• 한국환경보건학회지
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• 제49권5호
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• pp.262-274
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• 2023

Background: Exposure levels for heavy metals such as lead (Pb), mercury (Hg), and cadmium (Cd) have increased due to human activities. They are known to be a public health concern. Objectives: This study aimed to determine the exposure levels to heavy metals in the blood and urine of South Korean adults and to present the contribution rate of exposure pathways using an exposure algorithm for men aged 19~64, women aged 19~64, and all seniors aged 65 or older. Methods: We analyzed data from the Korean National Environmental Health Survey (KoNEHS) Cycle 4 (2018~2020). A total of 2,646 participants aged ≥19 years were included. Multiple regression analysis was performed to determine the factors affecting heavy metal concentrations. The contribution rate was calculated by applying three exposure algorithms for ingestion, inhalation, and dermal exposure. Results: Factors that commonly affect heavy metal concentrations in blood and urine were gender and age. The main influencing factors for Pb and Cd were education level and smoking status, while frequency of fish consumption and of alcohol consumption were indicated to be the main influencing factors for mercury. The contribution rates of lead and cadmium from food ingestion were 78.03~79.62% and 88.39~92.89%, respectively. Additionally, the highest contribution for mercury was accounted for by food at 81.69~85.77%. As a result of the risk assessment, cadmium was found to pose a potential health risk a with total cancer risk (TCR) of more than 1×10^-6. Conclusions: The KoNEHS could be an important study for determining the level of exposure to heavy metals and their influencing factors. Integrated exposure to heavy metals could assess the main exposure pathways, and this methodology could be applied to exposure management of heavy metals.

• Annals of Occupational and Environmental Medicine
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• 제35권
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• pp.2.1-2.15
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• 2023

Background: Phthalates are endocrine disrupting chemicals that are widely used in the production of items of daily life such as in polyvinylchloride plastics, insecticides, and medical devices. This study aimed to determine the association between phthalate exposure and shellfish consumption using data from the Korean National Environmental Health Survey (KoNEHS) cycle 3 (2015-2017), which is a nationally representative survey. Methods: In this study, we analyzed the KoNEHS cycle 3 data of 3,333 (1,526 men and 1,807 women) adults aged more than 19 years. Data related to the variables of sociodemographic factors, health-related behaviors, dietary factors, seafood consumption frequency, and urinary phthalate metabolites concentrations were collected. The concentrations of urinary phthalate metabolites of all the participants were divided into quartiles to define high and low concentration groups based on the 75th percentile concentration. A χ² test was conducted to analyze the distribution of independent variables. To analyze the relationship between shellfish consumption and phthalate exposure, the odds ratios (ORs) were calculated using logistic regression analysis. Results: Total adults with shellfish consumption frequency of over once a week showed the following adjusted ORs for high concentrations of the following metabolites compared with the group that consumed shellfish once a week or less: 1.43 (95% confidence interval [CI]: 1.01-2.06) for mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), 1.43 (95% CI: 1.01-2.03) for mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP), 1.57 (95% CI: 1.10-2.24) for ∑di-2-ethylhexyl phthalate (∑DEHP), 2.01 (95% CI: 1.46-2.77) for mono-carboxyoctyl phthalate (MCOP), 1.56 (95% CI: 1.11-2.18) for mono-carboxy-isononly phthalate (MCNP), and 2.57 (95% CI: 1.85-3.56) for mono (3-carboxypropyl) phthalate (MCPP). Conclusions: The concentrations of urinary phthalate metabolites (MEOHP, MECPP, ∑DEHP, MCOP, MCNP, and MCPP) were higher in adults with a higher frequency of shellfish consumption.

• 한국환경보건학회지
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• 제44권6호
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• pp.572-580
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• 2018

Objectives: Human biomonitoring (HBM) is a measurement of the chemicals and their metabolites in human biological samples and has been successfully employed to determine the exposure levels of environmental chemicals. In this study, we analyzed seasonal variations of the blood or urinary levels of chemicals, and assessed that these differences could affect the results of association study. Methods: The Korea National Environmental Health Survey (KoNEHS) is a nationwide survey that analyzes exposure levels of environmental pollutants, 19 kinds of chemicals including heavy metals and organic chemicals, and the exposure factors in the general population. Based on KoNEHS data, we analyzed the levels of chemicals concentrations over the total survey period (2012-2014) and each season, and assessed the association of thyroid measures with phthalate metabolite and BPA. Results: Exposure levels of blood mercury and lead were lower in summer compare to winter. Bisphenol A and PAHs metabolites were higher in spring and summer, but lower in autumn. VOCs metabolites were generally lower in summer and autumn. Phthalate metabolites were higher in all other seasons than in winter. Pyrethroid metabolite, 3-PBA, was higher in summer and autumn. Regarding seasonal variation of chemical exposures, the statistical significance and size of effects between thyroid measures and phthalate and BPA were changed with season. Conclusion: Seasonal variations of chemical exposure and health outcome should be considered for interpreting biomonitoring results from a public health context.

