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Review of Epidemiological Research and Perspectives for Future Environmental Health Progress in Korea

한국 환경보건 발전에 대한 역학 연구의 기여 및 전망

  • Lee, Kyoung-Mu (Department of Environmental Health, Korea National Open University) ;
  • Park, Moon-Young (Department of Environmental Health, School of Public Health, Seoul National University)
  • 이경무 (한국방송통신대학교 보건환경학과) ;
  • 박문영 (서울대학교 보건대학원 환경보건학과)
  • Received : 2022.04.19
  • Accepted : 2022.06.13
  • Published : 2022.06.30

Abstract

Background: Epidemiology is a fundamental study of public health, including environmental health, since the features and causes of diseases discovered through epidemiology provide crucial information for developing successful disease prevention strategies. Objectives: This paper tried to define the role and function of epidemiologic research in the field of environmental health, summarize examples of epidemiological studies with regard to selected environmental health events in South Korea, and address important issues that should be considered when conducting epidemiological research in the future. Methods: Epidemiological studies of selected environmental health events were reviewed and summarized in terms of their contribution to environmental health in South Korea. Based on the information, important issues were suggested for future epidemiological studies in environmental health. Results: The role and function of epidemiologic research in the field of environmental health includes the systematic description of the health effects caused by environmental exposure, verification of the causal relationship between environmental exposure and health effects, and provision of background data for conducting prevention strategies and developing policies. A number of epidemiological studies have contributed to characterizing and assessing the environmental risks involved in a series of environmental health events in South Korea. Conclusions: Important issues for future epidemiological studies may include health effects from chronic low-level environmental exposure, application of analytical epidemiology to elucidate causal relationships, use of exposure/disease/susceptibility biomarkers, accurate reconstruction of past exposure status, cohort recruitment and long-term follow-up, and in-advance surveillance of diseases with environmental causes.

