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1Department of Preventive Medicine, Dong-A University College of Medicine, Busan, Korea
2Department of Internal Medicine and Environmental Health Center, Kangwon National University, Chuncheon, Korea
3Department of Nano, Chemical & Biological Engineering, Seokyeong University, Seoul, Korea
4Environmental Health Center for Busan, Dong-A University, Busan, Korea
5Department of Preventive Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
6Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
7SD Medical Research Institute, Yongin, Korea
8Department of Public Health Sciences, Seoul National University, Seoul, Korea
9Department of Biomedical Laboratory Science, Eulji University College of Health Sciences, Seongnam, Korea
10Department of Convergence Medicine, Department of Digital Medicine, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
11Department of Life Sciences, Chung-Ang University, Seoul, Korea
12Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, Korea
13Department of Occupational and Environmental Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea
14Department of Preventive Medicine, Jeju National University College of Medicine, Jeju, Korea
© 2024, Korean Society of Epidemiology
This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Conflict of interest
The authors have no conflicts of interest to declare for this study.
Funding
This work was supported by the Korea Environment Industry & Technology Institute (KEITI) through the Core Technology Development Project for Environmental Diseases Prevention and Management project, funded by the Korea Ministry of Environment (MOE) (RS-2021-KE001377).
Author contributions
Conceptualization: Hong YS, Cho YM, Kim WJ. Data curation: Lee S, Eom SY, Cho YM, Choi KH, Kim WJ, Won S, Kang HG, Yoo HJ, Kim JW, Hong YS. Formal analysis: Kwon JY, Rho JH, Han D, Kim JW, Mun S. Funding acquisition: Hong YS, Cho YM, Kim WJ. Methodology: Lee S, Eom SY, Cho YM, Choi KH, Kim WJ, Won S, Kang HG, Yoo HJ, Kim JW, Hong YS. Project administration: Hong YS. Visualization: Kwon JY, Rho JH, Han D, Lee JH, Kim J. Writing – original draft: Kwon JY, Rho JH, Lee S, Han D, Kim J, Mun S, Hong YS. Writing – review & editing: Hong YS, Kim BG, Eom SY, Cho YM, Lee JH, Choi KH, Kim WJ, Won S, Kang HG, Yoo HJ, Kim JW, Lee K, Park WJ, Hong S.
Pb, lead; Cd, cadmium; Hg, mercury; POPs, persistence organic pollutants; beta-HCH, beta-Hexachlorocyclohexane; gamma-HCH, gamma-hexachlorocyclohexane; HCB, hexachlorobenzene; p,p’-DDE, p,p’-dichlorodiphenyldichloroethylene; p,p’-DDT, p,p’-dichlorodiphenyltrichloroethane; 4CB-52, 2,2’,5,5’-tetrachlorobiphenyl; 4CB-56, 2,3,3’,4’-tetrachlorobiphenyl; 4CB-74, 2,4,4’,5-tetrachlorobiphenyl; 5CB-101, 2,2’,4,5,5’-pentachlorobiphenyl; 5CB-105, 2,3,3’,4,4’-pentachlorobiphenyl; 5CB-118, 2,3’,4,4’,5-pentachlorobiphenyl; 5CB-123, 2,3’,4,4’,5’-pentachlorobiphenyl; 5CB-126, 3,3’,4,4’,5-pentachlorobiphenyl; 6CB-138, 2,2’,3,4,4’,5’-hexachlorobiphenyl; 6CB-153, 2,2’,4,4’,5,5’-hexachlorobiphenyl; 6CB-157, 2,3,3’,4,4’,5’-hexachlorobiphenyl; 6CB-167, 2,3’,4,4’,5,5’-hexachlorobiphenyl; 7CB-180, 2,2’,3,4,4’,5,5’-heptachlorobiphenyl; 7CB-187, 2,2’,3,4’,5,5’,6-heptachlorobiphenyl; 3BDE-28, 2,4,4’-tribromodiphenyl ether; 4BDE-47, 2,2’,4,4’-tetrabromodiphenyl ether; 5BDE-99, 2,2’,4,4’,5-pentabromodiphenyl ether; 5BDE-100, 2,2’,4,4’,6-pentabromodiphenyl ether; 6BDE-153, 2,2’,4,4’,5,5’-hexabromodiphenyl ether; 6BDE-154, 2,2’,4,4’,5,6’-hexabromodiphenyl ether; PFCs, perfluorinated compounds; As, arsenic; VOCs, volatile organic compounds; PGA, phenylglyoxylic acid; tt-MA, trans, trans-muconic acid; MHA, methylhippuric acid; BMA, benzyl-mercapturic acid; PAHs, polycyclic aromatic hydrocarbons; 8-OHdG, 8-hydroxy-2’-deoxyguanosine; MDA, Malondialdehyde; b2-MG, beta 2-microglobulin; NAG, N-acetyl-beta-D-glucosaminidase.
