Search Results (12)

Background: Environmental tobacco smoke (ETS) exposes adolescents to various environmental toxins, potentially affecting their developmental health. However, limited research exists on the associations between ETS exposure and the bodily burdens of environmental chemicals on adolescents. This study aimed to investigate the relationship between ETS exposure and the concentration of various environmental chemicals in adolescents, utilizing urinary cotinine as an objective biomarker. Methods: Data from 828 adolescents aged 12–17 years participating in the Korean National Environmental Health Survey (KoNEHS) were analyzed. ETS exposure was assessed via self-reported questionnaires and confirmed by urinary cotinine measurements. Levels of 33 environmental chemicals, including heavy metals, polycyclic aromatic hydrocarbons (PAHs), phthalates, phenols, volatile organic compounds (VOCs), and per- and polyfluoroalkyl substances (PFASs), were measured. Statistical analyses were conducted after adjusting for covariates. Results: Adolescents exposed to ETS showed significantly higher urinary cotinine and mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP) concentrations than non-exposed adolescents. Additionally, significant positive correlations were observed between urinary cotinine levels and metabolites of PAHs (NAP, OHFlu), phenols (BPA, BPS), phthalates (MMP), and VOCs (t,t-MA) after adjustments. However, ETS exposure was not significantly associated with heavy metal concentrations. Conclusions: This study described the association between ETS exposure and environmental chemicals. A trend has been identified between ETS exposure in adolescents and increased bodily concentrations of various environmental chemicals, including PAHs, phenols, phthalates, and VOCs. As adolescence is a critical developmental period of vulnerability to environmental toxins, reducing ETS exposure to protect adolescents’ health and prevent potential lifelong health effects should be emphasized. This study was based on a cross-sectional design, and some confounding factors and measurement limitations may exist. Therefore, caution is needed in interpreting causality, and further research is recommended to determine more precise causality and long-term health effects. Full article

Introduction: Korea has higher levels of heavy metals compared to other countries, raising the need to study the health impacts on vulnerable populations. This study examined the effects of heavy metal exposure—lead, mercury, and cadmium—on kidney function in residents of environmentally vulnerable areas compared to the general population in Korea. Methods: Epidemiological studies in vulnerable areas and official data from the Fourth Korean National Environmental Health Survey were analyzed to assess blood levels of lead and mercury and urinary cadmium. An integrated heavy metal concentration was calculated, combining the levels of these metals. Kidney function was evaluated using the estimated glomerular filtration rate (eGFR), classified into normal, mildly reduced, and impaired. Correlation and logistic regression analyses were used to examine relationships between heavy metal levels and eGFR. Results: The integrated heavy metal concentration in vulnerable areas was higher than in the general population. In the general population, increased heavy metal levels were associated with a decrease in eGFR, whereas in vulnerable areas, eGFR increased with higher heavy metal levels. In the general population, a rise in urinary cadmium increased the risk of eGFR decline by 19.9%, while in vulnerable areas, higher urinary cadmium reduced this risk by 23.3%. Conclusions: Contrasting relationships between heavy metal exposure and eGFR in vulnerable areas versus the general population may be due to long-term exposure and reduced renal excretion. This study underscores the need for continued monitoring in vulnerable areas, and future research should identify eGFR thresholds that correlate with heavy metal level shifts. Full article

In South Korea, a Human Biomonitoring (HBM) program, known as the Korean National Environmental Health Survey (KoNEHS), was launched in 2009. This study aims to provide an overview of environmental chemical exposures in South Korea based on data from the KoNEHS cycle 4 (2018–2020). To ensure population representativeness, Koreans aged 3 years and older were recruited from 426 sites across the country. A total of 6381 participants joined in the collection of biospecimens, which were subsequently analyzed for 33 environmental chemicals or their metabolites, including nine that were not included in the previous cycle. The five most common PFASs were detected in more than 99.7% of the participants. The GM of serum PFOS was the highest in adults at 15.1 µg/L (13.9, 16.4) and in adolescents at 7.97 µg/L (7.42, 8.56). In adults, there was a gradual decrease in the detection rate and concentration of some heavy metals and phthalate metabolites. In children and adolescents, the detection rate of BPA in urine decreased, while the rate of its substitutes BPF and BPS increased, and the rate of propyl paraben in urine decreased significantly. The results of the KoNEHS cycle 4 indicate that exposure levels to certain environmental chemicals are still high, highlighting further monitoring and on-going surveys to determine their trends, especially for newly investigated substances, such as PFASs. Full article

