Epidemiology and Health最新文献

{"title":"Health-related productivity loss among Korean workers: evidence from a nationally representative sample.","authors":"Heejoo Ko, Ji Eun Lee, Jaesung Choi, Dong-Wook Lee, Mo-Yeol Kang","doi":"10.4178/epih.e2026043","DOIUrl":"https://doi.org/10.4178/epih.e2026043","url":null,"abstract":"<p><strong>Objectives: </strong>Health-related productivity loss (HRPL) is a comprehensive measure of labor productivity lost because of health problems. This study examined the distribution of HRPL and its associations with a broad range of health conditions and occupational characteristics in a nationally representative sample of Korean workers and quantified the population-level productivity burden associated with each condition.</p><p><strong>Methods: </strong>This cross-sectional analysis included 12,554 workers from the 26th wave (2023) of the Korean Labor and Income Panel Study. HRPL was assessed using the Work Productivity and Activity Impairment Questionnaire-General Health version. Differences in HRPL were evaluated across sociodemographic, health-behavioral, and occupational characteristics. Linear regression models adjusted for age, sex, and occupation were used to estimate mean differences in HRPL associated with 34 self-reported health conditions. The condition-specific burden was calculated as condition prevalence multiplied by the adjusted mean difference in HRPL.</p><p><strong>Results: </strong>The overall mean HRPL was 19.0% and predominantly reflected presenteeism rather than absenteeism. Higher HRPL was observed among older workers and those with lower educational attainment, sleep duration outside the recommended range, lower leisure-time physical activity, higher occupational physical activity, and non-standard employment. The largest adjusted mean differences in HRPL were associated with infertility treatment (52.18 percentage points), anxiety (23.83), depression (20.43), cancer (20.23), and gastroenteritis (18.36). The greatest population-level burdens were associated with low back pain (109.2 burden units), neck or shoulder pain (85.0), upper- or lower-limb joint pain or dysfunction (73.5), and fatigue (61.5).</p><p><strong>Conclusion: </strong>HRPL is substantial among Korean workers and is associated with occupational characteristics and common health conditions.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2026043"},"PeriodicalIF":2.4,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural-urban differences in the association between senior-center meal use and micronutrient inadequacy among older Korean adults: KNHANES 2016-2023.","authors":"Ji-Sook Kong, Kirang Kim","doi":"10.4178/epih.e2026042","DOIUrl":"https://doi.org/10.4178/epih.e2026042","url":null,"abstract":"<p><strong>Objectives: </strong>Community-based meal programs, including senior-center meals, are provided to help meet the nutritional needs of older adults in Korea. However, evidence on how these meals contribute to daily nutrient intake and micronutrient adequacy remains limited, particularly across residential settings.</p><p><strong>Methods: </strong>Using data from the Korean National Health and Nutrition Examination Survey (KNHANES) 2016-2023, we analyzed adults aged ≥65 years with a 24-hour dietary recall (n=6,438). Participants were classified as senior-center meal users (SCMU, n=162) or home-only meal users (HOMU, n=6,276), after excluding those who could not be classified into either group. Survey-weighted regression models compared nutrient intake patterns and assessed nutrient inadequacy based on Estimated Energy Requirement (EER), Estimated Average Requirement (EAR), and Adequate Intake (AI) criteria. Survey-weighted logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) for nutrient inadequacy according to senior-center meal use and examined effect modification by residential area.</p><p><strong>Results: </strong>SCMU were older and more socioeconomically disadvantaged than HOMU. Although total nutrient intakes were similar, SCMU had higher lunch energy and nutrient intake, reflecting meal redistribution. Overall nutrient inadequacy did not differ. However, SCMU were associated with lower odds of vitamin A inadequacy (OR 0.33, 95% CI 0.14-0.75) and riboflavin inadequacy (OR 0.45, 95% CI 0.22-0.91) among rural, but not urban, residents (both Pinteraction < 0.05).</p><p><strong>Conclusion: </strong>Senior-center meals shifted a greater proportion of daily nutrient intake to lunch without substantially increasing total daily intake. SCMU had lower odds of vitamin A and riboflavin inadequacy among rural older adults.