Characteristics | Total | Exposure area | Control area | p-value | ||
---|---|---|---|---|---|---|
Total | 1,157 (100) | 953 (82.4) | 204 (17.6) | |||
Gender | Men | 411 (35.5) | 334 (35.0) | 77 (37.7) | 0.4652 | |
Women | 746 (64.5) | 619 (65.0) | 127 (62.3) | |||
Age (yr) | Mean±SD | 70.2±10.2 | 70.5±10.2 | 68.7±9.8 | 0.0201 | |
≤59 | 151 (13.1) | 118 (12.4) | 33 (16.2) | 0.0552 | ||
60-69 | 374 (32.3) | 297 (31.2) | 77 (37.7) | |||
70-79 | 417 (36.0) | 353 (37.0) | 64 (31.4) | |||
≥80 | 215 (18.6) | 185 (19.4) | 30 (14.7) | |||
Residence period (yr) | Mean±SD | 36.0±22.4 | 35.8±22.3 | 36.9±22.7 | 0.5321 | |
≤20 | 385 (33.3) | 322 (33.8) | 63 (30.9) | 0.7072 | ||
21-40 | 303 (26.2) | 252 (26.4) | 51 (25.0) | |||
41-60 | 281 (24.3) | 228 (23.9) | 53 (26.0) | |||
≥61 | 188 (16.2) | 151 (15.8) | 37 (18.1) | |||
Current job | Agriculture & fishery | 321 (27.7) | 214 (22.5) | 107 (52.5) | <0.0012 | |
Service work | 84 (7.3) | 73 (7.7) | 11 (5.4) | |||
Simple labor | 143 (12.4) | 134 (14.1) | 9 (4.4) | |||
Unemployed | 453 (39.2) | 387 (40.6) | 66 (32.4) | |||
Other | 156 (13.5) | 145 (15.2) | 11 (5.4) | |||
Monthly income (10,000 Korean won) | Unknown | 51 (4.4) | 42 (4.4) | 9 (4.4) | 0.3092 | |
Low (<50) | 357 (30.9) | 297 (31.2) | 60 (29.4) | |||
Medium (≥50, <200) | 462 (39.9) | 388 (40.7) | 74 (36.3) | |||
High (≥200) | 287 (24.8) | 226 (23.7) | 61 (29.9) | |||
Smoking status | Current | 94 (8.1) | 75 (7.9) | 19 (9.3) | 0.7102 | |
Past | 239 (20.7) | 195 (20.5) | 44 (21.6) | |||
Never | 824 (71.2) | 683 (71.7) | 141 (69.1) | |||
Drinking (alcohol) status | Current | 464 (40.1) | 378 (39.7) | 86 (42.2) | 0.0592 | |
Past | 259 (22.4) | 226 (23.7) | 33 (16.2) | |||
Never | 434 (37.5) | 349 (36.6) | 85 (41.7) | |||
Drinking water | Tap water | 390 (33.7) | 327 (34.3) | 63 (30.9) | 0.0032 | |
Purified water | 712 (61.5) | 590 (61.9) | 122 (59.8) | |||
Ground water | 55 (4.8) | 36 (3.8) | 19 (9.3) | |||
Fish intake frequency (usually) | None | 165 (14.3) | 133 (14.0) | 32 (15.7) | 0.7922 | |
≤3 times/wk | 893 (77.2) | 739 (77.5) | 154 (75.5) | |||
≥4 times/wk | 99 (8.6) | 81 (8.5) | 18 (8.8) | |||
No response | 0 (0.0) | 0 (0.0) | 0 (0.0) | |||
Seafood intake frequency (usually) | None | 155 (13.4) | 119 (12.5) | 36 (17.6) | 0.0063 | |
≤3 times/wk | 846 (73.1) | 692 (72.6) | 154 (75.5) | |||
≥4 times/wk | 151 (13.1) | 137 (14.4) | 14 (6.9) | |||
No response | 5 (0.4) | 5 (0.5) | 0 (0.0) | |||
Seafood intake within the last 1 day | Yes | 515 (44.5) | 421 (44.2) | 94 (46.1) | 0.0343 | |
No | 640 (55.3) | 532 (55.8) | 108 (52.9) | |||
No response | 2 (0.2) | 0 (0.0) | 2 (1.0) | |||
