Search

Additional file 3: Table S2. Odds ratios and 95% confidence intervals of symptoms and doctor-diagnoses of three allergic diseases for interquartile increases in individual-level annual average concentrations of NO2, PM10, and PM2.5 (6.46 ppm, 3.80 μg/m3, and 3.63 μg/m3, respectively) in 14,614 children of the Seoul Atopy Friendly School Project Survey in Seoul, Korea, for 2010.

Background Individual particulate respirator use may offer protection against exposure to particulate matter < 2.5 µm in diameter (PM2.5). Among elderly Korean women, we explored individual particulate respirator use and cardiopulmonary function. Methods Recruited in Seoul, Korea, 21 elderly, non-smoking women wore particulate respirators for six consecutive days (exlcuding time spent eating, sleeping, and bathing). We measured resting blood pressure before, during, and after respirator use and recorded systolic and diastolic blood pressure, mean arterial blood pressure, pulse pressure, and lung function. We also measured 12-hour ambulatory blood pressure at the end of the 6-day long experiment and control periods. Additionally, we examined physiological stress (heart rate variability and urinary 8-hydroxy-2′-deoxyguanosine) while wearing the particulate respirators. Person- and exposure-level covariates were also considered in the model. Results After the 6-day period of respirator use, resting blood pressure was reduced by 5.3 mmHg for systolic blood pressure (P = 0.013), 2.9 mmHg for mean arterial blood pressure (P = 0.079), and 3.6 mmHg for pulse pressure (P = 0.024). However, particulate respirator use was associated with changes in physiological stress markers. A parasympathetic activity marker (high frequency) significantly decreased by 24.0% (P = 0.029), whereas a sympathetic activity marker (ratio of low-to-high frequency) increased by 50.3% (P = 0.045). An oxidative stress marker, 8-hydroxy-2′-deoxyguanosine, increased by 3.4 ng/mg creatinine (P = 0.021) during the experimental period compared with that during the control period. Lung function indices indicated that wearing particulate respirators was protective; however, statistical significance was not confirmed. Conclusion Individual particulate respirator use may prevent PM2.5-induced blood-pressure elevation among elderly Korean women. However, the effects of particulate respirator use, including physiological stress marker elevation, should also be considered. Trial Registration Clinical Research Information Service Identifier: KCT0003526, Graphical Abstract

Background The most relevant time of PM10 exposure to affect airway hyperresponsiveness (AHR) and new development of asthma in school-aged children is unclear. The aims of this study were to investigate the most critical time of PM10 exposure to affect AHR and new diagnosis of asthma from AHR in school-aged children. Methods Elementary schoolchildren (n = 3570) have been enrolled in a nationwide prospective 4-year follow-up survey in Korea from 2005 to 2006. Individual annual PM10 exposure was estimated by using an ordinary kriging method from the prenatal period to 7 years of age. AHR at 7 years was defined by a methacholine PC20 ≤8 mg/mL. Results PM10 exposure during pregnancy and at 1 year of age showed significant effects on AHR (aOR: 1.694, 95% CI: 1.298-2.209; and aOR: 1.750, 95% CI: 1.343-2.282, respectively). PM10 exposure during pregnancy was associated with the risk of a new diagnosis of asthma (aOR: 2.056, 95% CI: 1.240-3.409), with the highest risk in children with AHR at age 7 (aOR: 6.080, 95% CI: 2.150-17.195). PM10 exposure in the second trimester was associated with the highest risk of a new diagnosis of asthma in children with AHR at age 7 (aOR: 4.136, 95% CI: 1.657-10.326). Conclusions Prenatal PM10 exposure in the second trimester is associated with an increased risk of a new diagnosis of asthma in school-aged children with AHR at 7 years. This study suggests that PM10 exposure during a specific trimester in utero may affect the onset of childhood asthma via AHR.

This study investigated whether the association between household air pollution (HAP) and nutritional status (stunting, underweight, or wasting) among children differ by caste/ethnicity. Child anthropometry data for 9,914 children aged 0–59 months were analyzed linearly as Z scores and as dichotomous categories. Exposure to HAP was significantly associated with a decrease in child height-for-age and child weight-for-age, as well as with stunting and underweight. Children in low caste (Dalits) had higher prevalence of stunting (odds ratio [OR] = 1.21; 95% confidence intervals [CI] = 1.01, 1.44), underweight (OR = 1.47; 95% CI = 1.24, 1.75), and wasting (OR = 1.53; 95% CI = 1.21, 1.92) than those children in upper caste group. This association was modestly attenuated with adjustment for HAP. Exposure to HAP partly explained the caste-ethnic difference in undernutrition among children in Nepal.

Background The global labor market is moving towards increasing job instability. Relatively few studies have examined the relationship between precarious employment and subjective well-being using quantitative scales. We evaluated the association between wage workers' employment status and their subjective well-being through the Cantril ladder scale using Korean Welfare Panel Survey data (KOWEPS). Methods This study used KOWEPS data. A total of 4,423 wage workers were divided into permanently employed workers, temporarily employed workers and daily employed workers. The relationship between precarious employment and subjective well-being was analyzed by multiple linear regression adjusted for potential confounding factors. Results The more unstable the employment status, the lower the subjective well-being, which can be expressed by the Cantril ladder scale. The mean score of both temporarily employed and daily employed workers were statistically significantly lower (B = -0.454, p < 0.001; B = -0.994, p < 0.001, respectively) than permanently employed workers. This appeared to be the same when occupational and sociodemographic factors were adjusted (B = -0.153, p = 0.002 for temporarily employed, B = -0.610, p < 0.001 for daily employed). Conclusions The more unstable the employment status, the lower the subjective well-being score according to the Cantril ladder scale.

Objective Estimating carcinogen exposure prevalence is important for preventing occupational cancers. To develop the Korean version of CARcinogen EXposure (CAREX), a carcinogen surveillance system used in many countries, we estimated lead exposure prevalence in the Korean working population. Methods We used three Korean nationwide data sources to obtain objective database-derived prevalences of lead exposure across industries: airborne lead measurement data from the work environment measurement database (WEMD), blood lead measurement data from the special health examination database (SHED), and lead exposure prevalence computed using data from the work environment condition survey (WECS), which is a nationwide occupational exposure survey. We also asked a panel of 52 experts with ≥20 years of experience in industrial hygiene practice for their judgment about lead exposure prevalence across industries after they reviewed the database-derived prevalences computed from the three exposure databases. We developed and compared various estimation methods for combining the experts' judgments. The 2010 census was used as the reference population to estimate the number of lead-exposed workers in 228 industries by multiplying the exposure prevalence by the number of workers in each industry. Results The database-derived prevalences of lead exposure in the 228 industries were calculated using data collected between 2009 and 2011 from the WEMD and SHED and from the 2009 WECS. From the various estimation methods assessed, the median values of experts' responses were selected as our estimates of lead exposure prevalence in each industry. As a result, it was estimated that 129,250 Korean workers were exposed to lead in 2010. Conclusions Based on objective databases, we developed a method for estimating exposure prevalence for the CAREX system by combining experts' judgments. This work may offer an unbiased approach to the development process that accounts for the uncertainty in exposure.

