kjhp Korean Journal of Health Promotion Korean J Health Promot 2234-2141 2093-5676 The Korean Society of Health Promotion and Disease Prevention 10.15384/kjhp.2015.15.3.136 kjhp-15-136 Original Article Radiation Exposure through Private Health Examinations in Korea KimHyun-Jong KimJung-Won LeeSoo-Hyung KimJoo-Yeon KimMoo-Young Department of Family Medicine, Seoul Medical Center, Seoul, Korea ￭ Corresponding author：Moo-Young Kim, MD Department of Family Medicine, Seoul Medical Center, 156 Sinnae-ro, Jungnang-gu, Seoul 02053, Korea Tel: +82-2-2276-8673, Fax: +82-2-2276-8533 E-mail: moowija@hanmail.net 122015 19122015 153 136140 02032015 25082015 Copyright © 2015 The Korean Society of Health Promotion and Disease Prevention 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Background

Due to the increase in general health examination centers, health examination programs are becoming more diversified in Korea. Some of the general health examination tests, such as computed tomography, result in substantial levels of radiation exposure. However, the amount of radiation exposure from these examinations has not been studied in Korea. Thus, the aim of this study was to investigate the level of radiation exposure from general health examinations.

 Methods

Through the Korean Hospitals Association website and portal sites, 296 general health examination facilities were included in the study. The information about whether radiation-related tests are included in the health examination program of each facility was collected from their internet website. The radiation exposure dose for each test was obtained from the Database Construction Report by the Korean Institute of Nuclear Safety.

 Results

The mean base exposure dose of health examination programs from 296 health facilities was 2.49±2.50 mSv. The mean maximum exposure dose was 14.82±9.55 mSv (maximum 40.1 mSv). The maximum exposure dose was the highest at university-associated hospitals (21.63±7.54 mSv) and lowest at hospitals with ≤30 beds (7.84±7.64 mSv). The contribution of computed tomography on the maximum exposure dose was the highest of all examinations (72%).

 Conclusions

This study verified that examinees are exposed to substantial levels of radiation during general health examinations. It is necessary to establish evidence-based screening programs considering radiation exposure during general health examinations.

 Radiation Health examination Tomography X-ray computed REFERENCES Seo HG Periodic health examination in its historical perspectives Uisahak 199981 7989 Jo BR Ahn EM Present Status and problems of health screening program in Korea Health and Welfare Forum 20134854 Division of Healthcare Policy, Ministry of Health & Welfare Korea Health Statistics 2011: Korea National Health and Nutrition Examination Survey (KNHANES V-2) Seoul Ministry of Health & Welfare 2012 [Accessed March 2, 2015]. https://knhanes.cdc.go.kr/knhanes/index.do Lee JK Kwon JW Jang HG Jung JH Kim WR Park SH Design and construction of a radiation dose database for Korean population Korea Institute of Nuclear Safety 2005 Do KH The health effects of low-dose radiation exposure J Korean Med Assoc 20115412 125361 Kaiser J Epidemiology. Radiation dangerous even at lowest doses Science 20053095732 233 Korea Occupational Safety and Health Agency KOSHA GUIDE(H - 62 - 2012) p.7. Smith-Bindman R Is computed tomography safe? N Engl J Med 20103631 14 Wender R Fontham ET Barrera E Jr Colditz GA Church TR Ettinger DS American Cancer Society lung cancer screening guidelines CA Cancer J Clin 2013632 10717 The Korean Academy of Family Medicine Lifetime health maintenance program for Koreans 3rd ed. Seoul The Korean Academy of Family Medicine 2009 4142 Yang HJ Lee JS Kim JS Lee JK Evaluation of scientific evidence for health screening tests provided by some hospitals in Korea J Korean Acad Fam Med 2006279 72332 Figures and Tables

Contribution of each examination on maximum effective dose. Abbreviations: PET, positron emission tomography; CT, computed tomography; UGI, upper gastrointestinal series.

General characteristics of the health examination centers

Variable Classification The number of samples Percentage
Area of hospitals Seoul 86 29.1
Gyeonggi 46 15.5
Metropolitan city 81 27.4
Others 83 28.0
Type of hospitalsa University hospitals 56 18.9
General hospitals 118 39.9
Hospitals 100 33.8
Specialized clinics 22 7.4
Available CT 245 82.8
Available CT and PET 75 25.3

Abbreviations: CT, computed tomography; PET, positron emission tomography.

General hospitals: medical facilities with more than 100 beds; Hospitals: medical facilities with more than 30 beds; Clinics: medical facilities only for outpatients.

Radiation exposure dose according to the area of the health examination centera

Variable Area of hospital Pb
Seoul (n=86) Gyeonggi (n=46) Metropolitan city (n=81) Others (n=83)
Base exposure dose (mSv) 1.92±1.38 2.37±3.10 2.65±2.08 2.98±3.22 0.049
Maximum exposure dose (mSv) 15.54±10.60 14.31±7.45 15.07±10.24 14.14±8.81 0.895

Abbreviation: mSv, milliSieverts.

Values are presented as mean±SD.

Calculated by Kruskal-Wallis test.

Radiation exposure dose according to the type of hospitala

Variable Type of hospitald P
University hospitals (n=56) General hospitals (n=118) Hospitals (n=100) Clinics for medical examination (n=22)
Base exposure dose (mSv) 2.78±2.05 2.59±2.23 2.14±3.18 2.81±0.60 <0.001b
Maximum exposure dose (mSv) 21.63±7.54 16.61±8.45 7.84±7.64 19.75±7.76 <0.001b
Available CT 55 (98.2) 111 (94.1) 57 (100.0) 22 (100.0) <0.001c
Available PET 38 (67.9) 25 (21.2) 3 (100.0) 9 (40.9) <0.001c

Abbreviations: mSv, milliSieverts; CT, computed tomography; PET, positron emission tomography.

Values are presented as N (%) or mean±SD.

Calculated by Kruskal-Wallis test.

Calculated by Chi-square test.

General hospitals: medical facilities with more than 100 beds; Hospitals: medical facilities with more than 30 beds; Clinics: medical facilities only for outpatients.