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2026042"},"PeriodicalIF":2.4,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A non-clinical risk model for periodontitis derived from a national health examination survey: development and external validation.","authors":"Seon-Jip Kim, Min-Joo Shin, Hyun-Jae Cho","doi":"10.4178/epih.e2026040","DOIUrl":"https://doi.org/10.4178/epih.e2026040","url":null,"abstract":"<p><strong>Objectives: </strong>Periodontitis is a prevalent non-communicable disease (NCD), but most risk stratification tools require periodontal examination, limiting use in public health settings. This study developed and externally validated a non-clinical model for identifying prevalent periodontitis using routinely collected NCD surveillance variables. Because survey cycles were cross-sectional, the model was diagnostic rather than prognostic.</p><p><strong>Methods: </strong>Data were obtained from the Korea National Health and Nutrition Examination Survey, a nationally representative survey with a complex sampling design. A survey-weighted multivariable logistic regression model was developed using cycle VII data (2016-2018; n=12,144) and externally validated without re-estimation using non-overlapping cycle VI data (2013-2015; n=12,523). Prevalent periodontitis was defined as a Community Periodontal Index score ≥3 in any sextant. Twelve pre-specified non-clinical predictors spanning demographic, socioeconomic, metabolic, and behavioural domains were entered without data-driven selection. Performance evaluation incorporated discrimination, calibration, reclassification, and decision curve analysis. Reporting followed the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis statement.</p><p><strong>Results: </strong>Discrimination improved from an area under the receiver operating characteristic curve (AUC) of 0.732 for the demographic-only model to 0.755 for the full model. Performance was retained during external validation (AUC, 0.728; calibration slope, 0.984; intercept, -0.106). Decision curve analysis demonstrated a positive net benefit across clinically plausible thresholds in both cohorts.</p><p><strong>Conclusion: </strong>Routinely collected NCD surveillance data can identify adults at high risk of periodontitis with externally reproducible performance. Non-clinical models utilising these data may support periodontal case-finding within NCD screening programmes, particularly in primary care and community settings.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2026040"},"PeriodicalIF":2.4,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quit intention by tobacco use type among adults using cigarettes and heated tobacco products: findings from the 2024 Korea Community Health Survey.","authors":"Jaehyung Kong, Heewon Kang, Eunsil Cheon, Sung-Il Cho","doi":"10.4178/epih.e2026041","DOIUrl":"https://doi.org/10.4178/epih.e2026041","url":null,"abstract":"<p><strong>Objectives: </strong>Since heated tobacco products (HTPs) entered the tobacco market, their market share and use have increased, but their implications for tobacco use patterns and cessation remain unclear. This study classified conventional cigarette (CC) and HTP use into detailed subgroups and examined whether tobacco consumption and intention to quit differed across tobacco use types.</p><p><strong>Methods: </strong>Data were analyzed from 40,434 adults who currently used CCs or HTPs in the 2024 Korea Community Health Survey. Tobacco use was classified into 5 groups according to lifetime and current CC and HTP use. Descriptive analyses were performed to assess group distributions, and multinomial and multivariable logistic regression models were fitted to identify associated factors and examine intention to quit within 6 months.</p><p><strong>Results: </strong>Among adults currently using CCs or HTPs, 73.7% reported exclusive CC use, 10.2% reported exclusive HTP use, and 16.1% reported dual use. Overall mean tobacco consumption was 14.4 sticks per day and was highest among dual users (20.7 sticks per day). Compared with the current CC and never HTP group, the current CC and former HTP group had higher odds of intending to quit (adjusted odds ratio [aOR] = 1.19, 95% CI: 1.06-1.34), whereas the current HTP and former CC group had lower odds of intending to quit (aOR = 0.78, 95% CI: 0.67-0.90).</p><p><strong>Conclusion: </strong>Intention to quit varied by tobacco use type. Cessation services should account for differences in tobacco use patterns and intention to quit across tobacco use groups, particularly among people with prior or current HTP use and those who use both CCs and HTPs.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2026041"},"PeriodicalIF":2.4,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sampling design, weighting, and attrition management in Korean longitudinal panel surveys: a comparative methodological review.","authors":"Joo Youn Kim, Hae Yong Park, Sei-Jong Baek, Jung Hyun Chang","doi":"10.4178/epih.e2026039","DOIUrl":"https://doi.org/10.4178/epih.e2026039","url":null,"abstract":"<p><strong>Objectives: </strong>No systematic comparison of Korean longitudinal panel surveys has evaluated sampling design, sample-size determination, weighting procedures, and attrition management within a single methodological framework. This review synthesises these features to support the design of community-based ageing panels.