• Journal of Environmental Health Sciences
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• v.40 no.1
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• pp.1-9
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• 2014

Objectives: The purpose of this review is to suggest future directions for the Korean Environmental Health Survey (KoNEHS) in terms of an environmental health monitoring system and recent environmental health issues in Korea. Methods: The national scale biomonitoring program and environmental health researches which conducted by Ministry of Environment was reviewed for this study. The scope, contents and utilization of results of KoNEHS as a biomonitoring program and other basic function for environmental health monitoring was analyzed. Results: Biomonitoring survey was conducted for basic functions, such as evaluating exposure levels of environmental chemicals and analyzing exposure factors. In order to expand the basic purposes of KoNEHS, the biomonitoring function should be strengthened by enlarging the range of chemicals analyzed and including all age groups in the biomonitoring and health status monitoring functions by using official health-care and mortality data. Exposure factors such as time-activity patterns and micro-environmental pollution levels were studied. The data from the environmental health study were established into a standardized database system for supporting environmental health policy. A definition and concept of environmental health services should be established. Conclusion: To achieve the aims of environmental health, changes in environmental health status and related factors must be observed and predicted reflecting real conditions. In this regard, improving the methodology and system through diverse approaches is necessary for KoNEHS.

• Annals of Occupational and Environmental Medicine
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• v.35
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• pp.5.1-5.14
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• 2023

Background: Perfluoroalkyl substances (PFAS) are chemicals widely used in various products in everyday life. Due to its unique strong binding force, the half-life of PFAS is very long, so bioaccumulation and toxicity to the human body are long-standing concerns. In particular, effects on kidney function have recently emerged and there are no studies on the effect of PFAS on kidney function through epidemiological investigations in Korea. From 2018 to 2020, the Korean National Environmental Health Survey (KoNEHS) cycle 4, conducted an epidemiological investigation on the blood concentration of PFAS for the first time in Korea. Based on this data, the relationship between PFAS blood concentration and kidney function was analyzed for adolescents. Methods: We investigated 5 types of PFAS and their total blood concentration in 811 middle and high school students, living in Korea and included in KoNEHS cycle 4, and tried to find changes in kidney function in relation to PFAS concentration. After dividing the concentration of each of the 5 PFAS and the total concentration into quartiles, multivariable linear regression was performed to assess the correlation with kidney function. The bedside Schwartz equation was used as an indicator of kidney function. Results: As a result of multivariable linear regression, when observing a change in kidney function according to the increase in the concentration of each of the 5 PFAS and their total, a significant decrease in kidney function was confirmed in some or all quartiles. Conclusions: In this cross-sectional study of Korean adolescents based on KoNEHS data, a negative correlation between serum PFAS concentration and kidney function was found. A well-designed longitudinal study and continuous follow-up are necessary.

• Journal of Environmental Health Sciences
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• v.48 no.2
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• pp.96-105
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• 2022

Background: Pyrethroid insecticides account for more than 30% of the global insecticide market and are frequently used in agricultural settings and residential and public pest control among the general population. While several animal studies have suggested that exposure to pyrethroids can alter glucose homeostasis, there is only limited evidence of the association between environmental pyrethroid exposure and diabetes in humans. Objectives: This study aimed to report environmental 3-phenoxybenzoic acid (3-PBA) concentrations in urine and evaluate its association with the risk of diabetes in Korean adults. Methods: We analyzed data from the Korean National Environmental Health Survey (KoNEHS) Cycle 2 (2012~2014) and Cycle 3 (2015~2017). A total of 10,123 participants aged ≥19 years were included. Multiple logistic regressions were used to calculate the odds ratios (ORs) for diabetes according to log-transformed urinary 3-PBA levels. We also evaluated age, sex, education, monthly income, marital status, alcohol drinking, physical activity, urinary cotinine, body mass index, and sampling season as potential effect modifiers of these associations. Results: After adjusting for all the covariates, we found significant dose-response relationships between urinary 3-PBA as quartile and the prevalence of diabetes in pooled data of KoNEHS Cycles 2 and 3. In subgroup analyses, the adverse effects of pyrethroid exposure on diabetes were significantly stronger among those aged 19~39 years (p-interaction<0.001) and those who consumed high levels of cotinine (p-interaction=0.020). Conclusions: Our findings highlight the potential diabetes risk of environmental exposure to pyrethroids and should be confirmed in large prospective studies in different populations in the future.