Introduction: Chronic obstructive pulmonary disease (COPD) is commonly affected by particulate matter (PM) exposure. In this study, we aimed to evaluate whether behavioral interventions to reduce PM exposure improve clinical outcomes in patients with COPD. Methods: A multicenter randomized controlled trial will be conducted involving 120 participants recruited from 3 hospitals in the capital region of the Republic of Korea. Patients aged 40 to 80 years with a diagnosis of COPD and a forced expiratory volume at 1 s

Prenatal particulate matter

Background The risk factors for renal cancer include smoking, obesity, hypertension, and exposure to trichloroethylene. Recent studies have shown that low sunlight exposure increases the risk of developing a range of cancers, including renal cancer. Given that most of the daytime is spent at work, a lack of occupational sunlight exposure can be a risk factor for renal cancer. Therefore, this study examined the relationship between occupational sunlight exposure and the incidence of renal cancer. Methods This was a university hospital-based case-control study on renal cancer. Of the 706 newly diagnosed patients with renal cell carcinoma (RCC), 633 cases were selected; 73 who had no occupational history were excluded. In addition, 633 controls were selected from the general population after 1:1 matching with respect to sex, age (within 5 years), and residential area (constituency-level). Information on sunlight exposure by the occupational group was referred to data from France. To estimate the association between occupational sunlight exposure and the RCC risk, the odds ratios (ORs) were calculated using conditional logistic regression analysis. Results Sunlight exposure was divided into quartiles and the risk of RCC was analyzed. The adjusted OR of RCC (OR: 0.664, 95% confidence interval: 0.449-0.983) was significantly lower for the Q4 group than Q1 group but the Q2 and Q3 groups did not show significant results. The risk of RCC tended to decrease with increasing exposure to sunlight (p for trend < 0.028). Conclusions Higher occupational sunlight exposure reduces the risk of RCC.

Objectives Polycyclic aromatic hydrocarbons (PAHs) are well-known carcinogens causing lung and skin cancers in exposed workers. Certain occupations, such as coke production, have been associated with high PAH exposure; however, the number of occupations tested to date remains small. Here, we sought to compare PAH exposure across a wide range of occupations based on levels of 1-hydroxypyrene (1-OHP), the urinary exposure surrogate of PAHs. Methods We collected urine 1-OHP data from the Korean National Environmental Health Survey (KoNEHS), a nationwide biomonitoring survey. We developed a linear regression model, controlling for sex, age, smoking, and survey cycle, and obtained resulting residuals. Then, we computed the fraction of exceeding the third quartile (Q3) level of residuals for each occupation, which is employed as a relative exposure indicator across occupations. Results A total of 15 125 measurements derived from three cycles of KoNEHS were used for analysis. The overall geometric means (GMs) and geometric standard deviation (GSD) of urine 1-OHP levels were 0.16 µg g−1 creatinine and 3.07, respectively. Among the sub-major occupational groups, ‘construction and mining related elementary occupations’ showed the highest fraction (0.45) of exceeding the Q3 level of residuals. Among the minor occupational groups, ‘deliverers’ showed a high fraction (0.42) of exceeding the Q3 level of residuals, which indicates rapidly growing occupations to be addressed. Conclusions Our results provide ancillary information regarding PAH exposure across occupations, especially for occupations for which PAH exposure has not been well characterized.

Background: The Mothers and Children's Environmental Health study (MOCEH) is a multi-centric prospective birth cohort study investigating effects of various environmental pollutants like heavy metals, endocrine disruptors, air pollutants, nutrition and lifestyle on birth outcomes, growth and development, health and disease of children. In this study, we report all the outcomes from the MOCEH study describing the different environmental pollutants affecting children’s health and disease. Methods: In MOCEH study, 1,751 pregnant women in their first trimester were recruited at 3 centers from 2006 to 2010 in South Korea. The children were followed from birth up to 6 years. Information on health outcomes of children including birth parameters, demographic characteristics, medical and child-rearing history, and nutritional status, were repeatedly obtained through the follow-ups by questionnaires administration, clinical evaluation, and biological specimen collection and measurements. Prenatal and postnatal measurement in biospecimen, i.e., lead, mercury, cadmium, manganese, 1-hydroxypyrene, 2-naphthol, malonadialdehyde, hippuric acid, bisphenol A and phthalate metabolites, and measurement in air samples, i.e., particulate matter, nitrogen dioxide, and total volatile organic compounds were performed. Results: The results show the adverse effect of prenatal exposure to heavy metals like mercury, lead and cadmium on children’s physical, cognitive and neurobehavioral development. Exposure to endocrine disruptors, air pollution, second hand smoke, and mother’s lifestyle during pregnancy affects children’s growth and development. We also identified specific window periods of exposure of pollutants significantly related to children’s health outcomes. Conclusion: The collective results from MOCEH study provide strong scientific evidence that exposures to prenatal and postnatal environmental pollutants have a negative effect on growth and development of children, which will be useful in implementing effective national policy to improve children’s environmental health. Keywords: Birth cohort, Children Environmental health, Environmental pollutants

Objectives To investigate the association between particulate matter with an aerodynamic diameter of less than 2.5 μm (PM2.5 ) exposure during each trimester of pregnancy and development of lower respiratory tract infections (LRTIs) during the first 3 years of life and whether GSTM1 gene polymorphisms modify these effects. Methods This study included 1,180 mother-child pairs from the Cohort for Childhood Origin of Asthma and allergic diseases. The PM2.5 levels during pregnancy were estimated by residential address using land-use regression models based on a national monitoring system. A diagnosis of LRTIs was based on a parental report of a physician's diagnosis. Real-time polymerase chain reaction was used for GSTM1 genotyping. Results Higher PM2.5 exposure during the third trimester was associated with LRTIs at 1 year of age (aRR, 1.06; 95% CI, 1.00-1.13). This result did not change after adjusting for PM2.5 exposures during the first and second trimesters (aRR, 1.06; 95% CI, 0.99-1.13). This association was significant after adjusting for PM2.5 exposures during first year of age (aRR, 1.08; 95% CI, 1.02-1.15) and exposures to NO2 and ozone at the third trimester (aRR, 1.07; 95% CI, 1.00-1.16). In addition, PM2.5 exposure during the third trimester increased the risk of LRTIs at 1 year of age in cases with the GSTM1 null genotype (aRR, 1.26; 95% CI, 1.01-1.57; P for interaction .20). Conclusion Higher PM2.5 exposure during the third trimester of pregnancy may increase the susceptibility to LRTIs at 1 year of age. This effect is modified by GSTM1 gene polymorphisms.