• 한국환경보건학회지
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• 제47권3호
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• pp.227-244
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• 2021

Objectives: The Korean National Environmental Health Survey provides representative biomonitoring data for environmental pollutants in South Korea. Over the last decade, there have been various studies published using this data. In this study, we aimed to provide information and implications by reviewing each study. Methods: We searched comprehensive electronic databases from PubMed, Google Scholar, and Naver Academic database using the key words 'Korean National Environmental Health Survey' and 'KoNEHS' through March 2021. A total of 57 studies were selected after reviewing the relevance of the data. Results: The most frequently studied pollutants were heavy metals (10), Cotinine (8), Bisphenol A (7), and Phthalates (6), in that order. In particular, Phthalates, Bisphenol A, and Parabens were often studied together (6). A decline in urinary cotinine and heavy metals in the body was shown over time among studies on exposure association. It was demonstrated that Phthalates and Bisphenol A were significantly related to obesity and diabetes from the studies of health impacts. Cross-section study design, spot urine, and insufficient health status information were mostly reported as limitations of the data. Conclusion: Since research has been focused on adults, further investigations of children and adolescents are required. In this regard, it is necessary to maintain the consistency of the data structure and provide integrated weights for all ages. In addition, it would allow the measurement of several environmental pollutants by considering subsample design. Lastly, integrated studies with multi-cycles and the health effects from co-exposure to multiple chemicals would be expected to provide important knowledge.

• 응용통계연구
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• 제36권4호
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• pp.337-347
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• 2023

표본설계는 개체 혹은 집락을 층으로 나눈후 층별로 독립적으로 표본추출하는 층화추출을 종종 채택한다. 층화 전략은 크게 층구분과 표본할당으로 구성되는데 이는 조사연구에서 반복적으로 고려되는 중요한 주제이다. 조사연구에서는 층화다단추출 방식의 복합표본설계를 채택하고 있지만 층효과 혹은 층효율성과 관련하여서 표본론 교재들에서 주로 단순추출에 대해서 다루어지고 있다. 본 연구는 이단추출에 대한 기존 층효율성 측도를 살펴보며 설계효과모형을 적용한 추가적인 층효율성 측도들을 제안하였다. 제안된 측도들을 활용하여 제4기 국민환경기초조사의 고등학교 대상 표본설계의 층화전략에 대해 평가하였다.

• 한국환경보건학회지
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• 제40권6호
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• pp.492-501
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• 2014

Objectives: The purpose of this study was to assess the validity of self-reported cigarette smoking status and investigate factors associated with the accuracy self-reported and measured urinary cotinine in Korean adults. Methods: We used data from the $1^{st}$ Korean National Environmental Health Survey (2009-2011) among adults aged ${\geq}19$ years (N=6,246). The survey examined self-reported smoking status, and urinary cotinine was regarded as the biomarker of exposure to tobacco smoke. Urinary cotinine was analyzed using a gas chromatography-mass spectrometry (GC/MS) and data analysis was conducted using IBM SPSS version 20.0, which uses the sample weight and calculates variance estimates to adjust for the unequal probability of selection into the survey. Results: We calculated a cut-off point (53.3 ug/L) by using a ROC (Receiver Operating Characteristic) curve. The smoking prevalence was 24.6% based on self-reported data and 28.2% based on urinary cotinine concentrations. When we assessed the agreement between self-reported and urinary cotinine, we found an average agreement of 97.7% among self-reported smokers and 94.5% among self-reported non-smokers. Among self-reported smokers, factors affected the discrepancy were age, household economic status and average number of cigarettes smoked per day. On the other hand, gender, former smoking experience, and exposure to SHS (second hand smoke) were associated with discrepancies among self-reported non-smokers. Conclusion: These results suggest that self-reported data on smoking status provide a valid estimate of actual smoking status. In future research, we will conduct a continuous monitoring study for reliability verification of the data to reduce potential interpretation errors.

• 한국환경보건학회지
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• 제48권6호
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• pp.315-323
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• 2022

Background: Socioeconomical disadvantaged communities are more vulnerable to environmental chemical exposure and associated health effects. However, there is limited information on chemical exposure among vulnerable populations in Korea. Objectives: This study investigated chemical exposure among underprivileged populations. We measured urinary metabolites of phthalates in urban disadvantaged communities and investigated their correlations with residential environment factors and relative socioeconomic vulnerability. Methods: Urine samples were collected from 64 residents in a disadvantaged community in Seoul. A total of eight phthalate metabolites were analyzed by liquid chromatography-mass spectroscopy. Analytical method used by the Korean National Environmental Health Survey (KoNEHS) was employed. Covariate variance analysis and general linear regression adjusted with age, sex and smoking were performed. Results: Several phthalate metabolites, namely monomethyl phthalate (MMP), monoethyl phthalate (MEP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), and mono-n-butyl phthalate (MnBP) had higher levels than those reported in the adults of 4th KoNEHS. Notably, the MnBP level was higher in the lower socioeconomic group (geometric mean [GM]=47.3 ㎍/g creatinine) compared to non-recipients (GM=31.9 ㎍/g creatinine) and the national reference level (GM=22.0, 28.2 and 32.2 ㎍/g creatinine for adults, 60's and 70's, respectively.). When age, sex and smoking were adjusted, MEP and MnBP were significantly increased the lower socioeconomic group than non-recipients (p=0.014, p=0.023). The lower socioeconomic group's age of flooring were higher than non-recipients, not statistically significant. Conclusions: These results suggest that a relatively low income and aged flooring could be considered as risk factors for increased levels of phthalate metabolites in socioeconomic vulnerable populations.

