptoms of poisoning, type of care received and the number of previous episodes of acute poisonings.

Pesticide poisonings in South Korea: Findings from the National Hospital Discharge Survey 2004-2006

Objectives: Pesticide poisoning stands as a major public health issue worldwide. The objective of this study was to examine the epidemiologic characteristics of pesticide-related hospitalizations in South Korea. Methods: Data from the Korea National Hospital Discharge Survey were analyzed to describe the epidemiologic characteristics of pesticide poisoning among hospitalized patients from 2004 through 2006. Pesticide-related hospitalizations were identified using the International Classification of Diseases, Tenth Revision codes. National estimates of pesticide-related hospitalizations were calculated using sampling weights for number of hospitalizations. Results: A total of 25,982 pesticide-related hospitalizations were estimated during the years 2004–2006, yielding an average annual pesticide-related hospitalization rate of 17.8 per 100,000 population in South Korea. Age-specific rates for pesticide-related hospitalization increased with age, with the highest rate noted among those aged 70 or above. The majority of pesticide-related hospitalization was cases of intentional poisoning in rural areas. Seasonal variation in the rate was observed, with summer being the highest among both men and women. Conclusions: Pesticide-related hospitalization is prevalent and demonstrates demographic and seasonal and regional variations. More effective strategies to reduce pesticide-related hospitalizations are required in South Korea.

Emergency department visits due to pesticide poisoning in South Korea, 2006–2009

Abstract Objectives. The objective of this study is to estimate the numbers and rate of emergency department visits in South Korea that are the result of pesticide poisoning and to describe their epidemiologic characteristics. Materials and methods. Data collected from the National Emergency Department Information System were used to estimate the number of emergency department visits due to pesticide poisoning in South Korea for the period spanning 2006 through 2009. Emergency department visits for pesticide poisoning were defined by ICD-10 codes (T60.0–T60.9). National estimates and their 95% confidence intervals were calculated per 100 000 population. Results. Among the 65 877 total poisoning-related emergency department visits in the data, 11 985 (18.2%) were emergency department visits resulting from pesticide poisoning. During the study period, the annual average rate of emergency department visits for pesticide poisoning was 26.8 per 100 000 population. Intentional pesticide poisoning (51.4%) was more frequent than unintentional. The fatality rate from intentional pesticide poisoning was also higher than that from unintentional or cases where the intention was unknown. In terms of age-specific rates of emergency department visits for pesticide poisoning, they increased with age, as did the gap between men and women. Conclusions. This study provide estimates for emergency department visits due to pesticide poisoning at the national level and suggests that pesticide poisonings, both intentional and unintentional, require significant public health interventions in South Korea.

Work-Related Risk Factors by Severity for Acute Pesticide Poisoning Among Male Farmers in South Korea

The objective of this study was to explore work-related risk factors of acute occupational pesticide poisoning among male farmers according to the severity of the poisoning. A nationwide sampling survey of male farmers was conducted in South Korea in 2011. A total of 1,958 male farmers were interviewed. Severity of occupational pesticide poisoning in 2010 was evaluated according to symptoms, types of treatment, and number of pesticide poisoning incidents per individual. A multinomial logistic regression model was used to estimate the odds ratio with 95% confidence intervals for risk factors of acute occupational pesticide poisoning. We found that the risk of acute occupational pesticide poisoning increased with lifetime days of pesticide application (OR = 1.74; 95% CI = 1.32–2.29), working a farm of three or more acres in size (OR = 1.49), not wearing personal protective equipment such as gloves (OR = 1.29) or masks (OR = 1.39). Those who engaged in inappropriate work behaviors such as not following pesticide label instructions (OR = 1.61), applying the pesticide in full sun (OR = 1.48), and applying the pesticide upwind (OR = 1.54) had a significantly increased risk of pesticide poisoning. There was no significant risk difference by type of farming. In addition, the magnitude of these risk factors did not differ significantly by severity of acute pesticide poisoning. In fact, our findings suggest that work-related risk factors contributed to the development of acute occupational pesticide poisoning without relation to its severity. Therefore, prevention strategies for reducing occupational pesticide poisoning, regardless of severity, should be recommended to all types of farming and the level of poisoning severity.