Background Tobacco smoking affects the incidence of various illnesses such as lung cancer, respiratory diseases, and cardiovascular diseases. In an effort to prevent smoking-related cancers, we aimed to estimate the smoking prevalence, intensity, and number of workers exposed to smoking, which would be specific to the occupational and industrial circumstances in Korea. Methods We used the Korean Working Condition Survey (KWCS) and Korea's Census data. Smoking prevalence and intensity were estimated using the KWCS data. The number of smokers was estimated by multiplying smoking prevalence with the number of workers in the occupation or industry. Smoking prevalence, intensity, and number of smokers were estimated for major, sub-major, and minor groups of occupation and industry. Results Of the total labor force in 2010, 52.66% of men and 5.24% of women workers were estimated to be current smokers. Men workers smoked 15.42 cigarettes/day, and women workers 11.29 cigarettes/day. In terms of occupation, “craft and related trades workers” demonstrated the highest smoking prevalence (52.24%). “Managers” smoked the highest number of cigarettes (16.63 cigarettes/day) and “equipment, machine operating, and assembling workers” comprised the largest number of estimated smokers (1,368,726 workers). In terms of industry, “mining and quarrying” had the highest smoking prevalence (69.27%). Those in “construction” smoked the highest number of cigarettes (17.16 cigarettes/day) and those in “manufacturing” comprised the largest number of estimated smokers (1,629,893 workers). Conclusion Our results may help in setting priorities for smoking prevention-related activities. In addition, these results can be used for epidemiological studies controlling for the effect of smoking by occupation or industry., Graphical Abstract

Purpose Exposure to particulate matter (PM) is a key public health issue, but effective intervention has not yet been established. A systematic literature review and meta-analysis has been conducted to assess the relationship between the use of air filters, one of the most commonly studied interventions, and respiratory outcomes in patients with chronic respiratory diseases. Methods We systematically reviewed intervention studies on PM using PubMed, EMBASE, and Cochrane databases up to September 2019. Studies that included data on PM concentration changes and respiratory symptoms or lung function in patients with respiratory diseases were eligible for inclusion. Effect estimates were quantified separately using the random-effects model. Results Six studies were included in the quantitative analysis. Air filter use reduced indoor PM2.5 by 11.45 µg/m3 (95% confidence interval [CI], 6.88, 16.01 µg/m3). Air filter use was not associated with improvements in respiratory symptoms in 5 of the 6 studies or significant changes in the predicted forced expiratory volume in one second (FEV1) (mean change, -1.77%; 95% CI, -8.25%, 4.71%). Air filter use was associated with improved peak expiratory flow rate by 5.86 (95% CI, 3.5, 8.19 of standardized difference). Conclusions The findings of this systematic review suggest that air filters may reduce indoor PM and increase peak expiratory rate in asthmatic patients. However, most studies showed no significant effects of air filters on respiratory symptoms or FEV1. Further studies in regions with high-density PM may provide additional information on this issue. Trial registration PROSPERO Identifier: CRD42020156258.

Background The effects of prenatal particulate matter with an aerodynamic diameter ranging from 0.1 μm to 2.5 μm (PM2.5) and vitamin D on atopic dermatitis (AD) phenotypes have not been evaluated. DNA methylation and cord blood (CB) vitamin D could represent a plausible link between prenatal PM2.5 exposure and AD in an offspring. Objective To determine the critical windows of prenatal PM2.5 exposure on the AD phenotypes, if vitamin D modulated these effects, and if placental DNA methylation mediated these effects on AD in offspring. Methods Mother–child pairs were enrolled from the birth cohort of the Cohort for Childhood Origin of Asthma and allergic diseases (COCOA) study. PM2.5 was estimated by land-use regression models, and CB vitamin D was measured by chemiluminescence immunoassay. AD was identified by the parental report of a physician’s diagnosis. We defined the following 4 AD phenotypes according to onset age (by the age of 2 years) and persistence (by the age of 3 years): early-onset transient and persistent, late onset, and never. Logistic regression analysis and Bayesian distributed lag interaction model were used. DNA methylation microarray was analyzed using an Infinium Human Methylation EPIC BeadChip (Illumina, San Diego, California) in placenta. Results PM2.5 exposure during the first trimester of pregnancy, especially during 6 to 7 weeks of gestation, was associated with early-onset persistent AD. This effect increased in children with low CB vitamin D, especially in those with PM2.5 exposure during 3 to 7 weeks of gestation. AHRR (cg16371648), DPP10 (cg19211931), and HLADRB1 (cg10632894) were hypomethylated in children with AD with high PM2.5 and low CB vitamin D. Conclusion Higher PM2.5 during the first trimester of pregnancy and low CB vitamin D affected early-onset persistent AD, and the most sensitive window was 6 to 7 weeks of gestation. Placental DNA methylation mediated this effect.

Concerns over adverse effects of air pollution on children's health have been rapidly rising. However, the effects of air pollution on childhood growth remain to be poorly studied. We investigated the association between prenatal and postnatal exposure to PM10 and children's weight from birth to 60 months of age. This birth cohort study evaluated 1129 mother-child pairs in South Korea. Children's weight was measured at birth and at six, 12, 24, 36, and 60 months. The average levels of children's exposure to particulate matter up to 10 μm in diameter (PM10) were estimated during pregnancy and during the period between each visit until 60 months of age. Exposure to PM10 during pregnancy lowered children's weight at 12 months. PM10 exposure from seven to 12 months negatively affected weight at 12, 36, and 60 months. Repeated measures of PM10 and weight from 12 to 60 months revealed a negative association between postnatal exposure to PM10 and children's weight. Children continuously exposed to a high level of PM10 (>50 μg/m3) from pregnancy to 24 months of age had weight z-scores of 60 that were 0.44 times lower than in children constantly exposed to a lower level of PM10 (≤50 μg/m3) for the same period. Furthermore, growth was more vulnerable to PM10 exposure in children with birth weight 3.3 kg. Air pollution may delay growth in early childhood and exposure to air pollution may be more harmful to children when their birth weight is low. Keywords: Air pollution, Particulate matter, Children growth, Weight

ObjectivePolycyclic aromatic hydrocarbons (PAH) are common dietary exposures that cross the human placenta and are classified as a probable human carcinogen. The aim of the present study was to investigate the potential impact of exposure to PAH-containing meat consumed during pregnancy on birth outcomes.DesignProspective birth cohort study. Only non-smoking women with singleton pregnancies, who were free from chronic disease such as diabetes and hypertension, were included in the study. Maternal consumption of PAH-rich meat was estimated through FFQ. Multiple linear regression was used to assess factors related to higher intake and the association between dietary PAH and birth outcomes.SettingRepublic of Korea, 2006–2011.SubjectsPregnant women (n 778) at 12–28 weeks of gestation enrolled in the Mothers and Children’s Environmental Health (MOCEH) study.ResultsThe multivariable regression model showed a significant reduction in birth weight associated with higher consumption level of foods rich in PAH, such as grilled or roasted meat, during pregnancy (β=−17·48 g, PP=0·561). Regression models performed for birth length and head circumference produced negative effects that were not statistically significant.ConclusionsConsumption of higher levels of barbecued, fried, roasted and smoked meats during pregnancy was associated with reduced birth weight. Dietary risk of PAH exposure in Korean women is of concern.