Keywords

References

  1. National Environmental Health Association. Definitions of Environmental Health. Available: https://www.neha.org/about-neha/definitions-environmental-health [accessed 1 April 2022].
  2. Lee KM, Ko KP, Kim SK. Environmental Epidemiology. Seoul: Korea National Open University Press; 2014.
  3. Rebbeck TR, Ambrosone CB, Shields PG. Molecular Epidemiology: Applications in Cancer and Other Human Diseases. New York: Informa Healthcare; 2008.
  4. Ministry of Environment. Environmental Health Act. Available: https://www.law.go.kr/%EB%B2%95%EB%A0%B9/%ED%99%98%EA%B2%BD%EB%B3%B4%EA%B1%B4%EB%B2%95 [accessed 21 June 2022].
  5. Korean Society of Environmental Health. Environmental Health. Seoul: Korea National Open University Press; 2016.
  6. Han SW. Environmental problems and response of the 21st century. J Environ Impact Assess. 1997; 6(2): 17-28.
  7. Han SJ, Jeong WG, Ku DW. Ulsan's Environmental Issues and Environmental Movements. Ulsan: Ulsan Research Institute; 2008.
  8. Harada M, Hotta N, Han M. Environmental pollution at Onsan industrial complex (Korea). Res Environ Disrupt. 1987; 16(4): 51-59.
  9. Korea Christian Institute for the Study of Justice and Development. Save Only Our Children! Seoul: Minjungsa; 1987.
  10. Environment and Pollution Research Society. Onsan Disease and Mass Migration of Onsan Residents, Then. Available: https://ecoi.tistory.com/entry/%E3%80%8C%EC%98%A8%EC%82%B0%EB%B3%91%EA%B3%BC-%EC%98%A8%EC%82%B0%EC%A3%BC%EB%AF%BC%EC%9D%98-%EC%A7%91%EB%8B%A8%EC%9D%B4%EC%A3%BC-%EA%B7%B8-%EB%8B%A4%EC%9D%8C%EC%97%90%E2%80%A6%E3%80%8D [accessed 21 June 2022].
  11. Korea Institute of Chemical Technology. Environmental Impact Assessment study on the Yeocheon Industrial Complex. Available: https://ecoarchive.org/items/show/35653 [accessed 21 June 2022].
  12. Graduate School of Public Health, Seoul National University. Epidemiologic Study on Health Effects from Environmental Pollution in Yeocheon Industrial Area. Available: https://ecoarchive.org/items/show/12001 [accessed 21 June 2022].
  13. Koo JR. 1996 Environmental News Closing. Environ Eng. 1997; 125: 14-17.
  14. Kim DH, Lee SK, Chun BY, Lee DH, Hong SC, Jang BK. Illness associated with contamination of drinking water supplies with phenol. Korean J Prev Med. 1993; 26(2): 202-209.
  15. Park JH, Lee JY. Epidemiologic study for the association between phenol contaminated drinking water and poor pregnancy outcomes in Taegu city. Korean J Epidemiol. 2000; 22(1): 20-31.
  16. Ahn JJ. Lessons learned from major environmental health disasters in South Korea and the role of environmental health experts. J Environ Health Sci. 2022; 48(1): 9-18. https://doi.org/10.5668/JEHS.2022.48.1.9
  17. Lim HS, Cheong HK, Kim JY, Cheong HK, Kim JR, Hong YC, et al. An epidemiologic study on the health hazards of inhabitants chronically exposed to glass fiber. Korean J Epidemiol. 1995; 17(1): 76-93.
  18. Cho SH, Ju YS, Kim KR, Lee KK, Hong KS, Eun HC, et al. Health assessment for glass fibre landfill at Gozan-dong, Inchon. Korean J Prev Med. 1997; 30(1): 77-101.
  19. Park HC. Interview/Residents of Gojan-dong Who Won a Law-suit for Damages Against Waste Glass Fiber - Min Myeon-sik. Available: http://ecoview.or.kr/%EC%82%AC%EB%9E%8C/9909-%EC%9D%B8%ED%84%B0%EB%B7%B0-%ED%8F%90%EC%9C%A0%EB%A6%AC%EC%84%AC%EC%9C%A0-%ED%94%BC%ED%95%B4-%EC%86%90%EB%B0%B0%EC%-86%8C%EC%86%A1-%EC%8A%B9%EB%A6%AC%ED%95%9C-%EA%B3%A0%EC%9E%94%EB%8F%99-%EC%A3%BC%EB%AF%BC%EB%93%A4-%EB%AF%BC%EB%A9%B4%EC%8B%9D [accessed 21 June 2022].
  20. Ministry of Patriots and Veterans Affairs. 5th Defoliant Damage Epidemiologic Investigation. Available: https://www.mpva.go.kr/mpva/downloadBbsFile.do?atchmnflNo=70815 [accessed 21 June 2022].
  21. Lee KM, Chun JB, Park DU, Lee WJ. Methods to minimize or adjust for healthy worker effect in occupational epidemiology. J Environ Health Sci. 2011; 37(5): 342-347. https://doi.org/10.5668/JEHS.2011.37.5.342
  22. Paik HK. Agent orange: long-term policy options in the Republic of Korea. Health Soc Welf Rev. 2000; 20(1): 142-177.
  23. Kwon HJ. Lessons of Goseong abandoned metal mine accident. J Environ Health Sci. 2011; 37(5): 335-341. https://doi.org/10.5668/JEHS.2011.37.5.335
  24. Kim S, Kwon HJ, Cheong HK, Choi K, Jang JY, Jeong WC, et al. Investigation on health effects of an abandoned metal mine. J Korean Med Sci. 2008; 23(3): 452-458. https://doi.org/10.3346/jkms.2008.23.3.452