</p><p><strong>Methods: </strong>A structured comparative methodological review was conducted using official statistical registries and national research institute databases. Twenty-two eligible Korean longitudinal panel surveys were identified, and nine panels-five directly relevant and four indirectly relevant to older-adult health research-were selected for in-depth analysis.</p><p><strong>Results: </strong>Among the six household- or population-based panels, four used stratified two-stage cluster sampling; the Korea Welfare Panel Study used stratified double sampling, and the Korean Retirement and Income Study used unequal-probability systematic sampling. Among the three registry-based panels, the Panel Survey of Employment for the Disabled and the Disability and Life Dynamics Panel used stratified probability sampling, whereas the sampling procedures of the Panel Study of Workers' Compensation Insurance could not be verified from publicly available documentation. Only the Korean Longitudinal Study of Ageing documented an explicit sample-size determination rationale, and none of the nine panels reported design effects. Weighting typically followed three sequential steps: design-weight derivation, nonresponse adjustment, and post-stratification calibration. Panel-specific refinements included weight trimming in the Korean Longitudinal Survey of Women and Families, combined weights after refreshment-sample integration in the Korea Welfare Panel Study, and separate cross-sectional and longitudinal weights in the Korea Health Panel Study. Percentage-based retention rates were available for six panels; the Korean Retirement and Income Study reported only retained household counts, and the Panel Survey of Employment for the Disabled and the Panel Study of Workers' Compensation Insurance reported no retention figures. Refreshment strategies included periodic supplementation in six panels, no refreshment in the Disability and Life Dynamics Panel, full redesign in the Panel Survey of Employment for the Disabled, and an unclassifiable strategy in the Panel Study of Workers' Compensation Insurance.</p><p><strong>Conclusion: </strong>Korean longitudinal panel surveys have converged on broadly similar sampling and weighting structures, but substantial gaps remain in the reporting of design effects, sample-size rationales, and wave-by-wave retention rates. Future community-based ageing panels should prespecify intracluster correlation coefficients and design effects, provide analysis-specific weights, document attrition-bias diagnostics, and plan refreshment procedures transparently.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2026039"},"PeriodicalIF":2.4,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poultry consumption, preparation methods for animal-based foods, and urinary bisphenol concentrations in Korean adults.","authors":"Seong-Ho Moon, Soonsu Shin, Jung Eun Kim, Hee Yong Kang, Taesoo An, Myoung Hun Kim, Jae-Hong Ryoo","doi":"10.4178/epih.e2026038","DOIUrl":"https://doi.org/10.4178/epih.e2026038","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to examine associations between preparation methods for animal-based foods and urinary concentrations of bisphenol A (BPA), bisphenol F (BPF), and bisphenol S (BPS) in Korean adults.</p><p><strong>Methods: </strong>We analysed data from 4,201 adults who participated in the Korean National Environmental Health Survey (2018-2020). Urinary BPA, BPF, and BPS concentrations were measured and standardised for urinary dilution using the covariate-adjusted standardisation method. Preparation methods were categorised as rarely consumed, raw, grilled/roasted, boiled/steamed, or fried/stir-fried. Survey-weighted logistic regression was used to estimate odds ratios (ORs) for high exposure, defined as concentrations at or above the 75th percentile, stratified by sex.</p><p><strong>Results: </strong>Among men, poultry consumption was associated with higher odds of elevated BPA across grilled/roasted (OR, 2.51; 95% CI: 1.28-4.92), boiled/steamed (OR, 2.62; 95% CI: 1.58-4.36), and fried/stir-fried preparations (OR, 2.22; 95% CI: 1.32-3.75). Pork consumption showed inverse associations with BPA. Among women, fried/stir-fried poultry was associated with higher BPF concentrations (OR, 1.85; 95% CI: 1.09-3.12). Sensitivity analyses supported the main findings, particularly the poultry-related associations with BPA among men and BPF among women.