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OBJECTIVE: This study categorized quality-of-life trajectories among disaster victims in South Korea and identified the characteristics and predictors of each trajectory.
BACKGROUND: Disaster victims experience tremendous physical and mental distress, which has a long-term impact on their quality of life.
METHODS: We conducted a cross-sectional study using data obtained from the fourth Long-term Survey on the Change of Life of Disaster Victims conducted from 2017 to 2019. The study included 257 participants who experienced a typhoon, earthquake, or fire and completed the three-year follow-up. Latent transition analysis was used to identify the potential class of quality-of-life trajectories among disaster victims. Independent t tests, χ2 tests, and logistic regression were used to identify the predictors of quality-of-life trajectories.
RESULTS: Two latent quality-of-life classes were identified: persistent low-level and persistent high-level. Factors associated with the persistent high-level trajectory included higher education level, no injury/disease from the disaster, better subjective health status, higher social support, and lower social maladjustment.
CONCLUSIONS: Quality of life early after a disaster is maintained throughout subsequent years; early and active support following disasters is essential to promote its rapid improvement.
CONCLUSIONS: Targeted educational programs in disaster-prone areas are recommended to bolster resilience among individuals with lower education. Moreover, governmental and institutional efforts are needed to support victims who lack resources for disaster recovery.
CONCLUSIONS: There is a need to establish community-based social support systems and enhance nurses\' disaster response capabilities to support vulnerable groups, with such interventions tailored to reflect disaster-affected victims\' unique characteristics and needs, along with ongoing research and evaluation for continuous improvements to nursing practice and disaster response.

BACKGROUND: A high consumption of carbonated soft drinks (i.e., soda drinks) and fast food is potentially associated with the observed global rise in adolescent allergic diseases. Thus, our study aimed to examine the potential associations between the consumption of soda drinks and fast food and allergic conditions, identifying specific relationships across subgroups and each allergic condition (asthma, allergic rhinitis, and atopic dermatitis).
METHODS: This study uses large-scale data from the Korea Youth Risk Behavior Web-Based Survey (total n = 865,614). Soda drinks and fast food were defined by a self-reported questionnaire and allergic conditions by physician-diagnosed within 1 year. Multivariable logistic regression was used to analyze the weighted odds ratios (ORs), along with 95% confidence intervals (CIs), for allergic diseases associated with the intake of soda drinks and fast food.
RESULTS: Among 865,614 adolescents in grades 7-12 (male, 51.40%), patients with asthma, allergic rhinitis, and atopic dermatitis were 18,568 (2.15%), 153,536 (17.74%), and 59,014 (6.82%), respectively. Current asthma was associated with soda drinks (OR, 1.07; 95% CI, 1.03-1.12) and fast food consumption (1.25; 1.17-1.33). Interestingly, stronger associations were observed for female high schoolers, compared to male high schoolers and middle schoolers, in relation to the consumption of soda drinks (1.31; 1.19-1.44) and fast food (1.46; 1.26-1.69) with asthma. Current allergic rhinitis and atopic dermatitis had no significant association with fast food consumption and soda drinks.
CONCLUSIONS: This first large-scale study suggests that fast food and soda drinks consumption are potentially associated with current asthma, with stronger associations observed in females than males, underscoring the need for sex-specific allergy prevention programs.

BACKGROUND: Globally, over 39% of individuals are obese. Metabolic syndrome, usually accompanied by obesity, is regarded as a major contributor to noncommunicable diseases. Given this relationship, the concepts of metabolically healthy and unhealthy obesity, considering metabolic status, have been evolving. Attention is being directed to metabolically healthy people with obesity who have relatively low transition rates to noncommunicable diseases. As obesity rates continue to rise and unhealthy behaviors prevail among young adults, there is a growing need for obesity management that considers these metabolic statuses. A nomogram can be used as an effective tool to predict the risk of transitioning to metabolically unhealthy obesity from a metabolically healthy status.
OBJECTIVE: The study aimed to identify demographic factors, health behaviors, and 5 metabolic statuses related to the transition from metabolically healthy obesity to unhealthy obesity among people aged between 20 and 44 years and to develop a screening tool to predict this transition.
METHODS: This secondary analysis study used national health data from the National Health Insurance System in South Korea. We analyzed the customized data using SAS (SAS Institute Inc) and conducted logistic regression to identify factors related to the transition from metabolically healthy to unhealthy obesity. A nomogram was developed to predict the transition using the identified factors.
RESULTS: Among 3,351,989 people, there was a significant association between the transition from metabolically healthy to unhealthy obesity and general characteristics, health behaviors, and metabolic components. Male participants showed a 1.30 higher odds ratio for transitioning to metabolically unhealthy obesity than female participants, and people in the lowest economic status were also at risk for the transition (odds ratio 1.08, 95% CI 1.05-1.1). Smoking status, consuming >30 g of alcohol, and insufficient regular exercise were negatively associated with the transition. Each relevant variable was assigned a point value. When the nomogram total points reached 295, the shift from metabolically healthy to unhealthy obesity had a prediction rate of >50%.
CONCLUSIONS: This study identified key factors for young adults transitioning from healthy to unhealthy obesity, creating a predictive nomogram. This nomogram, including triglycerides, waist circumference, high-density lipoprotein-cholesterol, blood pressure, and fasting glucose, allows easy assessment of obesity risk even for the general population. This tool simplifies predictions amid rising obesity rates and interventions.