The aim of this study was to investigate the association between benzene and toluene, and the ratio of triglycerides to high-density lipoprotein cholesterol (TG/HDL-C). This cross-sectional study analyzed 1928 adults using nationally representative data from the Korean National Environmental Health Survey (KoNEHS) Cycle 4 (2018–2020). Urinary trans, trans-muconic acid (t,t-MA) and benzylmercapturic acid (BMA) were measured by high-performance liquid chromatography–mass spectrometry (HPLC–MS/MS), and high-density lipoprotein cholesterol (HDL-C) and triglycerides (TGs) were analyzed by colorimetry. Survey logistic regression analysis was applied to examine the association between urinary t,t-MA and BMA and the TG/HDL-C ratio. Urinary t,t-MA is significantly associated with an elevated TG/HDL-C ratio in both men and women (for men, OR [95% (CI)]: 2nd quartile: 2.10 [1.04, 4.22]; 3rd quartile: 2.13 [0.98, 4.62]; 4th quartile: 2.39 [1.05, 5.45]; for women, OR [95% (CI)]: 2nd quartile: 1.21 [0.71, 2.06]; 3rd quartile: 1.65 [0.94, 2.90]; 4th quartile: 1.78 [1.01, 3.11]), with significant dose–response relationships (P for trend: for men, 0.029; women, 0.024). This study shows that environmental exposure to benzene is associated with the TG/HDL-C ratio in the Korean general population. This suggests that more stringent environmental health policies are needed to reduce benzene exposure. Full article

Perfluoroalkyl substances (PFAS), widely used throughout industry and daily life, are currently one of the environmental pollutants garnering the most attention worldwide. Recently, environmental pollutants have had a high profile as one of the main causes of chronic liver disease, such as non-alcoholic fatty liver disease. Research on PFAS is actively underway. Although Korea has a remarkably high prevalence of chronic liver disease, and it continues to increase, only a few studies have revealed the relationship between PFAS and liver disease. In addition, regulations on PFAS in Korea are delayed compared to developed countries, such as Europe and the United States, and public interest is insufficient compared to others. Therefore, we would like to investigate the exposure of Koreans to PFAS in the blood and examine the relationship between these substances and markers of liver function (AST, ALT, and GGT). This study was based on the results of the Korean National Environmental Health Survey (KoNEHS) 2015–2017 (Cycle 3), and a total of 2961 subjects were selected. The concentration of PFAS in the blood of Korean adults was measured to be significantly higher based on the geometric mean compared to the results of recently investigated American adults based on the National Health and Nutrition Examination Survey (NHANES, 2017–2018). A multivariable linear regression analysis adjusted for age, sex, body mass index (BMI), smoking status, alcohol intake, and regular exercise was performed to examine changes in three liver function markers as the serum PFAS concentration increased. We found that some of the five PFAS (PFOA, PFOS, PFHxS, PFNA, and PFDeA) were significantly associated with increased liver enzymes. It is necessary to recognize the threat of PFAS to the human body and to discuss regulations and alternatives in earnest. Continuous follow-up studies are required through a well-designed cohort. Full article

Nonalcoholic fatty liver disease (NAFLD) is a condition of excess accumulation of fats in the liver. Thyroid dysfunction is commonly observed in adult populations with NAFLD. In subjects with thyroid dysfunction, phthalates, which are chemical compounds widely used to increase the flexibility of various plastic products, may increase the risk of NAFLD prevalence. Therefore, our study aimed to evaluate the relationship between the levels of urinary phthalate metabolites and the risk of NAFLD stratified by the levels of thyroid-stimulating hormone (TSH). Data (n = 2308) were obtained from the Korean National Environmental Health Survey II (2012–2014). Using the hepatic steatosis index, participants were classified into non-NAFLD (<30) and NAFLD (>36) groups. Participants with euthyroidism were defined as 0.45–4.5 mIU/L for serum TSH and normal thyroxine (T4) levels (n = 2125). Subclinical hypothyroidism (SCH) was defined as a higher TSH level (4.5–10 mIU/L) with normal total T4 levels in the serum (n = 183). A multivariate analysis was performed to assess the association of the urinary phthalate concentration with the risk of NAFLD after stratification based on the thyroid hormone levels. The levels of phthalate metabolites in urine were not significantly associated with NAFLD in adults with euthyroidism. However, a significant increased risk of NAFLD in those with SCH was observed in the fourth quartile of mono (2-ethyl-5-hydroxyhexyl) phthalate (odds ratio (OR) 13.59, 95% confidence interval (CI) 12.13–86.44), mono (2-ethyl-5-oxohexyl) phthalate (OR 8.55, 95% CI 1.20–60.53), mono-(2-ethyl-5-carboxypentyl) phthalate (OR 9.06, 95% CI 1.78–45.96), and mono-benzyl phthalate (OR 6.05, 95% CI 1.62–22.54) compared to those of the lowest quartile after being adjusted with covariates. In conclusion, the levels of phthalate metabolites in urine are positively associated with NAFLD in adults with SCH. More experimental studies are needed to clarify the risk of NAFLD caused by phthalate exposure in cases with poor thyroid function. Full article

