Epidemiology and Health

Cohort Profile

Study protocol for the Korean Human Exposure Safety Survey (KoHESS): a national biomonitoring program for food and consumer product safety: Hyeon-Jeong Lim, Sang-Yong Eom, Sun-Haeng Choi, Seonmi Hong, Byung-Sun Choi, Young-Seoub Hong, Kwan Lee, Won-Ju Park, Jae-Seok Song, Nam-Jun Kim, Hyo-Jeong Hwang, Rihwa Choi, Hosub Im, Youn-Seok Kang, Hye-Young Lee, Mi-Ran Kim, Hyunjin Son, Yong-Dae Kim; Epidemiol Health. 2025;47:e2025060. Published online October 29, 2025; DOI: https://doi.org/10.4178/epih.e2025060

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Abstract Summary PDF Supplementary Material: Abstract
This protocol paper describes the design and methodology of the Korean Human Exposure Safety Survey (KoHESS), a three-year national biomonitoring program (2023-2025). Korea’s Act on Risk Assessment of Products for Human Use necessitates scientific evidence for aggregate exposure assessment and cumulative risk evaluation of hazardous substances in food and consumer products. Existing biomonitoring programs primarily focus on environmental exposures, limiting comprehensive assessment of products regulated by the Ministry of Food and Drug Safety. KoHESS employs repeated cross-sectional surveys targeting approximately 5,000 Koreans aged 3-79 years per cycle, using complex stratified multistage sampling for national representativeness. Data collection includes standardized anthropometric measurements, biological samples (blood, urine), comprehensive exposure source surveys, and 2-day 24-hour dietary recalls. Chemical analyses using liquid chromatography-tandem mass spectrometry and inductively coupled plasma mass spectrometry measure 24 perfluoroalkyl and polyfluoroalkyl substances compounds, 25 phthalate metabolites, and 7 heavy metals, with quality assurance through certified reference materials. KoHESS will provide scientifically robust data for establishing safety standards, enable advanced exposure modeling, facilitate risk assessments reflecting cumulative exposures, support targeted protection for vulnerable populations, and contribute to international biomonitoring networks while promoting preventive hazardous substance management systems.; Summary

Korean summary
- 식품의약품안전처(MFDS)가 주관하는 KoHESS (2023-2025)는 한국을 대표하는 5,000명의 국민(3~79세)을 대상으로 3년간 반복 수행되는 전국 규모의 인체 모니터링 프로그램이다. - 기존 환경 노출 데이터의 한계를 보완하여 식품 및 소비재 유래 유해 물질(PFAS 24종, 프탈레이트 25종, 중금속 7종)의 인체 노출 수준을 측정한다. - 수집된 과학적 데이터는 유해 물질의 통합 노출 평가, 누적 위해성 평가 및 제품 안전 기준 설정을 위한 핵심 근거 자료로 활용될 것으로 기대된다.

Key Message
- KoHESS (2023-2025) is a national, repeated cross-sectional biomonitoring program led by the Ministry of Food and Drug Safety (MFDS), targeting 5,000 Koreans (3-79 years) per cycle. - It measures 24 PFAS, 25 phthalate metabolites, and 7 heavy metals, specifically focusing on hazardous substances from food and consumer products, filling gaps in existing environmental data. - The data provides robust scientific evidence crucial for aggregate exposure assessment, cumulative risk evaluation, and establishing safety standards for regulated products.

Brief Communication

Levels of exposure markers among residents in environmentally vulnerable areas in Korea, the general population in Korea, and Asians in the United States: Kyung-Hwa Choi, Dahee Han, Sang-Yong Eom, Yong Min Cho, Young-Seoub Hong, Woo Jin Kim; Epidemiol Health. 2025;47:e2025007. Published online February 25, 2025; DOI: https://doi.org/10.4178/epih.e2025007

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Abstract Summary PDF Supplementary Material