Local food self-sufficiency (%) | Rice | ≥50 | 256 (22.1) | 199 (20.9) | 57 (27.9) | 0.0272 |
<50 | 901 (77.9) | 754 (79.1) | 147 (72.1) | |||
Vegetables | ≥50 | 528 (45.6) | 400 (42.0) | 128 (62.7) | <0.0012 | |
<50 | 629 (54.4) | 553 (58.0) | 76 (37.3) | |||
(Sweet and) Potatoes | ≥50 | 304 (26.3) | 211 (22.1) | 93 (45.6) | <0.0012 | |
<50 | 853 (73.7) | 742 (77.9) | 111 (54.4) | |||
Nuts and seeds | ≥50 | 270 (23.3) | 199(20.9) | 71(34.8) | <0.0012 | |
<50 | 887 (76.7) | 754 (79.1) | 133 (65.2) |
Variables | Total | Exposure area | Control area | p-value1 |
---|---|---|---|---|
Total | 1,157 (100) | 953 (82.4) | 204 (17.6) | |
Hypertension | 0.011 | |||
Yes | 553 (47.8) | 472 (49.5) | 81 (39.7) | |
No | 604 (52.2) | 481 (50.5) | 123 (60.3) | |
Diabetes | 0.733 | |||
Yes | 237 (20.5) | 197 (20.7) | 40 (19.6) | |
No | 920 (79.5) | 756 (79.3) | 164 (80.4) | |
Chronic obstructive pulmonary disease | 0.019 | |||
Yes | 53 (4.6) | 50 (5.2) | 3 (1.5) | |
No | 1,104 (95.4) | 903 (94.8) | 201 (98.5) | |
Asthma | 0.049 | |||
Yes | 53 (4.6) | 49 (5.1) | 4 (2.0) | |
No | 1,104 (95.4) | 904 (94.9) | 200 (98.0) | |
Allergic disease (dermatitis/rhinitis) | 0.042 | |||
Yes | 77 (6.7) | 70 (7.3) | 7 (3.4) | |
No | 1,080 (93.3) | 883 (92.7) | 197 (96.6) | |
Kidney disease | 0.109 | |||
Yes | 38 (3.3) | 35 (3.7) | 3 (1.5) | |
No | 1,119 (96.7) | 918 (96.3) | 201 (98.5) | |
Arthritis | 0.015 | |||
Yes | 306 (26.4) | 266 (27.9) | 40 (19.6) | |
No | 851 (73.6) | 687 (72.1) | 164 (80.4) | |
Lung/Bronchial/Laryngeal cancer | 0.093 | |||
Yes | 13 (1.1) | 13 (1.4) | 0 (0.0) | |
No | 1,144 (98.9) | 940 (98.6) | 204 (100) | |
Other cancers | 0.917 | |||
Yes | 110 (9.5) | 91 (9.5) | 19 (9.3) | |
No | 1,047 (90.5) | 862 (90.5) | 185 (90.7) |
Pollution source | Environmental hazards | Environmental disease (expected) |
---|---|---|
Abandoned metal mines | Heavy metals, etc. | Kidney disease, cancer, osteoporosis, respiratory diseases, etc. |
Refineries (smelters) | Heavy metals, gaseous substance, etc. | |
Industrial complexes | Heavy metals, VOCs, PAHs, PMs (fine dust), gaseous substances, phthalates, etc. | Asthma, chronic obstructive pulmonary disease (respiratory diseases), allergic disease, etc. |
Waste incinerators | Heavy metals, PM, POPs, VOCs, etc. | |
Coal-fired power plants | PMs, heavy metals, PAHs, gaseous substance, electromagnetic waves, etc. | |
Cement factories | Heavy metals, VOCs, PAHs, PM, etc. |
Biological sample | Environmental hazards |
---|---|