Cardiovascular disease (CVD) is a leading cause of death in Korea. Dyslipidemia, characterized by the presence of abnormal lipid levels, has been suggested as an early diagnostic and preventable factor for CVD. Recent studies have shown that exposure to lead (Pb), cadmium (Cd), and mercury (Hg) affects lipid metabolism. This study aimed to verify the association between heavy metal concentrations and serum lipid profiles in the general population. A representative sample of 2591 Korean adults from the Korean National Environmental Health Survey (2015–2017) was analyzed. The associations between heavy metals [Blood Pb (BPb), blood Hg (BHg), urinary Hg (UHg), urinary Cd (UCd)] and serum lipid profiles [total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), non-low level of high-density lipoprotein cholesterol (Non-HDL-C)] were assessed using regression analysis. After adjusting for demographic and socioeconomic factors, the proportional changes in serum lipid levels were significantly associated with increases in BPb, BHg, and UHg levels (p for trend < 0.05). Overall, BPb, BHg, and Uhg levels positively correlated with dyslipidemia, whereas UCd levels did not show a significant association. Our results suggest that heavy metal exposure, at low levels, may contribute to an increased prevalence of dyslipidemia in Korean adults. Full article

The Korean National Environmental Health Survey (KoNEHS) program provides useful information on chemical exposure, serves as the basis for environmental health policies, and suggests appropriate measures to protect public health. Initiated on a three-year cycle in 2009, it reports the concentrations of major environmental chemicals among the representative Korean population. KoNEHS Cycle 3 introduced children and adolescents into the analysis, where the blood and urine samples of 6167 participants were measured for major metals, phthalates, phenolics, and other organic compounds. Lead, mercury, cadmium, metabolites of DEHP and DnBP, and 3-phenoxybenzoic acid levels of the Korean adult population tended to decrease compared to previous survey cycles but remained higher than those observed in the US or Canada. Both bisphenol A (BPA) and trans,trans-muconic acid concentrations have increased over time. Heavy metal concentrations (blood lead, and cadmium) in children and adolescents were approximately half that of adults, while some organic substances (e.g., phthalates and BPA) were high. BPA showed higher levels than in the US or Canada, whereas BPF and BPS showed lower detection rates in this cycle; however, as these are increasingly used as a substitute for BPA, further research is necessary. As environmental chemicals may affect childhood health and development, additional analyses should assess exposure sources and routes through continuous observations. Full article

Background: Exposure to lead (Pb), cadmium (Cd), and mercury (Hg) has been reported to be associated with liver-related diseases. However, studies examining the association between heavy metal exposure and liver injury in a large population are scant and characterized by inconsistent results. This study aimed to evaluate the association between levels of heavy metal exposure and liver injury in the general population. Methods: Data for 2953 participants aged 19 years or more obtained from the Korean National Environmental Health Survey (KoNEHS) Cycle 3 (2015–2017) were used. The associations between levels of blood or urine heavy metals (Pb, Cd, and Hg) and liver function biomarkers [aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyl transferase (GGT)] were evaluated using multiple linear regression analysis. Results: Regarding the blood Pb (BPb), AST was higher in those of the 4th quartile, ALT was higher in those of the 2nd and 4th quartiles, and GGT was higher in those of the 3rd and 4th quartiles than in the 1st quartile. For urinary Cd (UCd), AST was higher in those of the 4th quartile; ALT was higher in those of the 2nd, 3rd, and 4th quartiles; and GGT was higher in the 4th quartile than in the 1st quartile. For the blood Hg (BHg), AST was higher in those of the 2nd and 4th quartile, ALT was higher in those of the 2nd, 3rd, and 4th quartiles; and GGT was higher in those of the 3rd and 4th quartiles than in the 1st quartile. There was no significant difference between urinary Hg (UHg) and liver function markers. Conclusion: Heavy metal exposure showed an association with liver injury among the general adult population in Korea. Further studies are required to clarify the relationship between heavy metals and liver injury. Full article