Abstract

This study compares biomarker levels among environmentally vulnerable residents in Korea, the general Korean population, and Asians in the United States. We selected 953 exposed residents and 204 controls from the Forensic Research via Omics Markers in Environmental Health Vulnerable Areas (FROM) study (2021-2023), 4,239 participants from the fourth Korean National Environmental Health Survey (2018-2020), and 996 Asians from the U.S. National Health and Nutrition Examination Survey (2017-March 2020). The analyzed biomarkers included blood and urinary metals, urinary metabolites of polycyclic aromatic hydrocarbons, nicotine, volatile organic compounds, and serum perfluorocarbon metabolites. The highest median biomarker levels varied by pollution source among older adults. In refineries, blood lead and cadmium (Cd), as well as urinary Cd and 2-hydroxyfluorene, were highest. Abandoned metal mines exhibited the highest blood and urinary mercury, urinary Cd, total arsenic (As), 2-naphthol, and cotinine levels. Coal-fired power plants showed the highest urinary 1- hydroxyphenanthrene levels, while cement factories had the highest urinary As3+ levels. Sprawls demonstrated the highest urinary monomethylarsonic acid, 1-hydroxypyrene, and phenylglyoxylic acid levels, and industrial areas recorded the highest levels of trans, trans-muconic acid, benzylmercapturic acid, and 2-methylhippuric acid. In general, biomarker levels were higher among exposed residents in the FROM study than in the general population; however, urinary 2-hydroxyfluorene and As5+ levels did not differ significantly. Exposure to pollution sources in environmentally vulnerable areas may elevate biomarker levels in residents.

Summary

Korean summary
본 연구는 환경보건 취약지역 거주자, 대한민국의 일반인구집단, 미국에 거주하는 아시아인의 체내 환경유해물질 바이오마커 농도를 비교하였다. 체내 바이오마커의 농도는 석유정제시설, 폐금속광산, 화력발전소 등 환경보건 취약지역의 유형에 따라 차이를 보였다. 본 연구가 가지는 과학적, 역학적 의미는 환경보건 취약지역 유형별 환경유해물질 노출의 차이와 그로 인한 잠재적 건강영향을 알아봄으로써 환경보건 취약계층을 위한 특이적인 중재가 이루어질 수 있도록 하는데 있다.

Key Message
This study examines environmental health risks for vulnerable populations by comparing biomarker levels among exposed residents in Korea, the general Korean population, and Asians in the United States. Biomarker levels were found to be elevated near pollution sources such as refineries, metal mines, and power plants, with variations based on pollutant types. The scientific and epidemiological significance lies in revealing disparities in exposure and potential health effects, thereby contributing to targeted interventions for environmentally vulnerable groups.

Citations

Citations to this article as recorded by

PAHs and VOCs Exposures of Residents Living near a Smelter and Their Relationship to Inflammation and Chronic Diseases: A Cross-Sectional Study
Haneul Kim, Yong Min Cho, Dahee Han, Mi Jeong Kim, Minju Chae, Yeonseo Cho, Jang-Hee Lee, Min-Ho Yang, Kyung-Hwa Choi, Young-Seoub Hong, Woo Jin Kim
Journal of Environmental Health Sciences.2025; 51(4): 222. CrossRef
Associations Between Indoor Air Pollution and Urinary Volatile Organic Compound Biomarkers in Korean Adults
Byung-Jun Cho, Seon-Rye Kim
Toxics.2025; 13(8): 692. CrossRef
Environmental Pollutant Exposure Levels and Risk Perception among Residents Living in Environmentally Vulnerable Areas: Findings from the Gyeonggi Environmental Health Survey
Mijeong Kim, Yong Min Cho, Dahee Han, Haneul Kim, Minju Chae, Yeonseo Cho, Hosub Im, Yanghee Kim
Journal of Environmental Health Sciences.2025; 51(6): 442. CrossRef

Data Profile

Introduction to the forensic research via omics markers in environmental health vulnerable areas (FROM) study: Jung-Yeon Kwon, Woo Jin Kim, Yong Min Cho, Byoung-gwon Kim, Seungho Lee, Jee Hyun Rho, Sang-Yong Eom, Dahee Han, Kyung-Hwa Choi, Jang-Hee Lee, Jeeyoung Kim, Sungho Won, Hee-Gyoo Kang, Sora Mun, Hyun Ju Yoo, Jung-Woong Kim, Kwan Lee, Won-Ju Park, Seongchul Hong, Young-Seoub Hong; Epidemiol Health. 2024;46:e2024062. Published online July 12, 2024; DOI: https://doi.org/10.4178/epih.e2024062

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Abstract

This research group (forensic research via omics markers in environmental health vulnerable areas: FROM) aimed to develop biomarkers for exposure to environmental hazards and diseases, assess environmental diseases, and apply and verify these biomarkers in environmentally vulnerable areas. Environmentally vulnerable areas—including refineries, abandoned metal mines, coal-fired power plants, waste incinerators, cement factories, and areas with high exposure to particulate matter—along with control areas, were selected for epidemiological investigations. A total of 1,157 adults, who had resided in these areas for over 10 years, were recruited between June 2021 and September 2023. Personal characteristics of the study participants were gathered through a survey. Biological samples, specifically blood and urine, were collected during the field investigations, separated under refrigerated conditions, and then transported to the laboratory for biomarker analysis. Analyses of heavy metals, environmental hazards, and adducts were conducted on these blood and urine samples. Additionally, omics analyses of epigenomes, proteomes, and metabolomes were performed using the blood samples. The biomarkers identified in this study will be utilized to assess the risk of environmental disease occurrence and to evaluate the impact on the health of residents in environmentally vulnerable areas, following the validation of diagnostic accuracy for these diseases.