• Annals of Occupational and Environmental Medicine
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• v.35
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• pp.53.1-53.15
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• 2023

Background: Plastics are high-molecular-weight materials composed of long carbon chains. They are prevalent in daily life, present in various items such as food containers and microwavable packaging. Phthalates, an additive used to enhance their flexibility, are endocrine-disrupting chemicals. We utilized the data from the Korean National Environmental Health Survey (KoNEHS) cycle 3, representing the general South Korean population, to investigate the relationship between the use of plastics in refrigerator food storage and phthalate exposure. Methods: We assessed 3,333 adult participants (aged ≥ 19 years) including 1,526 men and 1,807 women, using data from KoNEHS cycle 3. Using the 75th percentile concentration, urine phthalate metabolites were categorized into high and low-concentration groups. χ² test was conducted to analyze variations in the distribution of each variable, considering sociodemographic factors, health-related factors, food intake, the use of plastics, and the concentration of urine phthalate metabolites as the variables. To calculate odds ratios (ORs) for the high-concentration group of urine phthalate metabolites based on the use of plastics in refrigerator food storage, logistic regression analysis was conducted. Results: In men, the use of plastics in refrigerator food storage had significantly higher adjusted ORs compared to those using the others. The adjusted ORs were calculated as follows: mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) had an OR of 1.35 (95% confidence interval [CI]: 1.05-1.72), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) had an OR of 1.48 (95% CI: 1.16-1.88), mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP) had an OR of 1.32 (95% CI: 1.04-1.66), ∑di(2-ethylhexyl) phthalate (∑DEHP) had an OR of 1.37 (95% CI: 1.08-1.74) and mono-n-butyl phthalate (MnBP) had an OR of 1.44 (95% CI: 1.13-1.84). Conclusion: The concentrations of urine phthalate metabolites (MEHHP, MEOHP, MECPP, ∑DEHP, and MnBP) were significantly higher in men who used plastics in refrigerator food storage compared to those using the others.

• Journal of Environmental Health Sciences
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• v.47 no.1
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• pp.87-100
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• 2021

Objectives: The purpose of this study was to analyze the factors affecting Bisphenol A (BPA) exposure in children and adolescents using the results of the Korean National Environmental Health Survey (KoNEHS) cycle 3. Methods: A total of 2,380 subjects (n=571, 887, and 922 for 3-5, 6-11, and 12-17 years of age, respectively) were analyzed using an environmental exposure survey and environmental chemical substances concentration levels. Univariable linear regression analysis was performed to determine associated variables such as sex, age, income level, housing type, secondhand smoke time, cup noodles and canned food consumption, seafood consumption, new furniture (within the previous six months), drinking water type, and consumption of herbal medicines. Variables with p-values of less than 0.2 were extracted from the results and a multivariable linear regression analysis was performed using stepwise selection. Results: Univariable linear regression analysis showed positive associations between BPA concentration levels and variables including sex, age, secondhand smoke time, new furniture (within the previous six months), renovated living space (within the previous six months), fish and shellfish consumption, plastic-bottled drink consumption, and herbal medicine. As a result of performing multivariable linear regression analysis, the lower was the age the higher was the concentration of BPA levels. Additionally, women showed higher BPA levels than those of men. The more frequently fish was consumed, the higher was the BPA concentration. Moreover, higher BPA concentrations were observed when taking herbal medicine. Conclusions: The main factors affecting BPA concentration levels were age, gender, and consumption of fish and herbal medicine.

• Journal of Environmental Health Sciences
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• v.44 no.6
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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.