  25. National Institute of Environmental Research. Environmental Health Effects Survey on Residents Living Near the Cement Factory in Yeongwol County. Available: https://www.incheon.go.kr/ecopia/EC050201/1662376 [accessed 21 June 2022].
  26. Lee CH, Kang YA, Chang KJ, Kim CH, Hur JI, Kim JY, et al. Acute health effects of the Hebei oil spill on the residents of Taean, Korea. J Prev Med Public Health. 2010; 43(2): 166-173. https://doi.org/10.3961/jpmph.2010.43.2.166
  27. Chung KY, Lee SH. Survey and analysis of impact of Hebei Spirit oil pollution incident on surrounding environment. J Digit Converg. 2012; 10(6): 205-211. https://doi.org/10.14400/JDPM.2012.10.6.205
  28. Kim KH, Kwon SJ. Psychological impacts of the Hebei Sprit oil spill event on Taean residents. ECO. 2008; 12(1): 83-107.
  29. Korea Disease Control and Prevention Agency. Hospital based case-control study on lunginjury with unknown causes. Public Health Wkly Rep. 2011; 4(45): 825-829.
  30. Korea Disease Control and Prevention Agency. Order for Withdrawal of Six Humidifier Disinfectant Products from the Market Issued. Available: https://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=708&CONT_SEQ=260456 [accessed 21 June 2022].
  31. Cheon CK, Jin HS, Kang EK, Kim HB, Kim BJ, Yu JH, et al. Epidemic acute interstitial pneumonia in children occurred during the early 2006s. Korean J Pediatr. 2008; 51(4): 383-390. https://doi.org/10.3345/kjp.2008.51.4.383
  32. Korean Society of Environmental Health. Case Studies on Victims of Humidifier Disinfectants. Available: https://ecoarchive.org/items/show/13761 [accessed 21 June 2022].
  33. Park DU, Choi YY, Ahn JJ, Lim HK, Kim SK, Roh HS, et al. Relationship between exposure to household humidifier disinfectants and risk of lung injury: a family-based study. PLoS One. 2015; 10(5): e0124610. https://doi.org/10.1371/journal.pone.0124610
  34. Yang HJ, Kim HJ, Yu J, Lee E, Jung YH, Kim HY, et al. Inhalation toxicity of humidifier disinfectants as a risk factor of children's interstitial lung disease in Korea: a case-control study. PLoS One. 2013; 8(6): e64430. https://doi.org/10.1371/journal.pone.0064430
  35. Park JH, Kim HJ, Kwon GY, Gwack J, Park YJ, Youn SK, et al. Humidifier disinfectants are a cause of lung injury among adults in South Korea: a community-based case-control study. PLoS One. 2016; 11(3): e0151849. https://doi.org/10.1371/journal.pone.0151849
  36. Paek D, Koh Y, Park DU, Cheong HK, Do KH, Lim CM, et al. Nationwide study of humidifier disinfectant lung injury in South Korea, 1994-2011. Incidence and dose-response relationships. Ann Am Thorac Soc. 2015; 12(12): 1813-1821. https://doi.org/10.1513/AnnalsATS.201504-221OC
  37. Lee ES, Cheong HK, Paek DM, Kim SH, Leem JH, Kim PG, et al. Characteristics of exposure to humidifier disinfectants and their association with the presence of a person who experienced adverse health effects in general households in Korea. J Environ Health Sci. 2020; 46(3): 285-296. https://doi.org/10.5668/JEHS.2020.46.3.285
  38. Yoon J, Lee SY, Lee SH, Kim EM, Jung S, Cho HJ, et al. Exposure to humidifier disinfectants increases the risk for asthma in Children. Am J Respir Crit Care Med. 2018; 198(12): 1583-1586. https://doi.org/10.1164/rccm.201805-0840le
  39. Lamichhane DK, Leem JH, Lee SM, Yang HJ, Kim J, Lee JH, et al. Family-based case-control study of exposure to household humidifier disinfectants and risk of idiopathic interstitial pneumonia. PLoS One. 2019; 14(9): e0221322. https://doi.org/10.1371/journal.pone.0221322
  40. Ministry of Environment. A Report on the Epidemiologic Correlation between Exposure to Humidifier Disinfectant and Disease (Interstitial Lung Disease, Asthma, Pneumonia). Available: https://www.healthrelief.or.kr/home/board/law/view.do [accessed 21 June 2022].
  41. Cho JH. Influence of the use of humidifier disinfectant on children's academic achievement. J Environ Health Sci. 2021; 47(4): 310-319. https://doi.org/10.5668/JEHS.2021.47.4.310
  42. Park DU, Kim JW, Ryu SH, Park JH, Kwon JH, Lee SY, et al. Review of health effects caused by chloromethylisothiazolinone (CMIT) and methylisothiazolinone (MIT) -focusing on humidifier disinfectant-associated lung injury (HDLI). J Environ Health Sci. 2020; 46(3): 312-323. https://doi.org/10.5668/JEHS.2020.46.3.312
  43. Chung KC. Epidemiological study of air pollution and its affects on health of urban population. Korean J Prev Med. 1969; 2(1): 5-22.
  44. Kwon HJ, Cho SH, Kim SM, Ha MN, Han SH. Cross-sectional study on respiratory symptoms due to air pollution using a questionnaire. Korean J Prev Med. 1994; 27(2): 313-325.