Acute Pesticide Poisoning among Children in South Korea: Findings from National Health Insurance Claims Data, 2006–2009

OBJECTIVES The aim of this study was to estimate the incidence of acute pesticide poisoning among children in South Korea and describe the related epidemiologic characteristics. METHODS We evaluated the age-standardized rates of incidence of pesticide poisoning among children in South Korea from 2006 through 2009 using National Health Insurance claims data. RESULTS A total of 1232 children aged 0-14 years were identified from the acute pesticide poisoning cases reported across South Korea during the study period. The annual average age-standardized rate of incidence from acute pesticide poisoning was 3.6 per 100 000. The majority of the cases were identified in the categories of the 1-4-year-old age-group (56.5%), outpatients (80.0%), single-day visit to a hospital (70.4%) and summer occurrence (43.3%). CONCLUSIONS Acute pesticide poisoning is prevalent among children in South Korea; therefore, intervention efforts are needed to reduce the cases of pesticide poisoning among children.

A Pilot Study for Pesticide Poisoning Symptoms and Information on Pesticide Use among Farmers

Department of Preventive Medicine, Korea University College of Medicine *Department of Preventive Medicine, Keimyung University College of Medicine **Agro-Material Safety Evaluating Division, Department of Agro-Food Safety, National Academy of Agricultural Science, Rural Development Administration(Received January 7, 2011/Revised February 18, 2011/Accepted February 18, 2011)ABSTRACTThis study aimed to determine the feasibility of survey questionnaires for pesticide poisoning. We conducted a pilotstudy to develop a questionnaire for evaluating pesticide poisoning symptoms and to examine the validity of self-reported information for individual pesticides used. In December 2010 we interviewed 20 farmers with self-reportedpesticide poisoning histories residing in Gyeonggi Province. For validity of pesticide information, the purchased pes-ticide lists from the agricultural cooperative federation were compared with individual self-reported pesticides used.Neurological symptoms were the most common among clinical symptoms related to pesticide poisoning, followed bygastrointestinal, dermal and eye symptoms. Insecticides were the main causative pesticide class for poisoning. Twentyone major symptoms were selected for screening for acute pesticide poisoning in a field study based on the pilot resultsand literature reviews. Substantial under-reporting was found in data on self-reported individual pesticides used (9.2%),as well as low accuracy (36%) compared with their actual purchase lists. In this pilot study, we suggest the selectedsymptom lists may apply to a field survey of pesticide poisoning. However, the self-reported information on individualpesticides may not be valid and alternative methods need to be developed.Keywords: agricultural workers, occupational exposure, pesticide poisoning, symptoms, validity

Exposure to Dichlorodiphenyltrichloroethane and the Risk of Breast Cancer: A Systematic Review and Meta-analysis

Objectives This study extended and updated a meta-analysis of the association between exposure to dichlorodiphenyltrichloroethane (DDT) and the risk of breast cancer. Methods We reviewed the published literature on exposure to DDE and breast cancer risk to update a meta-analysis from 2004. The total of 35 studies included 16 hospital-based case–control studies, 11 population-based case–control studies, and 10 nested case–control studies identified through keyword searches in the PubMed and EMBASE databases. Results The summary odds ratio (OR) for the identified studies was 1.03 (95% confidence interval 0.95–1.12) and the overall heterogeneity in the OR was observed (I2 = 40.9; p = 0.006). Subgroup meta-analyses indicated no significant association between exposure to DDE and breast cancer risk by the type of design, study years, biological specimen, and geographical region of the study, except from population-based case–control studies with estimated DDE levels in serum published in 1990s. Conclusion Existing studies do not support the view that DDE increases the risk of breast cancer in humans. However, further studies incorporating more detailed information on DDT exposure and other potential risk factors for breast cancer are needed.

Economic burden of acute pesticide poisoning in South Korea

Objectives  To investigate the magnitude and characteristics of the economic burden resulting from acute pesticide poisoning (APP) in South Korea.

Corrigendum to Exposure to Dichlorodiphenyltrichloroethane and the Risk of Breast Cancer: A Systematic Review and Meta-analysis [Osong Public Health Res Perspect, 5, 2, (2014), 77-84] DOI:10.1016/j.phrp.2014.02.001

[This corrects the article DOI: 10.1016/j.phrp.2014.02.001.].