• Journal of Environmental Health Sciences
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• v.44 no.4
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• pp.370-379
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• 2018

Objectives: Bisphenol A (BPA) has been extensively used in a variety of consumer products, resulting in widespread non-occupational human exposure. It is often detected in the human body. Studies have reported many health effects associated with endocrine and metabolic disruptions, including obesity, diabetes, hypertension, and cardiovascular diseases. This study was performed to explain the relationship between BPA exposure and obesity in the Korean adult population. Methods: The second stage of the Korean National Environmental Health Survey (KoNHES) was conducted from 2012 to 2014 with 6,478 persons participating. Using the results of the survey, we analyzed the exposure levels for BPA and the influence on obesity of BPA. Results: In model 1, the volume-based measure concentration of BPA, total, female and the 30s to 60s age group were positively related with BMI. In model 2, creatinine adjusted as a covariate and positive associations for BPA with BMI were observed in the female group and was marginally significantly associated in low body weight group. In model 3, creatinine adjusted (g/g-creatinine), BPA exposure, and BMI were positively related with sex, in females, and there was a marginally significant association with the low body weight group in the BMI categories. BMI was significantly associated with BPA in the female group in all three models. Conclusion: This study added further evidence that exposure to EDCs, include bisphenol A, is related with obesity among the general population. Given the environmental health concerns over BPA, it is necessary to develop comprehensive measures to reduce BPA exposure.

• Journal of Environmental Health Sciences
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• v.47 no.3
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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.

• Journal of Environmental Health Sciences
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• v.45 no.5
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• pp.529-540
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• 2019

Objectives: The aim of this study is to compare exposure levels of PAHs and benzene metabolites in the urine of nationally representative adults in Korea and identify exposure factors in relation to questionnaire results. Methods: The study analyzed PAHs and benzene metabolites in the urine of adults aged 19 and older recruited in Cycles 1-3 of the Korean National Environmental Health Survey (KoNEHS). Participants were administered questionnaires on demographic characteristics, lifestyle, and dietary habits to identify the association with exposure levels to environmental chemicals. Results: 1-hydroxypyrene and t,t-muconic acid levels in this study were higher than those in large-scale biomonitoring conducted in other countries (the US and Canada), while 2-hydroxynaphthalene levels were lower. Most environmental chemicals exhibited significant differences depending on gender and age, and exposure levels tended to increase with grilled food intake. In addition, variables such as smoking, distance between home and a road, travelling on public transportation, and ventilation time had a significant effect on exposure to environmental chemicals. Conclusions: The importance of this study lies in utilizing the representative results of KoNEHS, large scale biomonitoring conducted in Korea over roughly ten years. Variables including smoking and roasted food intake were found to affect exposure to PAHs and benzene, which can be used to establish baseline exposure levels of environmental chemicals in Korea.

• Journal of Environmental Health Sciences
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• v.47 no.3
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• pp.245-258
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• 2021

Objectives: In many previous studies, endocrine disruptors (EDCs) have been found to affect delays in puberty. Various EDCs have been reported on, but there have been only limited epidemiologic studies on the effects of exposure to environmental heavy metals and pyrethroid pesticides on puberty delay. Therefore, the aim of this study was to investigate the association of exposure to environmental mercury, cadmium, and pyrethroid pesticides with delayed puberty in children based on national survey data that represents Korean children. Methods: We selected 450 children at the ages of 9-11 years old from the third Korean National Environmental Health Survey (3rd KoNEHS). The relations of urinary Hg, Cd, and 3-PBA with pubertal development were evaluated using multiple logistic regression analyses. Results: Urinary Hg levels were significantly associated with delayed puberty in boys [testicle development: OR=0.41 (95% CI: 0.20, 0.84); genitalia development: OR=0.35 (95% CI: 0.15, 0.81)]. Girls with higher Hg levels were more likely to experience delayed menarche [OR=0.23 (95% CI: 0.06, 0.90)]. We observed a significant 49% reduction in odds for menarche per increasing unit of urinary cadmium levels [OR=0.51 (95% CI: 0.24, 1.01)]. In addition, urinary 3-PBA showed a negative association with genitalia development in boys and menarche in girls [genitalia development: OR=0.73 (95% CI: 0.55, 0.96); menarche: OR=0.56 (95% CI: 0.32, 1.00)]. Conclusions: The results of this study support the hypothesis that exposure to environmental mercury, cadmium and pyrethroid pesticides may affect puberty delays. Additional evidence needs to be obtained through further prospective studies.