UNASSIGNED: Effective data collection and surveillance of epidemiological trends are essential in confronting the growing challenges associated with substance use (SU), especially in light of emerging trends and underreporting of cases. However, research and data are scarce regarding SU and substance use disorder (SUD) in Korea.
UNASSIGNED: We conducted a scoping review to identify data sources and surveillance methods used in SU research in Korea up to December 2023. This review was complemented by semi-structured consultations with experts in this area in Korea, whose feedback led to revisions of previously identified data sources and assessments.
UNASSIGNED: Our review identified 32 publications conducting secondary analyses on existing data to examine the epidemiology of SU and SUD in Korea. Of these, 14 studies utilized clinical databases to explore the prescription patterns of addictive substances, particularly opioids. Eleven data sources showed promise for advancing SU research; however, they face substantial limitations, including a lack of available data, missing data, the absence of key variables, the exclusion of marginalized populations not captured within the clinical system, and complexities in matching individual-level data across time points and datasets.
UNASSIGNED: Current surveillance methods for SU in Korea face considerable challenges in accessibility, usability, and standardization. Moreover, existing data repositories may fail to capture information on populations not served by clinical or judicial systems. To systematically improve surveillance approaches, it is necessary to develop a robust and nationally representative survey, refine the use of existing clinical data, and ensure the availability of data on treatment facilities.

UNASSIGNED: Comorbidities increase susceptibility to severe coronavirus disease 2019 (COVID-19) infections, but limited information has been published regarding HIV and COVID-19 co-infections. This study explored the relationships among socioeconomic characteristics, sexual behaviors, and COVID-19 infection rates among Korean men who have sex with men (MSMs) who are also living with HIV.
UNASSIGNED: Data were collected through a web survey aimed at members of the largest gay portal site in Korea, supported by the National Research Foundation of Korea (n=1,005). The primary independent variables included COVID-19-related vaccinations and sexual behaviors. The dependent variable was the incidence of COVID-19 infection among respondents during the pandemic. For statistical analysis, hierarchical multiple logistic regression was performed, controlling for potential confounding variables.
UNASSIGNED: Model I indicated that older MSM were less likely to contract COVID-19 (adjusted odds ratio [aOR], 0.975; 95% CI, 0.962-0.989). Model II demonstrated that HIV-positive MSM were nearly twice as likely to be infected with COVID-19 compared to their HIV-negative counterparts (aOR, 1.974; 95% CI, 1.144-3.408). Furthermore, even after accounting for COVID-19 vaccination status in model III, HIV-positive MSM continued to show a higher risk of infection (aOR, 1.934; 95% CI, 1.118-3.346).
UNASSIGNED: The findings of this study indicate that HIV-positive MSM are at an increased risk of contracting COVID-19, even when their vaccination status is considered. Therefore, it is essential to prioritize the prevention of COVID-19 infections in HIV-positive individuals by administering appropriate antiretroviral therapy and ensuring adherence to public health guidelines.

BACKGROUND: This study investigated sex differences in the age-varying trends of depressive symptoms, substance use, and their relationships throughout the adult lifespan. Using a nationwide sample from South Korea, this study aimed to confirm existing patterns and identify unique characteristics specific to the South Korean context.
METHODS: Time-Varying Effect Modeling (TVEM) was applied to data from 17,484 participants (9987 women and 7497 men) in the Korea National Health and Nutrition Examination Survey.
RESULTS: Consistent with global trends, the results revealed a higher prevalence of depressive symptoms among women and a greater prevalence of substance use among men. However, the findings also illuminated unique patterns within the South Korean context. Substance use among South Korean men peaked during their 40s, whereas South Korean women consistently exhibited lower rates of substance use. Additionally, a stronger association between depressive symptoms and substance use was identified in women compared to men.
CONCLUSIONS: The study used cross-sectional data, limiting the analysis of temporal dynamics between depressive symptoms and substance use. Additionally, TVEM cannot distinguish between aging and cohort effects. Furthermore, the assessments of depressive symptoms and substance use were based on self-report. Finally, the study did not include adolescents or sex and gender minorities in its sample.
CONCLUSIONS: These results emphasize the need for targeted interventions, particularly among women in their 20s and older adulthood, where there is a heightened co-occurrence of depressive symptoms and substance use. These findings also highlight the importance of sex- and culture-sensitive approaches tailored to the South Korean context.

