Background The purpose of this study was to review the nationwide emergency care-related health policies during the coronavirus disease 2019 (COVID-19) pandemic disaster in Korea and to analyze the effects of the policies on the safety of patients who visit emergency departments (EDs) during this period. Methods This study is a quasi-experiment study. The study population was patients who visited all 402 EDs in Korea between December 31, 2019 and May 13, 2020, using the National Emergency Department Information System (NEDIS) database. The study period was classified into 5 phases according to the level of national crisis warning of infectious disease and the implementation of emergency care-related health policies, and all study phases were 27 days. The primary outcome was in-hospital mortality, and the secondary outcome was length of stay (LOS) in the ED during the COVID-19 outbreak. Results The number of ED visits during the study period was 2,636,341, and the in-hospital mortality rate was 1.4%. The number of ED visits decreased from 803,160 in phase 1 to 496,619 in phase 5 during the study period. For in-hospital mortality, the adjusted odds ratio (OR) (95% confidence interval) was 0.77 (0.74–0.79) in phase 5 compared to phase 3. Additionally, by subgroup, the ORs were 0.69 (0.57–0.83) for the patients with acute myocardial infarction and 0.76 (0.67–0.87) for severe trauma in phase 5 compared to phase 3. The ED LOS increased while the number of ED visits decreased as the COVID-19 pandemic progressed, and the ED LOS declined after policy implementation (beta coefficient: −5.3 [−6.5 to −4.2] minutes in phase 5 compared to phase 3). Conclusion Implementing appropriate emergency care policies in the COVID-19 pandemic would have contributed to improving the safety of all emergency patients and reducing in-hospital mortality by preventing excessive deaths.

Little is known regarding the exact relationship between osteoporosis and cardiovascular disease. Moreover, previous research on the relationships between components of metabolic syndrome (MetS) and bone mineral density (BMD) has primarily focused on women and older men; there have been few studies in younger men. We performed a cross-sectional study to assess whether MetS is associated with BMD in the femoral neck or lumbar spine in Korean adults. We further attempted to identify the MetS component, which is the most important factor in BMD. We performed a multiple regression analysis to analyze data on 2,989 subjects from the Fourth Korea National Health and Nutrition Examination Survey. We examined the association between MetS and individuals MetS components and BMD. After adjustment for age, height, weight, smoking status, alcohol consumption and exercise, waist circumference (WC) and diastolic blood pressure (DBP) showed independent negative associations with femoral neck and spine BMD in men in all age groups. Triglyceride concentration was also negatively associated with femoral neck BMD in younger men (<45 years). In premenopausal women, WC, DBP, and high-density lipoprotein cholesterol were negatively associated with spine BMD. In postmenopausal women, WC was negatively associated with femoral neck BMD. These results suggest that WC in men in all age groups may be the most important factor in bone mineral density.

Our findings are consistent with the interpretation that residents nearby to a steel mill are exposed to PAHs through ambient exposures.

PURPOSE: This study was to ascertain the risk factors of pulmonary function decline (forced expiratory volume in 1 s [FEV(1)], forced vital capacity [FVC]) among those exposed to lead in the vicinity of industrial complex. METHODS: In total, 263 men and women, aged over 30, were recruited from two cities during a 2-year follow-up. Spirometry testing was conducted first at baseline and then after 2-years of follow-up. The change in FVC and FEV(1) during the study period was analyzed according to blood lead (BPb), urinary cotinine, and 1-hydroxypyrene, after controlling for sex, height, baseline FVC or FEV(1), and airway hyperresponsiveness. RESULTS: With increase in age, both FEV(1) and FVC declined. More marked decline in FVC was noted for men than for women (p < 0.05), while the decline in FEV(1) was not. Biological variables, especially height (p < 0.05) and pulmonary status (p < 0.0001), were associated with the decline in both FEV(1) and FVC. Even after controlling these other variables, blood lead level was also significantly associated with the decline of FVC. CONCLUSIONS: Even though the decline in FEV(1) and FVC with aging was within a normal range, people with smaller height were more vulnerable to the decline of both FEV(1) and FVC and especially higher level of BPb was accompanied with larger decline of FVC. Oxidative stress in relation to lead accumulation in adult may contribute to rapid aging of pulmonary function.

Purpose Considering the risk of coronavirus disease (COVID-19) transmission through infected droplets, emergency department (ED) operations in response to febrile patients should be planned. We investigated the general and clinical characteristics of febrile patients visiting the ED and changes in admission rates via the ED during the COVID-19 outbreak. Materials and Methods We performed a retrospective analysis of prospectively collected patients who visited 402 EDs in the Republic of Korea with febrile symptoms between January 27 and May 31, 2020 and compared them to those enrolled before the COVID-19 outbreak. The primary outcome was admission rate; the secondary outcome was length of stay (LOS) in the ED. Results In total, 266519 patients had febrile symptoms at ED presentation after the COVID-19 outbreak. In 2019, before the outbreak, there were 437762 patients. The rate of ED visits among pediatric patients (aged <15 years) decreased to 21.4% after the COVID-19 outbreak, compared with 41.8% in 2019. The proportion of patients admitted after ED management was higher after the outbreak (31.3%) than before (25.2%). The adjusted odds ratio for admission was 1.04 (95% confidence interval: 1.02–1.05) after the outbreak. Compared to before the COVID-19 outbreak, the median ED LOS increased by 16 min after the outbreak. Conclusion This study confirmed that admission rates and ED LOS increased for febrile patients visiting the ED after the COVID-19 outbreak. This could provide evidence for developing ED-related strategies in response to the ongoing COVID-19 outbreak and other infectious disease pandemics.