Childhood undernutrition remains a highly influential risk factor in terms of the global burden of disease. Increasing evidence links infant and young child feeding (IYCF) practices to undernutrition. However, the results are inconsistent, and more country-specific studies are needed.To determine the associations between IYCF practices and nutritional outcomes among children aged 0-23 months using a nationally representative dataset.The study used data from the 2011 Nepal Demographic and Health Survey, and the data were analysed for children aged 0-23.9 months who had corresponding data for the outcome variables of interest (n = 890). Multiple linear and logistic regressions were undertaken and adjusted for the complex design of the survey, controlling for child, maternal, household and community characteristics.Of the 890 children included in the study, 83% received age-appropriate breastfeeding but only 48% were breastfed within 1 hour of birth. Exclusive breastfeeding under 6 months of age was associated with a higher weight-for-age Z-score (WAZ) and a lower probability of wasting, but the estimated effects were of borderline significance. A significant negative association was found between continued breastfeeding at 1 year and WAZ and weight-for-height Z-score (WHZ). Timely introduction of complementary feeding in children aged 6-8 months was associated with a higher WAZ [effect size (ES) 0.6, P 0.01] and higher WHZ (ES 0.6, P 0.05). Higher dietary diversity index (DDI) was associated with higher height-for-age Z-score (ES 0.1, P 0.05 for each DDI point). Children who achieved minimum meal frequency had a higher WAZ (ES 0.3, P 0.05).This is the first study to relate the wide ranges of IYCF indicators with child nutritional outcomes in Nepal, and it underscores the need to improve age-appropriate complementary feeding practices with a sustained focus on exclusive breastfeeding to reduce undernutrition in infants and young children.

This study was conducted to examine how each psychosocial factor on working conditions is related to a worker's well-being. Data from the 2011 Korean Working Conditions Survey were analyzed for 33,569 employed workers aged ≥15 years. Well-being was evaluated through the WHO-5 questionnaire and variables about occupational psychosocial factors were classified into eight categories. The prevalence ratios were estimated using Poisson regression model. Overall, 44.3% of men and 57.4% of women were in a low well-being group. In a univariate analysis, most of the psychosocial factors on working conditions are significantly related with a worker's low well-being, except for insufficient job autonomy in both genders and job insecurity for males only. After adjusting for sociodemographic and structural factors on working conditions, job dissatisfaction, lack of reward, lack of social support, violence and discrimination at work still showed a statistically significant association with a worker's low well-being for both genders. We found that psychosocial working conditions were associated with the workers' well-being.

IntroductionPatients with chronic obstructive pulmonary disease (COPD) are vulnerable to particulate matter (PM) exposure which can increase acute exacerbations and hospitalisation. Interventions to avoid PM exposure are important but evidence-based guidance is lacking. This study aims to assess the impact of PM on lung function, quality of life and exacerbations in patients with COPD using a panel design study; it will also provide evidence for interventional measures to reduce harm from PM exposure.Methods and analysisA prospective panel study of patients with COPD aged ≥40 years will be conducted. Patients will be required to have a forced expiratory volume in one second Ethics and disseminationThis study was approved by the Institutional Review Board of each site. The participants received comprehensive information and provided informed consent. The result of this study will be discussed in the form of conference presentations and peer-reviewed publications.Trial registration numberNCT04020237.

Humidifier disinfectant damages caused by the misuse of humidifier disinfects, such as polyhexamethylene guanidine (PHMG), resulted in chemical disasters in South Korea in 2011. About four million people were exposed to humidifier disinfectants (HDs) in the 17 years between 1994 and 2011. Although fatal lung damage was initially reported, investigations into the victims’ injuries revealed that the damage was not limited to the lungs, but that systemic damage was also confirmed. Considering the spread of HD from the lungs to the whole body, the toxic effects of PHMG from reactive oxygen species (ROS), NOTCH signaling pathways, and mitochondrial dysfunction resulted in endothelial damage in the lungs, blood vessels, liver, kidneys, bone marrow, nerves, and muscles. The main toxic mechanisms involved in HD damage may be the NOTCH pathway and mitochondrial damage. There are many case reports which include neurologic disorders (ADHD, depression, posttraumatic stress disorder), muscular disorder (exercise intolerance, myalgia), energy metabolism disorder (chronic fatigue syndrome), and immunologic disorder (rheumatoid arthritis) in HDs victims. These case reports involve multi-system involvement in HDs victims. Further well-designed study is needed to clarify whether mitochondrial dysfunction is associated with multi-organs involvement in HDs victims.

The Korean CHildren's ENvironmental health Study (Ko-CHENS) is a nationwide prospective birth cohort showing the correlation between the environmental exposures and the health effects to prevent the environmental diseases in children, and it provides the guidelines for the environmental hazardous factors, applying the life-course approach to the environmental-health management system. The Ko-CHENS consists of 5000 Core and 65,000 Main Cohorts. The children in the Core Cohort are followed up at 6 months, every year before their admission into the elementary school, and every 3 years from the first year after this admission. The children in the Cohort will be followed up through the data links (Statistics Korea, National Health Insurance Service [NHIS], and Ministry of Education). The individual biospecimens will be analyzed for 19 substances. The long-term-storage biological samples will be used for the further substance analysis. The Ko-CHENS will investigate whether the environmental variables including the perinatal outdoor and indoor factors and the greenness contribute causally to the health outcomes in the children and adolescents. In addition to the individual surveys, the assessments of the outdoor exposures and health outcomes will use the national air-quality monitoring data and claim data of the NHIS, respectively. The two big-data forms of the Ko-CHENS are as follows: The Ko-CHENS data that can be linked with the nationally registered NHIS health-related database, including the medical utilization and the periodic health screening, and the birth/mortality database in the Statistics; the other is the Big-CHENS dataset that is based on the NHIS mother delivery code, for which the follow-up of almost 97% of the total birth population is expected. The Ko-CHENS is a very cost-effective study that fully exploits the existing national big-data systems with the data linkage.