  45. Hong YC, Leem JH, Ha EH, Christiani DC. PM(10) exposure, gaseous pollutants, and daily mortality in Inchon, South Korea. Environ Health Perspect. 1999; 107(11): 873-878. https://doi.org/10.2307/3454474
  46. Lee JT, Shin D, Chung Y. Air pollution and daily mortality in Seoul and Ulsan, Korea. Environ Health Perspect. 1999; 107(2): 149-154. https://doi.org/10.1289/ehp.99107149
  47. Lee MY, Lee CW, Suh SK. Effect of air pollution on daily mortality in Daegu (1993-1997). Korean J Occup Environ Med. 2000; 12(2): 235-248. https://doi.org/10.35371/kjoem.2000.12.2.235
  48. Hwang SS, Lee JH, Jung GW, Lim JH, Kwon HJ. Spatial analysis of air pollution and lung cancer incidence and mortality in 7 metropolitan cities in Korea. J Prev Med Public Health. 2007; 40(3): 233-238. https://doi.org/10.3961/jpmph.2007.40.3.233
  49. Im HJ, Lee SY, Yun KJ, Ju YS, Kang DH, Cho SH. A case-crossover study between air pollution and hospital emergency room visits by asthma attack. Korean J Occup Environ Med. 2000; 12(2): 249-257. https://doi.org/10.35371/kjoem.2000.12.2.249
  50. Choi H, Lim DH, Kim JH, Son BK, Lim JW. Study on the interrelationship of air pollution and respiratory diseases in Inchon city via children who visited the emergency room of Inha University Hospital. J Korean Pediatr Soc. 2000; 43(10): 1372-1379.
  51. Kim SH, Son JY, Lee JT, Kim TB, Park HW, Lee JH, et al. Effect of air pollution on acute exacerbation of adult asthma in Seoul, Korea: a case-crossover study. Korean J Med. 2010; 78(4): 450-456.
  52. Oh JS, Park SH, Kwak MK, Pyo CH, Park KH, Kim HB, et al. Ambient particulate matter and emergency department visit for chronic obstructive pulmonary disease. J Korean Soc Emerg Med. 2017; 28(1): 32-39.
  53. Han C, Kim S, Lim YH, Bae HJ, Hong YC. Spatial and temporal trends of number of deaths attributable to ambient PM2.5 in the Korea. J Korean Med Sci. 2018; 33(30): e193. https://doi.org/10.3346/jkms.2018.33.e193
  54. Kang D, Jang Y, Choi H, Hwang SS, Koo Y, Choi J. Space-time relationship between short-term exposure to fine and coarse particles and mortality in a nationwide analysis of Korea: a Bayesian hierarchical spatio-temporal model. Int J Environ Res Public Health. 2019; 16(12): 2111. https://doi.org/10.3390/ijerph16122111
  55. Korea Radioisotope Association. Residents and workers in the nuclear power plant area, there are no health problems. Radioisot J. 1996; 11(2): 43-46.
  56. Ministry of Education and Science Technology. Epidemiological Investigation on Cancer Risk among Radiation Workers in Nuclear Power Plants and Residents nearby Nuclear Power Plants in Korea. Available: https://scienceon.kisti.re.kr/srch/selectPORSrchReport.do?cn=TRKO201300013259 [accessed 21 June 2022].
  57. Kim JM, Kim MH, Ju YS, Hwang SS, Ha M, Kim BK, et al. Reanalysis of epidemiological investigation of cancer risk among people residing near nuclear power plants in South Korea. Int J Environ Res Public Health. 2018; 15(3): 481. https://doi.org/10.3390/ijerph15030481
  58. Lee WJ. Can screening effects explain increased risk of thyroid cancer among population living near nuclear power plants in Korea? Environ Health Toxicol. 2015; 30: e2015013. https://doi.org/10.5620/eht.e2015013
  59. Lee BI, Jeong JW. Policy measures for Korean society's conflicts arising in areas of nuclear power plant - focused on cases of conflicts around Wolsong nuclear power plant area. Korean J Confl Manag Stud. 2014; 1(2): 7-32.
  60. Ministry of Environment. Held the Final Presentation of the Resident Health Impact Survey in Changjeom Village. Available: https://me.go.kr/home/web/board/read.do?pagerOffset=0&maxPageItems=10&maxIndexPages=10&searchKey=&searchValue=&menuId=286&orgCd=&boardMasterId=1&boardCategoryId=39&boardId=1094540&decorator [accessed 21 June 2022].
  61. Glymour MM, Bibbins-Domingo K. The future of observational epidemiology: improving data and design to align with population health. Am J Epidemiol. 2019; 188(5): 836-839. https://doi.org/10.1093/aje/kwz030
  62. Kim OJ. The long-term exposure to particulate matter air pollution (PM10) and mortality [dissertation]. [Seoul]: Seoul National University; 2018.
  63. Haines A, Ebi K. The imperative for climate action to protect health. N Engl J Med. 2019; 380(3): 263-273. https://doi.org/10.1056/NEJMra1807873
  64. Gubler DJ, Reiter P, Ebi KL, Yap W, Nasci R, Patz JA. Climate variability and change in the United States: potential impacts on vector- and rodent-borne diseases. Environ Health Perspect. 2001; 109(Suppl 2): 223-233.