</p><p><strong>Conclusion: </strong>Preparation patterns for animal-based foods were associated with urinary bisphenol concentrations in Korean adults. Poultry-related associations were observed for BPA among men and BPF among women; however, the cross-sectional design and the lack of direct information on food sources, processing, and packaging preclude causal or packaging-specific interpretations.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2026038"},"PeriodicalIF":2.4,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the EORTC QLQ-C30 and the FACT-G for assessing health-related quality of life among adult cancer patients in Cameroon.","authors":"Hermann Eugene Imele Metenou, Etienne Atenguena Okobalemba, Berthe Sabine Esson Mapoko, Micha Johannes Pilz, Peter Vuylsteke, Abdou Nsounfon Wouoliyou, Arlène Kouamassong Ngueguim, Aliou Nassourou Souadatou, Thérèse Marline Litingui Mboba, Marie-José Essi","doi":"10.4178/epih.e2026033","DOIUrl":"https://doi.org/10.4178/epih.e2026033","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the psychometric properties of the French and English versions of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ -C30) and Functional Assessment of Cancer Therapy-General (FACT -G) among adults with cancer in Cameroon.</p><p><strong>Methods: </strong>We conducted a secondary analysis of a hospital-based, multicenter cross-sectional study carried out between December 2024 and August 2025 at three public oncology centers in Yaoundé. Adults with a confirmed cancer diagnosis completed a questionnaire package that included the EORTC QLQ-C30 and FACT-G. We assessed content validity, floor and ceiling effects, internal consistency, construct validity, measurement invariance across language groups, convergent and discriminant validity, and concurrent criterion validity. Sensitivity analyses were performed by re-estimating FACT-G models after excluding misfitting items.</p><p><strong>Results: </strong>Data from 507 participants were analyzed. Both instruments showed good content validity and excellent overall internal consistency. The EORTC QLQ-C30 had a well-supported factor structure and full measurement invariance across language groups, although several subscales and items showed pronounced floor and ceiling effects. The FACT-G showed poor structural fit, driven largely by low-loading items, particularly in the social/family well-being subscale. Excluding all problematic items improved confirmatory factor analysis fit and yielded satisfactory cross-language invariance for a modified FACT-G. Concurrent criterion validity was moderate to strong overall.</p><p><strong>Conclusion: </strong>For health-related quality-of-life assessment in Cameroonian oncology settings, the EORTC QLQ-C30 should be preferred over the FACT-G, despite substantial floor and ceiling effects that warrant caution when interpreting responsiveness and sensitivity to change. Future studies should extend the measurement range of the EORTC QLQ-C30, strengthen the conceptual equivalence of the FACT-G, and assess longitudinal validity in this setting.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2026033"},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality risk associated with acetylcholinesterase inhibitor use in Parkinson's disease dementia according to sex and age at disease onset: a nationwide cohort study.","authors":"Bora Yoon, Hwa Jung Kim","doi":"10.4178/epih.e2026015","DOIUrl":"10.4178/epih.e2026015","url":null,"abstract":"<p><strong>Objectives: </strong>Dementia increases mortality risk; however, most studies evaluating acetylcholinesterase inhibitors (AChEIs) have focused on Alzheimer's disease. The survival effects of AChEIs in Parkinson's disease dementia (PDD) remain unclear. This study evaluated the association between AChEI use and mortality in PDD, stratified by sex and age at Parkinson's disease (PD) onset.</p><p><strong>Methods: </strong>This retrospective cohort study used data from the Korean National Health Insurance Service from January 2002 to December 2021. Patients diagnosed with PDD after PD onset were included. Propensity score matching (2:1) was performed to match AChEI users with non-users. Kaplan-Meier survival analyses and subgroup analyses were conducted according to sex and age at PD onset.</p><p><strong>Results: </strong>AChEI use was associated with a 24% reduction in mortality risk (hazard ratio [HR], 0.76; 95% confidence interval [CI], 0.74 to 0.78; p<0.001). The survival benefit persisted throughout follow-up and was more pronounced in females (HR, 0.71; 95% CI, 0.69 to 0.74) than in males (HR, 0.83; 95% CI, 0.80 to 0.86). In late-onset PDD, AChEI use was associated with a 26% reduction in mortality (HR, 0.74; 95% CI, 0.72 to 0.76), whereas no significant association was observed in young-onset PDD (HR, 1.02; 95% CI, 0.92 to 1.33; p=0.665). Survival outcomes were comparable between donepezil and rivastigmine users.