Background Occupational injuries increase burden on society as well as personal health. Low satisfaction with life may not only increases the risk of occupational injuries directly, but also influences other factors that increase the risk of occupational injury. Along with previous studies on the risk of occupational injury, we sought to explore the relationship between satisfaction with life and occupational injury. Methods The study participants were 6234workers health screened at a university hospital in Incheon. Information on occupational injury and satisfaction with life scale (SWLS) was obtained in a self-report format. Participants were allocated to one of four SWLS groups; the dissatisfied group, the slightly dissatisfied group, the slightly satisfied group, and the satisfied group. The analysis was performed using the chi-square test primarily and by logistic regression adjusted for potential confounders. Results In men, the un-adjusted and adjusted odds ratios (ORs) of low satisfaction with life (SWLS

Introduction According to 2011 annual report of national cancer registration program, age-standardised incidence of non-hodgkin lymphoma, leukaemia, multiple myeloma, Hodgkin lymphoma is 6.8, 5.0, 1.4, 0.5 per 1,00,000. Although incidence rate is low, social attention is increasing due to the fatality. While there has been many foreign studies on association between occupational risk factor and lymphatic, haematopoietic cancer, a study reflecting the domestic situation is insufficient. So we conducted case-control study using data from occupational cancer monitoring system to assess risk factor. Methods Cases were 384 leukaemia, 523 non-hodgkin lymphoma, 218 multiple myeloma patients reported from occupational cancer monitoring system from 2011 to 2014. Controls were selected randomly matched on age, sex, residence. All participants were interviewed for lifestyle habits, exposure or occupational history of group1, group2A carcinogen. Analysis was performed using chi-square test primarily, and logistic regression to adjust for smoking status. Results Analysing by chi-square test, excess risks were shown for exposure to benzene, formaldehyde, TCE, PAH in leukaemia, to benzene, formaldehyde, TCE in non-hodgkin lymphoma, to benzene, formaldehyde in multiple myeloma. Analysing by logistic regression to adjust for age, sex, smoking status, excess risk were shown for exposure to benzene, formaldehyde, pesticide in non-hodgkin lymphoma, to benzene in multiple myeloma. Other exposures were associated with lymphatic or haematopoietic cancer, but were not significant. Conclusion Increased risk of lymphatic or haematopoietic cancer were associated with some occupations and chemicals. But other exposures showed no statistically significant association due to insufficient number of samples. There is a need for sufficient number of samples to obtain additional association between exposure and cancer risk.

Objectives CAREX (CARcinogen EXposure) is a carcinogen surveillance system employed in many countries. To initiate Korean CAREX, we focused on estimating the exposure intensity of lead across industries, which is a suspected carcinogen. Methods We extracted airborne lead measurements from the work environment measurement database (WEMD) which is the Korean nationwide measurement database. In addition, we elicited the experts’ opinion about lead exposure intensity across industries by conducting a questionnaire. Experts provided estimates of lead exposure levels as the boundary of the 5th and 95th percentiles. We assumed that experts provided their estimates based on the assumption of log-normal distributions of exposure. First, for each industry, estimates of log-transformed geometric means (logGM) and log-transformed geometric standard deviations (logGSD) were extracted from the experts’ responses, followed by combining them to quantify the experts’ prior Normal-Inverse-Gamma prior distribution. Then, the corresponding logGM and logGSD from lead measurement data for each industry were updated with the experts’ prior distribution through a Bayesian framework, yielding posterior distributions of logGM and logGSD. Results WEMD contains 83 035 airborne lead measurements collected between 2002–2007. Total 17 occupational hygiene professionals with more than 20 year experience provided lead exposure estimates. In industries where measurement data is abundant, the measurement data dominate the posterior exposure estimates, while in industries with a limited number of measurements, experts’ opinion played an important role in determining posterior exposure estimates. For example, rubber manufacturing industry with 246 measurements (GM 1.72; GSD 1.94) and 6 experts’ responses (GM 0.79; GSD 6.73) showed posterior exposure estimates of GM 1.60 and GSD 2.34. Conclusions Our method of estimating the exposure intensity of CAREX may introduce an unbiased approach to the development process by utilising both prior knowledge of experts and measurement data simultaneously. In addition, it will supply a framework for future updates.

Objectives Estimation of exposure prevalences of carcinogens is important for preventing occupational cancers. For developing Korean CAREX (CARcinogen EXposure) which is a carcinogen surveillance system employed in many countries, as an exemplary carcinogen, we estimated lead exposure prevalences in Korean working population. Methods We used three nationwide data sources to retrieve objective default estimates of lead exposure prevalence across industries: the work-environment monitoring database (WEMD), the special health examination database (SHED), and the Work Environment Condition Survey (WECS). Furthermore, we surveyed experts for their judgment about lead exposure prevalence across industries after reviewing the default estimates computed from aforementioned three exposure databases. We developed various estimation methods combining experts’ judgment, and then compared with each other. The 2010 Census was used as the reference population to estimate the number of lead-exposed workers for the 228 industries through multiplying the exposure prevalence with the number of workers in each industry. Results Default estimates of exposure prevalence for 228 industries were calculated using the WEMD and SHED collected between 2009–2011, and the 2009 WECS. A total of 52 experts who have 20 or more experience in industrial hygiene practice participated in the study and provided their judgment on the lead exposure prevalences as a number for the 228 industries. Among various estimation methods, the median values of experts’ responses were selected for our estimates of lead exposure prevalence in each industry. As a result, a total of 129,247 Korean workers was estimated to be exposed to lead in the year of 2010. Conclusions We developed a method estimating exposure prevalences combining experts’ judgment based on objective databases. Our effort for estimating the exposure prevalences of CAREX may introduce an unbiased approach to the development process accounting for uncertainty of exposure.

This study was undertaken to investigate the associations between chronic exposure to particulate matter of medium aerodynamic diameter ≤10 or ≤2.5 µm (PM10 or PM2.5) and nitrogen dioxide (NO2) levels and lung function and to examine a possible change in these relationships by demographic and lifestyle factors. Chronic obstructive pulmonary disease (COPD) was defined using the Global Initiative for COPD criteria (forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) of

This study examined the role of exposure to traffic-related air pollution (TRAP) on susceptibility to asthma in children with past episodes of bronchiolitis.The baseline data included 2,627 school children aged 6-14 years who had participated in the longitudinal follow-up survey of the Children's Health and Environmental Research of Korea. Lifetime wheezing, past episodes of bronchiolitis, and doctor-diagnosed asthma were evaluated using an International Study of Asthma and Allergies in Childhood questionnaire. We used generalized linear regression with binomial distribution to calculate the relative risk (RR) between TRAP, assessed by proximity to a main road and the total length of roads, and asthma.Compared with the subjects who had less than 100 m of road length within 200-m radius from their home, those with more than 500 m of road length had significantly increased odds for infantile bronchiolitis (adjusted OR [aOR]: 1.57, 95% confidence interval [CI]: 1.01-2.42). Positive exposure-response relationships were found between residential proximity to the main road and asthma (aOR: 1.79, 95% CI: 1.05-3.06;75 m vs.700 m from a main road, P for the trend = 0.02). Closer residential proximity to the main road (75 m) and bronchiolitis combined increased the risks of newly diagnosed asthma (adjusted RR: 3.62, 95% CI: 1.07-12.26) compared with those without bronchiolitis and living ≥ 75 m away from the main road.TRAP appeared to be associated with an increased asthma among children with bronchiolitis, indicating the importance of modifying effects of bronchiolitis in asthma pathogenesis.