Mercury is widely distributed in the environment, and a plausible association between mercury exposure and hepatic damage has been reported. Non-alcoholic fatty liver disease (NAFLD), which comprises a spectrum of liver diseases, has recently been recognized in non-obese subjects. However, there have been no studies on the relationship between internal mercury levels and NAFLD in non-obese individuals. Therefore, we investigated the association between blood mercury levels and NAFLD in non-obese subjects. Cross-sectional data (n = 5919) were obtained from the Korean National Environmental Health Survey (2012–2014). NAFLD was defined using the hepatic steatosis index (HSI). Blood mercury levels were log-transformed and divided into quartiles based on a weighted sample distribution. The association between blood mercury levels and NAFLD was analyzed using a multivariate logistic analysis after body mass index stratification. The geometric mean of blood mercury in the overweight group was significantly higher than that of the non-obese group (p < 0.001). The weighted frequencies of patients with NAFLD based on the HSI were 3.0–7.2% for the non-obese subjects and 52.3–63.2% for the overweight subjects. In the multivariate analysis, blood mercury levels were positively associated with NAFLD for both the overweight and non-obese groups (all p for trend < 0.001). Increased blood mercury levels are closely associated with NAFLD. In particular, mercury could be a risk factor for NAFLD in the non-obese population. Full article

The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing worldwide. Recent experimental studies suggested that phthalates might induce NAFLD. Therefore, this study aimed to investigate the relationship between phthalates metabolites and NAFLD in the human population. This cross-sectional analysis was performed using data from the Korean National Environmental Health Survey II (2012–2014) among Korean adults (n = 5800). NAFLD was diagnosed using the hepatic steatosis index (HSI) in the absence of other causes of chronic liver diseases. Among the participants (mean age 46 years, 47.5% male), the prevalence of NAFLD was associated with urinary levels of mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono-(2-ethyl-5-oxohexyl) phthalate, mono-(2-ethyl-5-carboxypentyl) phthalate, mono-benzyl phthalate (MBzP), and mono-n-butyl phthalate (MnBP) compared to the reference group. In the multivariate model, the odds ratios (ORs), 95% confidence interval (CI) for NAFLD were 1.33 (1.00–1.78) and 1.39 (1.00–1.92) in the 3rd and 4th quartile of MEHHP, respectively. Based on the study findings, high levels of urinary phthalates are associated with the prevalence of NAFLD in Korean adults. Further investigation is required to elucidate the causal relationship. Full article

From a public health perspective, there is growing concern about dietary mercury intake as the most important source of mercury exposure. This study was performed to estimate dietary mercury exposure and to analyze the association between mercury intake and blood mercury levels in Koreans. The study subjects were 553 adults, comprising a 10% representative subsample of the Korean National Environmental Health Survey (KoNEHS) 2012–2014, who completed a health examination, a face-to-face interview, and a three-day food record. Dietary mercury and methylmercury intakes were assessed from the three-day food record, and blood mercury concentration was measured using a mercury analyzer. The association between dietary mercury intake and blood mercury levels was analyzed by comparing the odds ratios for the blood mercury levels above the Human BioMonitoring (HBM) I value (5 μg/L) among the three groups with different mercury intakes. The average total mercury intake was 4.74 and 3.07 μg/day in males and females, respectively. The food group that contributed most to mercury intake was fish and shellfish, accounting for 77.8% of total intake. The geometric mean of the blood mercury concentration significantly and linearly increased with the mercury and methylmercury intakes (p < 0.001). The odds ratios for blood mercury levels above the HBM I value in the highest mercury and methyl mercury intake group were 3.27 (95% Confidence Interval (CI) 1.79–5.95) and 3.20 (95% CI 1.77–5.79) times higher than that of the lowest intake group, respectively. Our results provide compelling evidence that blood mercury level has a strong positive association with dietary intake, and that fish and shellfish contribute most to the dietary mercury exposure. Full article