Summary

Korean summary
환경보건 취약지역 주민을 대상으로 실시한 현장 역학 조사에서 혈액과 소변 시료를 안정적으로 확보하였다. 현장에서 확보한 시료는 즉시 이송하여 오믹스 분석을 통해 환경유해인자별, 환경성질환별 특이적인 바이오마커를 개발한다.

Key Message
Blood and urine samples were stably obtained from on-site epidemiological investigations done on residents in environmental health vulnerable areas, and samples obtained from the sites were immediately transported to the omics laboratory after separation under biobank system. Through this analysis, we aimed to develop biomarkers specific to each environmental hazard and disease.

Citations

Citations to this article as recorded by

Mediation Effect of Oxidative Stress in the Associations between Cadmium Exposure and Renal Tubular Damage of Residents in Metal-Polluted Regions in Korea
Dahee Han, Kyung-Hwa Choi, Jang-Hee Lee, Young-Seoub Hong, Woo Jin Kim, Yong Min Cho
Exposure and Health.2026;[Epub] CrossRef
Integrative methylation profiling uncovers IL10RB hypomethylation as a mediator between environmental heavy metal exposure and lung cancer risk
Hyeongyu Shin, Chul-Hong Kim, Jeeyoung Kim, JungYeon Kwon, Min Heo, Nam-Eun Kim, Sujin Seo, Yong Min Cho, Young-Seoub Hong, Jung-Woong Kim, Woo Jin Kim, Sungho Won
Environmental Pollution.2026; 390: 127537. CrossRef
Heavy metal exposure and its effects on APOC3, CFAI, and ZA2G
Nam-Eun Kim, Min Heo, Hyeongyu Shin, Ah Ra Do, Jeeyoung Kim, Hee-Gyoo Kang, Sora Mun, Hyun Ju Yoo, Mi Jeong Kim, Jung-Woong Kim, Chul-Hong Kim, Young-Seoub Hong, Yong Min Cho, Heejin Jin, Kyungtaek Park, Woo Jin Kim, Sungho Won
Journal of Hazardous Materials.2025; 482: 136574. CrossRef
A Comparative Study on the Paradoxical Relationship Between Heavy Metal Exposure and Kidney Function
Jee Hyun Rho, Seungho Lee, Jung-Yeon Kwon, Young-Seoub Hong
Diagnostics.2025; 15(1): 86. CrossRef
Levels of exposure markers among residents in environmentally vulnerable areas in Korea, the general population in Korea, and Asians in the United States
Kyung-Hwa Choi, Dahee Han, Sang-Yong Eom, Yong Min Cho, Young-Seoub Hong, Woo Jin Kim
Epidemiology and Health.2025; 47: e2025007. CrossRef
PAHs and VOCs Exposures of Residents Living near a Smelter and Their Relationship to Inflammation and Chronic Diseases: A Cross-Sectional Study
Haneul Kim, Yong Min Cho, Dahee Han, Mi Jeong Kim, Minju Chae, Yeonseo Cho, Jang-Hee Lee, Min-Ho Yang, Kyung-Hwa Choi, Young-Seoub Hong, Woo Jin Kim
Journal of Environmental Health Sciences.2025; 51(4): 222. CrossRef
Development and application of an LC-MS/MS method for urinary DNA adduct profiling in residents of environmentally vulnerable areas
Bo-Ri Kim, Jeong-Kyu Ji, Jang-Hun Jeong, Kyung-Hwa Choi, Yong Min Cho, Woo Jin Kim, Yong-Dae Kim, Heon Kim, Young-Seoub Hong, Sang-Yong Eom
Ecotoxicology and Environmental Safety.2025; 303: 118833. CrossRef