• 한국환경보건학회지
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• 제49권6호
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• pp.344-352
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• 2023

Background: With its developed port and related industries, the concentration of fine dust is high in Busan compared to other cities in South Korea. Many studies have reported the health effects of fine dust, but there has been a lack of information regarding concentrations of volatile organic compounds among those who exposed to high levels of fine dust. Objectives: This study aimed to define an area with high concentrations of particulate matter and perform biomonitoring surveys among the residents of the area. Methods: Air quality data was collected and the mean level of each district in Busan was derived. We then defined the area with the highest concentrations of PM₁₀ as a target site. Urine samples were collected from the 400 participants and analyzed for VOCs metabolites - trans,trans-Muconic Acid (t,t-MA) and N-AcetylS-(benzyl)-L-cysteine (BMA). Interviews were conducted by trained investigators to examine demographic information. The levels of t,t-MA and BMA were compared with representative South Korean population data (Korean National Environmental Health Survey). The association of the VOC metabolites and fine dust were analyzed by general linear regression analysis. Results: The mean of PM₁₀ in the target site was 42.50 ㎍/m³ from 2018 to 2020. Among the 400 participants in the target site, 74.8% were female and the average age of the participants was 66 years. The geometric mean of t,t-MA was 71.15 ㎍/g creatinine and the BMA was 7.00 ㎍/g creatinine among the residents. The levels were higher than the geometric mean from the 4th KoNEHS. The levels of t,t-MA showed significance in BMI, smoking status, and household income. BMA showed significance in gender and age. Conclusions: Compared to the general population of South Korea, the target site's residents had higher biomonitoring levels. Based on this study, continuous screening for high risk areas, including the target site, and biomonitoring of the residents are required.

• 한국환경보건학회지
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• 제47권3호
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• pp.205-226
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• 2021

Objectives: Biomonitoring programs have been widely implemented in the field of environmental health, both in Korea and worldwide. Recently, it has been suggested that the storage, management, and utilization of biosamples collected from biomonitoring programs should be organized based on a biobank system. Therefore, we attempted to review the current status of representative biomonitoring programs and biobank systems that have been implemented in Korea and in other countries. Methods: We searched for bio-samples collected in domestic and foreign biomonitoring programs and their applications. For this, we referred to research papers, homepages hosted by biomonitoring programs, and project reports. We also checked information for biobanks related with biomonitoring programs, including the operating systems, facilities, technologies, and regulations of biobanks. Results: We summarized six domestic and 32 foreign biomonitoring programs. These biomonitoring programs collected bio-samples to determine the relationship between environmental chemicals and diseases. Domestically, bio-samples from KoNEHS, KorSEP, MOCEH, KoCHENS, and KorEHS-C were stored at -80℃ in a deep freezer at the National Institute of Environmental Research, while KNHANES samples were stored at Korea Biobank, which has a stabilized biobanking system with a well-established database. Nine foreign biomonitoring programs (JECS, China-NHBP, CKB, CHMS, NHANES, GerES, Germaan ESB, MoBa, and UK Biobank) were ongoing for large populations. Among them, CKB, GermanESB, and UK biobank have been maintained for at least 10 years with their own biomonitoring programs as well as advanced systems for the safe storage of bio-samples. Conclusion: Currently on-going biobanks have devoted considerable efforts to managing bio-samples for public purposes. The preceding domestic and foreign biomonitoring programs and biobanks will be great references for constructing biobank facilities and systems for environmental public health in Korea in the future.

• 한국환경보건학회지
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• 제46권2호
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• pp.214-223
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• 2020

Objectives: The aim of this study is to identify temporal trends in urinary cotinine levels and exposure factors among Non-smokers in Korean adults. Methods: Biological samples and questionnaire data were collected from representative Korean adults recruited in the Korean National Environmental Health Survey from 2009 to 2017. Multiple regression analysis was performed to determine the factors affecting urinary cotinine concentrations of non-smokers. Results: The urinary cotinine levels of Korean non-smokers decreased in Cycle 2 (1.04 ㎍/L, 2012-2014) compared to Cycle 1 (1.93 ㎍/L, 2009-2011) but increased slightly in Cycle 3 (1.37 ㎍/L, 2015-2017). Among the diverse variables, the main factors of cotinine exposure were secondhand smoke exposure and the presence of smokers in the family. Conclusions: The results of this study identified temporal trends in cotinine exposure among non-smokers in the Korean adult population. These findings will be used to develop further assessment and environmental health policies on secondhand smoke exposure.