Depression is a leading cause of reduced work ability and absence due to sickness. The objective of this study was to investigate how depressive symptoms are prospectively associated with subsequent absence, whether caused by illness or accidents, among manufacturing workers. This prospective study was conducted on 2,349 male and female employees that underwent a regular health examination at a university hospital. Depressive symptoms were measured at baseline using the Center for Epidemiologic Studies Depression (CES-D) Scale. Data on self-reported absence due to illness and accidents were obtained during a follow up of 1 yr. The incidences of sickness absence were 6.0% for men and 17.3% for women. Men and women with depressive symptoms (CES-D ≥16) were found to have higher odds of sickness absence during follow up (men: OR=4.06; 95% CI: 2.32-7.11; women: OR=1.75; 95% CI: 1.02-2.98), after adjustment for demographic and occupational factors. When depressive symptoms were divided into quartiles, significantly higher ORs of sickness absence were observed only among employees with the highest quartile of depressive symptoms. The study shows that depressive symptoms are a risk factor for future absence due to illness or accidents among manufacturing workers.

Purpose This study evaluated the relationship of living near to main roads to allergic diseases, airway hyperresponsiveness (AHR), allergic sensitization, and lung function in Korean children. Methods A total of 5,443 children aged 6-14 years from 33 elementary schools in 10 cities during 2005-2006 were included in a baseline survey of the Children's Health and Environmental Research. We assessed association of traffic-related air pollution (TAP) exposure with the distance to the nearest main road, total road length of main roads and the proportion of the main road area within the 200-m home area. Results Positive exposure-response relationships were found between the length of the main road within the 200-m home area and lifetime wheeze (adjusted prevalence ratio [PR] for comparison of the longest to the shortest length categories=1.24; 95% CIs, 1.04-1.47; P for trend=0.022) and diagnosed asthma (PR=1.42; 95% CIs, 1.08-1.86; P for trend=0.011). Living less than 75 m from the main road was significantly associated with lifetime allergic rhinitis (AR), past-year AR symptoms, diagnosed AR, and treated AR. The distance to the main road (P for trend=0.001), the length of the main road (P for trend=0.041), and the proportion of the main road area (P for trend=0.006) had an exposure-response relationship with allergic sensitization. A strong inverse association was observed between residential proximity to the main load and lung function, especially FEV1, FEV1/FVC, and FEF₂₅₋₇₅. The length of the main road and the proportion of the main road area were associated with reduced FEV1 in schoolchildren. Conclusions The results of this study suggest that exposure to traffic-related air pollution may be associated with increased risk of asthma, AR, and allergic sensitization, and with reduced lung function in schoolchildren.

Introduction: Although acute exposure to ambient air pollution is a possible risk factor for pneumonia, little is known about the effect of prolonged exposure. Aims and Objectives: This study aims to investigate whether prolonged exposure to air pollutants is associated with pneumonia. Methods: We calculated the incidence rates of pneumonia using a nationwide sample cohort which comprised one million random subjects from the Korean National Health Insurance Sharing Service. Daily levels of nitrogen oxide (NO2), sulfur dioxide (SO2), particulate matter (PM10), ozone (O3) and carbon monoxide (CO) were obtained from the Korean Ministry of Environment, and matched in each of the sixteen administrative district regions of Korea. We employed a Poisson regression analysis for regional results, and a meta-analysis with random effect model for showing the overall associations. We examined the lag effect up to 10 weeks preceding the occurrence of pneumonia. Results: We detected 76,508 cases of pneumonia from 2011 to 2013. Annual incidence rates of pneumonia were 2.44 to 2.62 person per one million. NO2 and SO2 concentrations had a significant association with incidence of pneumonia at time lag 0 (10.13±2.34, p Conclusions: Exposure to NO2 and SO2 was associated with an increased incidence of pneumonia in Korea. Moreover, the effect of air pollution exposure lasted up to 5 weeks for NO2 and 10 weeks for SO2.

Exposure to harmful environmental factors is particularly detrimental to younger children. We investigated the relationship between environmental tobacco smoke (ETS) exposure in pre-schoolers at home and the level of high-sensitivity C-reactive protein (hs-CRP), a predictive factor for cardiovascular disease. This study was conducted in 2014 and was based on the data of preschool children from the Korean Environmental Health Survey in Children and Adolescents (2012 to 2014), a nationally representative sample. Of 577 children, aged three to five years, 482 were eventually selected for the analysis after excluding those with missing variables, or whose hs-CRP level exceeded the reference value. The proportion of pre-school children exposed to ETS at home was 14.8%. The odd ratios (OR)s of hs-CRP > 1mg/L were 4.90 (95% Confidence Interval (CI) = 1.04–23.17) and 11.66 (95% CI = 1.90–71.65) in the groups exposed to ETS 3–4 times and ≥5 times daily, respectively, compared to the non-exposed group. The risk of elevated levels of hs-CRP showed an increasing trend proportionally to the increase in ETS exposure frequency (p for trend = 0.03). Anti-smoking educational programs for parents and guardians may be helpful to reduce ETS exposure at home.

Few studies have examined the effects of air pollution on fetal growth based on ultrasound measures during pregnancy. More data is needed to evaluate the windows of special vulnerability. Our aim was to investigate the association of ambient air pollution during pregnancy with fetal and neonatal characteristics in a cohort of Korean women. Maternal exposure to particulate matter with an aerodynamic diameter

Maternal lead exposure is associated with poor birth outcomes. However, modifying effects of polymorphism in glutathione S-transferases (GST) gene and infant sex remain unexplored. Our aim was to evaluate whether associations between prenatal lead and birth outcomes differed by maternal GST genes and infant sex. Prospective data of 782 mother-child pairs from Mothers and Children's Environmental Health (MOCEH) study were used. The genotyping of GST-mu 1 (GSTM1) and theta-1 (GSTT1) polymorphisms was carried out using polymerase chain reaction. Multivariable linear regression was used to examine whether the association between blood lead (BPb) level and birth outcomes (birthweight, length, and head circumference) varied by maternal GST genes and sex. We did not find a statistically significant association between prenatal BPb levels and birth outcomes; in stratified analyses, the association between higher BPb level during early pregnancy and lower birthweight (β=-224 per square root increase in BPb; 95% confidence interval (CI): -426, -21; false discovery rate p=0.036) was significant in males of mothers with GSTM1 null. Results were similar for head circumference model (β=-0.78 per square root increase in BPb; 95% CI: -1.69, 0.14, p=0.095), but the level of significance was borderline. Head circumference model showed a significant three-way interaction among BPb during early pregnancy, GSTM1, and sex (p=0.046). For combined analysis with GSTM1 and GSTT1, GSTM1 null and GSTT1 present group showed a significant inverse association of BPb with birthweight and head circumference in males. Our findings of the most evident effects of BPb on the reduced birthweight and head circumference in male born to the mother with GSTM1 null may suggest a biological interaction among lead, GST genes and sex in detoxification process during fetal development.