COVID-19: Original Article

Korea Seroprevalence Study of Monitoring of SARS-COV-2 Antibody Retention and Transmission (K-SEROSMART): findings from national representative sample: Jina Han, Hye Jin Baek, Eunbi Noh, Kyuhyun Yoon, Jung Ae Kim, Sukhyun Ryu, Kay O Lee, No Yai Park, Eunok Jung, Sangil Kim, Hyukmin Lee, Yoo-Sung Hwang, Jaehun Jung, Hun Jae Lee, Sung-il Cho, Sangcheol Oh, Migyeong Kim, Chang-Mo Oh, Byengchul Yu, Young-Seoub Hong, Keonyeop Kim, Sun Jae Jung, Mi Ah Han, Moo-Sik Lee, Jung-Jeung Lee, Young Hwangbo, Hyeon Woo Yim, Yu-Mi Kim, Joongyub Lee, Weon-Young Lee, Jae-Hyun Park, Sungsoo Oh, Heui Sug Jo, Hyeongsu Kim, Gilwon Kang, Hae-Sung Nam, Ju-Hyung Lee, Gyung-Jae Oh, Min-Ho Shin, Soyeon Ryu, Tae-Yoon Hwang, Soon-Woo Park, Sang Kyu Kim, Roma Seol, Ki-Soo Park, Su Young Kim, Jun-wook Kwon, Sung Soon Kim, Byoungguk Kim, June-Woo Lee, Eun Young Jang, Ah-Ra Kim, Jeonghyun Nam, The Korea Community Health Survey Group, Soon Young Lee, Dong-Hyun Kim; Epidemiol Health. 2023;45:e2023075. Published online August 17, 2023; DOI: https://doi.org/10.4178/epih.e2023075

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea.

METHODS

In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022.

RESULTS

In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%.

CONCLUSIONS

The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.

Summary

Korean summary
인구집단을 기반으로 하여 대표성 있는 표본을 추출하여 COVID-19 항체유병률 조사를 전국적으로 수행함으로 지역사회 단위에서 지속적으로 모니터링할 수 있는 COVID-19 감시체계 구축의 기반을 마련하였다. 2022년 8월 우리나라 국민의 대부분이 COVID-19에 대한 항체를 보유하고 있었고 인구 3명 중 1명은 미확진 감염자로 추정되었다.

Key Message
The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19. In August 2022, most of the Korean people had antibodies to COVID-19, and one in three people was estimated to have an unreported infection. This study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.

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Effectiveness of the 2023-2024 monovalent XBB.1.5 vaccine against SARS-CoV-2 infection in people aged over 65 years in South Korea: a population-based cohort study
Suyoung Jo, Seunghyun Lee, Huiseon Kim, Hyunji Won, Gi-eun Rhie, Hye-Sook Jeong, June-Woo Lee, Ah-Ra Kim, Byung Chul Chun, Kyong Ran Peck, Dong-Hyun Kim
International Journal of Infectious Diseases.2026; 163: 108238. CrossRef
Modeling vaccination prioritization strategies for post-pandemic COVID-19 in the Republic of Korea accounting for under-reporting and age-structure
Geunsoo Jang, Jihyeon Kim, Robin N. Thompson, Hyojung Lee
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Original Article

No Association Between Functional Polymorphisms in COMT and MTHFR and Schizophrenia Risk in Korean Population: Ho Jin Kang, Byeong Moo Choe, Seong Hwan Kim, Seung-Rak Son, Kyoung-Mu Lee, Byoung Gwon Kim, Young-Seoub Hong; Epidemiol Health. 2010;32:e2010011. Published online December 24, 2010; DOI: https://doi.org/10.4178/epih/e2010011

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Abstract PDF

Abstract

<sec><title>OBJECTIVES</title>Common genetic SNPs in two genes, encoding catechol-O-methyltransferase (COMT) and methylenetetrahydrofolate reductase (MTHFR), which are interconnected with COMT gene regulation, have been reported to contribute to schizophrenia risk. In this study, we evaluated the association between functional polymorphisms in COMT and MTHFR and schizophrenia risk with a case-control study in a Korean population.</sec><sec><title>METHODS</title>We performed a case-control study by genotyping analysis using 360 cases and 348 controls in Korean subjects to determine the association between functional polymorphisms in COMT and MTHFR and schizophrenia risk.</sec><sec><title>RESULTS</title>Four functional SNPs in COMT (Val158Met and rs165599) and MTHFR (C677T and A1298C) were genotyped by primer extension assay. None of the genotype distributions for the four SNPs was significantly different between cases and controls. Stratified analysis did not show any significant gender difference for any polymorphism. In addition, we found no evidence of a gene-gene interaction in the analysis of combined genotypes.</sec><sec><title>CONCLUSION</title>Our results suggest no significant association between the selected functional polymorphisms of COMT or MTHFR in Korean schizophrenia subjects. However, further studies are required to confirm our findings in a larger number of subjects.</sec>

Summary

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