UNASSIGNED: It remains unknown whether patients with pre-existing depressive conditions are at high risk of severe COVID-19. Therefore, this study aims to investigate the association between patients with pre-existing depressive conditions and severe COVID-19.
UNASSIGNED: This study is part of the Korea Disease Control and Prevention Agency-COVID19-National Health Insurance Service cohort study of an ongoing large-scale health screening survey of adults 18 years and older residing in South Korea. Pre-existing depression status was measured from 552,860 patients who participated in a biennial health screening from 2019 to 2020. Finally, 29,106 confirmed COVID-19 patients were enrolled and followed up to track any severe clinical events within 1 month of their diagnosis date. Adjusted odds ratio (aOR) and 95% confidence interval (CI) were calculated using multivariate-adjusted logistic regression analysis.
UNASSIGNED: We identified 2868 COVID-19 patients with severe clinical events and 26,238 COVID-19 patients without severe clinical events. The moderate-to-severe depressive symptoms group showed an elevated odds of severe outcomes of COVID-19 (aOR, 1.46; 95% CI, 1.25-1.72), including those without vaccination (aOR, 1.32; 95% CI, 1.08-1.61) and those with complete vaccination (aOR, 1.76; 95% CI, 1.18-2.63). In addition, those who were diagnosed with depression along with depressive symptoms at the health screening revealed an increased risk of severe outcomes of COVID-19 (aOR, 2.22; 95% CI, 1.22-4.05).
UNASSIGNED: Moderate-to-severe depressive symptoms were associated with higher odds of severe COVID-19 events in both no and complete vaccination groups. Participants with depressive symptoms may be at higher risk of severe outcomes of COVID-19.

Occupational diseases, characterized by the gradual accumulation of work-related harmful effects over extended periods, often lack a distinct, identifiable incident causative of the disease. This ambiguity in pinpointing the work-relatedness of such diseases stems from the intricate interplay between occupational risks, workers\' pathophysiological predispositions, and pre-existing health conditions, all of which evolve slowly over time. Consequently, establishing a definitive causal relationship between occupational exposure and disease manifestation becomes a pivotal, yet challenging, aspect in securing industrial accident insurance benefits. In contrast to occupational accidents, where causality is relatively more discernible, the complexity escalates in the context of occupational diseases. Typically, employers maintain the majority of data pertinent to establishing causality, but this data is frequently inadequate. Furthermore, the onus of proving the work-relatedness of a disease falls on the worker, a process that necessitates specialized medical knowledge, thereby compounding the difficulty. Imposing the burden of proof on workers in occupational disease litigation could lead to a lapse in worker protection. This paper critically explores methodologies to safeguard workers, focusing specifically on the burden of proof concerning causality in occupational diseases. This analysis aims to highlight the challenges workers face in establishing a connection between their work and disease, proposing potential legal and policy solutions to ensure more equitable and just outcomes in occupational disease claims.

BACKGROUND: While extensive studies have elucidated the relationships between exposure to air pollution and chronic diseases, such as cardiovascular disorders and diabetes, the intricate effects on specific kidney diseases, notably primary glomerulonephritis (GN)-an immune-mediated kidney ailment-are less well understood. Considering the escalating incidence of GN and conspicuous lack of investigative focus on its association with air quality, investigation is dedicated to examining the long-term effects of air pollutants on renal function in individuals diagnosed with primary GN.
METHODS: This retrospective cohort analysis was conducted on 1394 primary GN patients who were diagnosed at Seoul National University Bundang Hospital and Seoul National University Hospital. Utilizing time-varying Cox regression and linear mixed models (LMM), we examined the effect of yearly average air pollution levels on renal function deterioration (RFD) and change in estimated glomerular filtration rate (eGFR). In this context, RFD is defined as sustained eGFR of less than 60 mL/min per 1.73 m2.
RESULTS: During a mean observation period of 5.1 years, 350 participants developed RFD. Significantly, elevated interquartile range (IQR) levels of air pollutants-including PM10 (particles ≤10 micrometers, HR 1.389, 95 % CI 1.2-1.606), PM2.5 (particles ≤2.5 micrometers, HR 1.353, 95 % CI 1.162-1.575), CO (carbon monoxide, HR 1.264, 95 % CI 1.102-1.451), and NO2 (nitrogen dioxide, HR 1.179, 95 % CI 1.021-1.361)-were significantly associated with an increased risk of RFD, after factoring in demographic and health variables. Moreover, exposure to PM10 and PM2.5 was associated with decreased eGFR.
CONCLUSIONS: This study demonstrates a substantial link between air pollution exposure and renal function impairment in primary GN, accentuating the significance of environmental determinants in the pathology of immune-mediated kidney diseases.