Purpose To investigate the association between long-term exposure to ambient air pollution and lung cancer incidence in Koreans. Materials and methods This was a population-based case-control study covering 908 lung cancer patients and 908 controls selected from a random sample of people within each Korean province and matched according to age, sex, and smoking status. We developed land-use regression models to estimate annual residential exposure to particulate matter (PM₁₀) and nitrogen dioxide (NO₂) over a 20-year exposure period. Logistic regression was used to estimate odds ratios (ORs) and their corresponding 95% confidence intervals (CI). Results Increases in lung cancer incidence (expressed as adjusted OR) were 1.09 (95% CI: 0.96-1.23) with a ten-unit increase in PM₁₀ (μg/m³) and 1.10 (95% CI: 1.00-1.22) with a ten-unit increase in NO₂ (ppb). Tendencies for stronger associations between air pollution and lung cancer incidence were noted among never smokers, among those with low fruit consumption, and among those with a higher education level. Air pollution was more strongly associated with squamous cell and small cell carcinomas than with adenocarcinoma of the lung. Conclusion This study provides evidence that PM10 and NO₂ contribute to lung cancer incidence in Korea.

Although there has been suggestive evidence of the association between TRAP and ADs, findings remained inconsistent possibly due to limited population. We investigated the association between TRAP and ADs in a large population of children with rich spatial coverage and expanded age span in Seoul, Korea. TRAP exposures were estimated by categorized proximity to the nearest major road (≤150, 150–300, 300–500, and >500 m) and density of major roads within 300 meters from children’s residences. We estimated the association between two TRAP exposures and three ADs using generalized mixed model after adjusting for individual characteristics. We also investigated whether the association varied by household and regional socioeconomic status. We found associations of atopic eczema with road density [OR = 1.08; 95% CI = 1.01–1.15] and road proximity [1.15, 1.01–1.32; 1.17, 1.03–1.34; and 1.16, 1.01–1.34 for ≤150, 150–300, and 300–500 m, resp., compared to >500 m]. There was no association with asthma and allergic rhinitis. Effect estimates were generally the highest in the low socioeconomic region. Children living in areas surrounded by large and busy roads were likely to be at greater risks for atopic eczema, with increased vulnerability when living in deprived areas.

For the first nationwide representative survey on the environmental health of children and adolescents in Korea, we designed the Korean Environmental Health Survey in Children and Adolescents (KorEHS-C) as a two-phase survey and planned a sampling strategy that would represent the whole population of Korean children and adolescents, based on the school unit for the 6-19 years age group and the household unit for the 5 years or less age group. A pilot study for 351 children and adolescents aged 6 to 19 years in elementary, middle, and high school of two cities was performed to validate several measurement methods and tools, as well as to test their feasibility, and to elaborate the protocols used throughout the survey process. Selected exposure biomarkers, i.e., lead, mercury, cadmium in blood, and bisphenol A, metabolites of diethylhexyl phthalate and di-n-butyl phthalate and cotinine in urine were analyzed. We found that the levels of blood mercury (Median: 1.7 ug/L) and cadmium (Median: 0.30 ug/L) were much higher than those of subjects in Germany and the US, while metabolites of phthalates and bisphenol A showed similar levels and tendencies by age; the highest levels of phthalate metabolites and bisphenol A occurred in the youngest group of children. Specific investigations to elucidate the exposure pathways of major environmental exposure need to be conducted, and the KorEHS-C should cover as many potential environmental hazards as possible.

Objectives CARcinogen EXposure (CAREX) is a carcinogen-surveillance system employed in many countries. To develop Korean CAREX, the intensity of exposure to lead, as an example, was estimated across industries. Methods Airborne-lead measurement records were extracted from the work-environment measurement database (WEMD), which is a nationwide workplace-monitoring database. Lead measurements were log-transformed; then, the log-transformed geometric means (LGMs) and log-transformed geometric standard deviations (LGSDs) were calculated for each industry. However, the data of many industries was limited. To address this shortcoming, experts' judgments of the lead exposure levels across industries were elicited. Experts provided their estimates of lead exposure levels as the boundary of the 5th and 95th percentiles, and it is assumed that these estimates are based on the log-normal distributions of exposure levels. Estimates of LGM and LGSD were extracted from each expert's response and then combined to quantify the experts' prior distribution. Then, the experts' prior distributions for each industry were updated with the corresponding LGMs and LGSDs calculated from the WEMD data through a Bayesian framework, yielding posterior distributions of the LGM and LGSD. Results The WEMD contains 83035 airborne-lead measurements that were collected between 2002 and 2007. A total of 17 occupational-hygiene professionals with >20 years of experience provided lead exposure estimates. In industries where measurement data were abundant, the measurement data dominated the posterior exposure estimates. For example, for one industry, 'Manufacture of Accumulator, Primary Cells, and Primary Batteries,' 1152 lead measurements [with a geometric mean (GM) of 14.42 µg m-3 and a geometric standard deviation (GSD) of 3.31] were available and 15 experts' responses (with a GM of 7.06 µg m-3 and a GSD of 4.15) were collected, resulting in a posterior exposure estimate of 14.41µg m-3 as the GM with a GSD of 3.31. For industries with a limited number of measurements available in the WEMD, experts' decisions played a significant role in determining the posterior exposure estimates. For example, for the 'Manufacture of Weapons and Ammunition' industry, 15 lead measurements (with a GM of 6.45 µg m-3 and a GSD of 3.37) were available and seven experts' responses (with a GM of 3.28 µg m-3 and a GSD of 4.54) were obtained, resulting in a posterior exposure estimate of 5.42 µg m-3 as the GM with a GSD of 3.73. Conclusions The proposed method for estimating the intensity of exposure to carcinogens may introduce an unbiased approach to the development process by simultaneously utilizing both prior knowledge of experts and measurement data. In addition, it supplies a framework for future updates.

ObjectivesPolycyclic aromatic hydrocarbons are a well-known carcinogen causing lung and skin cancers in exposed workers. Several occupations such as coke production have been reported to be associated with high PAHs exposure. However, previous reports have been confined in several occupations. Thus, we aimed to evaluate PAHs exposure across a wide range of occupations using its urinary metabolite 1-hydroxypyrene (1-OHP).MethodsTo evaluate PAHs exposure across occupations, we collected the urine 1-OHP data from the Korean National Environmental Health Survey which is a nationwide bio-monitoring survey. The data contained information about urine 1-OHP levels, cigarette smoking status, and standard occupational codes. We calculated summary statistics of urine 1-OHP levels for each occupation. In addition, we calculated the relative exposure indicators which are the proportions of exceeding the quartile levels. Since cigarette smoking is a single most influential factor of PAHs exposure, we repeated the analyses by excluding current smokers.ResultsOverall geometric means (GM) of all populations and non-smoker populations were 0.13µg/L and 0.10µg/L, respectively. For the major group of occupation, ‘Craft and Related Trades Workers’ and ‘Equipment, Machine Operating and Assembling Workers’ showed the highest urine 1-OHP levels, while ‘Homemaker’ showed the lowest level. For the sub-major group of occupation, ‘Video and Telecommunications Equipment Related Occupations’ showed the highest percentage (61%) of exceeding the third quartile (Q3) level of all populations. While ‘Legal and Administration Professional Occupations’ showed the lowest percentage of exceeding the Q3 level of all populations. For the minor group of occupation, ‘Horticultural and Landscape Workers’ showed the highest percentage (64%) of exceeding the Q3 level of all populations. While ‘Kindergarten teachers’ showed the lowest percentage of exceeding the Q3 level of all populations.ConclusionsOur results will provide ancillary information about PAHs exposure across occupations, especially in occupations where PAHs exposure has not well known.