</p><p><strong>Conclusions: </strong>AChEI use improved survival in patients with PDD, particularly in females and in those with late-onset PD, with the greatest benefit observed during early and medium-term follow-up periods. These findings suggest that AChEIs may confer a survival advantage in PDD regardless of the specific agent used.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2026015"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatiotemporal analysis of sudden infant death syndrome incidence in Korea, 2013-2023.","authors":"Seungbae Jeon, Minsu Cha, Sunghyun Yun","doi":"10.4178/epih.e2026027","DOIUrl":"10.4178/epih.e2026027","url":null,"abstract":"<p><strong>Objectives: </strong>This study examined temporal trends and geographic variation in sudden infant death syndrome (SIDS) incidence in Korea.</p><p><strong>Methods: </strong>We analyzed a nationwide cardiac arrest registry to identify SIDS cases from 2013 to 2023. The study period was divided into 3 phases: pre-pandemic (2013-2019), pandemic (2020-2021), and post-pandemic (2022-2023). Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were estimated using Poisson regression, whereas standardized incidence ratios (SIRs) and 95% credible intervals (CrIs) were derived from Bayesian spatial models across all administrative districts. Spatial clustering was evaluated using Moran's I.</p><p><strong>Results: </strong>Overall, 884 eligible cases were identified: 575 in the pre-pandemic period, 172 in the pandemic period, and 137 in the post-pandemic period. SIDS incidence increased significantly from the mid-2010s onward, with an annual increase of approximately 8-9%. Compared with the pre-pandemic period, SIDS incidence was significantly higher during the pandemic period (IRR, 1.52; 95% CI, 1.28 to 1.80) and the post-pandemic period (IRR, 1.34; 95% CI, 1.11 to 1.61). Spatial clustering of SIDS incidence increased progressively across the 3 periods (Moran's I: 0.359, 0.654, and 0.952, respectively; p<0.001). Pyeongtaek-si, Gyeonggi-do, was the only district with a significantly increased SIR in the pre-pandemic period (posterior mean, 1.602; 95% CrI, 1.007 to 2.424); no district met the significance thresholds in the subsequent periods.</p><p><strong>Conclusions: </strong>SIDS incidence in Korea has increased significantly since the mid-2010s, with progressive spatial clustering toward southwestern regions across the 3 study periods. The emergence of high-incidence and low-incidence clusters underscores the need for targeted interventions.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2026027"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between smoking and the risk of dental implant failure in Korean adults: a nationwide cohort study.","authors":"Yu-Rin Kim, Minkook Son, Hyeon Ji Kim, Seon-Rye Kim","doi":"10.4178/epih.e2026002","DOIUrl":"10.4178/epih.e2026002","url":null,"abstract":"<p><strong>Objectives: </strong>We evaluated the associations of smoking status, intensity, duration, and cumulative exposure with the risk of dental implant failure in Korean adults.</p><p><strong>Methods: </strong>This retrospective cohort study utilized the National Health Insurance Service-Health Screening Cohort (2016-2019). Overall, 23,573 individuals who had completed the dental implant process were included. Smoking status was categorized as non-smoker, ex-smoker, or current smoker. Smoking intensity, duration, and cumulative exposure were classified using standardized thresholds (>10 cigarettes per day, >10 years, and >10 pack-years). Implant failure was defined as reimplantation or removal. Cox proportional hazards models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for demographic, clinical, and behavioral covariates.</p><p><strong>Results: </strong>During follow-up, 605 implant failures occurred: 344 in non-smokers, 182 in ex-smokers, and 79 in current smokers. The corresponding incidence rates per 1,000 person-years were 11.56, 16.54, and 22.33, respectively. Current smoking was significantly associated with higher implant failure risk (adjusted HR, 1.59; 95% CI, 1.20 to 2.09), while ex-smokers displayed a non-significant increase (adjusted HR, 1.16; 95% CI, 0.94 to 1.45). A dose-response relationship was observed: smoking more than 10 cigarettes per day, smoking for more than 10 years, or exceeding 10 pack-years was associated with significantly increased risk.</p><p><strong>Conclusions: </strong>Smoking is a significant, dose-dependent risk factor for dental implant failure in Korean adults. Current smokers have the highest risk; smoking cessation may reduce adverse outcomes. These findings emphasize the importance of detailed smoking assessments and cessation counseling in implant care and public health strategies.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2026002"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12946569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}