Background Night shift work has well-known adverse effects on health. However, few studies have investigated the relationship between thyroid diseases and night shift work. This study aimed to examine night shift workers and their changes in thyroid stimulating hormones (TSH) levels over time. Methods Medical check-up data (2011–2015) were obtained from 967 female workers at a university hospital in Incheon, Korea. Data regarding TSH levels were extracted from the records, and 2015 was used as a reference point to determine night shift work status. The relationships between TSH levels and night shift work in each year were analyzed using the general linear model (GLM). The generalized estimating equation (GEE) was used to evaluate the repeated measurements over the 5-year period. Results The GEE analysis revealed that from 2011 to 2015, night shift workers had TSH levels that were 0.303 mIU/L higher than the levels of non-night shift workers (95 % CI: 0.087–0.519 mIU/L, p = 0.006) after adjusting for age and department. When we used TSH levels of 4.5 ≥ mIU/L to identify subclinical hypothyroidism, night shift workers exhibited a 1.399 fold higher risk of subclinical hypothyroidism (95 % CI: 1.050–1.863, p = 0.022), compared to their non-night shift counterparts. Conclusions This result of this study suggests that night shift workers may have an increased risk of thyroid diseases, compared to non-night shift workers.

Background Worldwide, exposure to second-hand smoke (SHS) has been responsible for more than 0.6 million deaths and 10.9 million disability-adjusted life years (DALYS) lost in never smokers in 2004. The world health organization (WHO) reported smoking-related death of 58,000 per year in South Korea. There is recent emerging evidence of the associations of SHS exposure with anxiety or depression and poor mental health. Although exposure to second-hand smoke (SHS) has been associated with various physical health conditions and mental health, we are unaware of any studies examining its association with psychological well-being as mental factor. This study aimed to investigate the association between self-reported exposure to SHS and well-being among non-smoking wageworkers. Methods The Third Korean Working Conditions Survey (KWCS, 2011) was conducted on a representative sample of economically active population aged 15 years or over, who were either employees or self-employed at the time of interview. In this study, after removing inconsistent data, 19,879 non-smoking wageworkers among 60,054 workers were participated. Psychological well-being was measured through the WHO-Five Well-Being Index (1998 version). Univariate and multiple logistic regression models were used to examine the association of SHS exposure with psychological well-being. Results The unadjusted OR of poor psychological well-being (OR: 1.594, 95 % CI: 1.421-1.787) was significantly higher for SHS exposure group compared to non-exposure group. Multiple logistic regression analysis results indicated that these relationships were still significant after adjusting for potential confounders (adjusted OR: 1.330, 95 % CI: 1.178-1.502). Conclusions Exposure to SHS was associated with poor well-being measured by the WHO-5 well-being index, indicating the importance of reducing SHS exposure at the workplace for psychological well-being amongst non-smoking wageworkers.

Introduction : The aim of this study was to assess the effect of toxic chemicals and cancer risks of residents living near small factories in non-urban. Methods : We used data from national cancer ...

Objectives : The objectives of the study were to perform a population based case-control study with lung cancer and renal cell cancer in Korea Methods : Case control study involving 421 lung cancer...

Introduction: According to the latest cancer registry data, in Korea the mortality rates of lung cancer ranked first among cancers. There is accumulating evidence that air pollution causes lung can...

Background Birth defects are a leading cause of neonatal and infant mortality, and several studies have indicated an increase in the prevalence of birth defects; more recent investigations have suggested that the trends of some defects are increasing in rapidly industrialized areas. This study estimates the prevalence rate and types of birth defects in Korea. Methods This study used medical insurance benefit data of 403,250 infants aged less than one year from the National Health Insurance Corporation from seven metropolitan areas in Korea for 2009 and 2010. Results The prevalence rate of birth defects was 548.3 per 10,000 births (95 % CI: 541.1–555.6), 306.8 among boys and 241.5 among girls. Anomalies of the circulatory system (particularly septal defects) were the most common (180.8 per 10,000), followed by defects of the genitourinary tract (130.1 per 10,000) (particularly obstructive genitourinary and undescended testis), musculoskeletal system (105.7 per 10,000), digestive system (24.7 per 10,000), and central nervous system (15.6 per 10,000). Conclusions Relatively higher rates of some birth defects were found in the metropolitan areas. The high differences of birth prevalences for septal heart defects and undescended testis are probably due in part to progress in clinical management and more frequent prenatal diagnosis. Environmental exposure might play a critical role in the development of some birth defects. In attempting to describe the prevalence and spatio-temporal variations of birth defects in Korea, establishment of a registry system of birth defects and environmental surveillance are needed.

BackgroundThis study examined levels of blood lead and mercury, and urinary cadmium, and associated sociodemographic factors in 3–18 year-old Korean children and adolescents.Materials and methodsWe used the nationally representative Korean Environmental Health Survey in Children and Adolescents data for 2012–2014 and identified 2388 children and adolescents aged 3–18 years. The median and 95th percentile exposure biomarker levels with 95% confidence intervals (CIs) were calculated. Multivariate regression analyses were performed on log transformed exposure biomarker levels adjusted for age, sex, area, household income, and father’s education level. The median exposure biomarker levels were compared with data from Germany, the US, and Canada, as well as the levels of Korean children measured at different times.ResultsThe median levels of blood lead and mercury, as well as urinary cadmium were 1.23μg/dL, 1.80μg/L, and 0.40μg/L (95% CIs, 1.21–1.25, 1.77–1.83, and 0.39–0.41, respectively). The blood lead levels were significantly higher in boys and younger children (p

Lead, which is widely used in industry, is a common element found in low concentrations in the Earth’s crust. Implementations to reduce environmental lead concentrations have resulted in a considerable reduction of lead levels in the environment (air) and a sustained reduction in the blood lead levels of the average citizen. However, people are still being exposed to lead through a variety of routes in everyday commodities. Lead causes health problems such as toxicity of the liver, kidneys, hematopoietic system, and nervous system. Having a carcinogenic risk as well, the IARC classifies inorganic lead compounds as probably carcinogenic to humans (Group 2A). Occupational lead poisonings have decreased due to the efforts to reduce the lead concentrations in the working environment. In contrast, health hazards associated with long-term environmental exposure to low concentrations of lead have been reported steadily. In particular, chronic exposure to low concentrations of lead has been reported to induce cognitive behavioral disturbances in children. It is almost impossible to remove lead completely from the human body, and it is not easy to treat health hazards due to lead exposure. Therefore, reduction and prevention of lead exposure are very important. We reviewed the toxicity and health hazards, monitoring and evaluation, and management of lead exposure.