Blood | Heavy metals (Pb, Cd, Hg); Adducts; Proteomes; Metabolomes; Epigenomes; POPs (beta-HCH, gamma-HCH, HCB, p,p’-DDE, p,p’-DDT, 4CB-52, 4CB-56, 4CB-74, 5CB-101, 5CB-105, 5CB-118, 5CB-123, 5CB-126, 6CB-138, 6CB-153, 6CB-157, 6CB-167, 7CB-180, 7CB-187, 3BDE-28, 4BDE-47, 5BDE-99, 5BDE-100, 6BDE-153, and 6BDE-154); PFCs (perfluorooctanoic acid, perfluorooctane sulfonic acid, perfluorohexane sulfonic acid, perfluorodecanoic acid and perfluorononanoic acid) |
Urine | Heavy metals (Cd, As, As speciation); Adducts; VOCs (PGA, tt-MA, MHA, BMA); PAHs (2-naphthol, 1-Hydroxypyrene, 2-Hydroxyfluorene, 1-Hydroxyphenanthrene); Nicotinine metabolites; Oxidative damage biomarkers (8-OHdG, MDA); Kidney function indicators (β2-MG, NAG) |
Characteristics | Total | Exposure area | Control area | p-value | ||
---|---|---|---|---|---|---|
Total | 1,157 (100) | 953 (82.4) | 204 (17.6) | |||
Gender | Men | 411 (35.5) | 334 (35.0) | 77 (37.7) | 0.465 |
|
Women | 746 (64.5) | 619 (65.0) | 127 (62.3) | |||
Age (yr) | Mean±SD | 70.2±10.2 | 70.5±10.2 | 68.7±9.8 | 0.020 |
|
≤59 | 151 (13.1) | 118 (12.4) | 33 (16.2) | 0.055 |
||
60-69 | 374 (32.3) | 297 (31.2) | 77 (37.7) | |||
70-79 | 417 (36.0) | 353 (37.0) | 64 (31.4) | |||
≥80 | 215 (18.6) | 185 (19.4) | 30 (14.7) | |||
Residence period (yr) | Mean±SD | 36.0±22.4 | 35.8±22.3 | 36.9±22.7 | 0.532 |
|
≤20 | 385 (33.3) | 322 (33.8) | 63 (30.9) | 0.707 |
||
21-40 | 303 (26.2) | 252 (26.4) | 51 (25.0) | |||
41-60 | 281 (24.3) | 228 (23.9) | 53 (26.0) | |||
≥61 | 188 (16.2) | 151 (15.8) | 37 (18.1) | |||
Current job | Agriculture & fishery | 321 (27.7) | 214 (22.5) | 107 (52.5) | <0.001 |
|
Service work | 84 (7.3) | 73 (7.7) | 11 (5.4) | |||
Simple labor | 143 (12.4) | 134 (14.1) | 9 (4.4) | |||
Unemployed | 453 (39.2) | 387 (40.6) | 66 (32.4) | |||
Other | 156 (13.5) | 145 (15.2) | 11 (5.4) | |||
Monthly income (10,000 Korean won) | Unknown | 51 (4.4) | 42 (4.4) | 9 (4.4) | 0.309 |
|
Low (<50) | 357 (30.9) | 297 (31.2) | 60 (29.4) | |||
Medium (≥50, <200) | 462 (39.9) | 388 (40.7) | 74 (36.3) | |||
High (≥200) | 287 (24.8) | 226 (23.7) | 61 (29.9) | |||
Smoking status | Current | 94 (8.1) | 75 (7.9) | 19 (9.3) | 0.710 |
|
Past | 239 (20.7) | 195 (20.5) | 44 (21.6) | |||
Never | 824 (71.2) | 683 (71.7) | 141 (69.1) | |||
Drinking (alcohol) status | Current | 464 (40.1) | 378 (39.7) | 86 (42.2) | 0.059 |
|
Past | 259 (22.4) | 226 (23.7) | 33 (16.2) | |||
Never | 434 (37.5) | 349 (36.6) | 85 (41.7) | |||
Drinking water | Tap water | 390 (33.7) | 327 (34.3) | 63 (30.9) | 0.003 |
|
Purified water | 712 (61.5) | 590 (61.9) | 122 (59.8) | |||
Ground water | 55 (4.8) | 36 (3.8) | 19 (9.3) | |||
Fish intake frequency (usually) | None | 165 (14.3) | 133 (14.0) | 32 (15.7) | 0.792 |
|
≤3 times/wk | 893 (77.2) | 739 (77.5) | 154 (75.5) | |||
≥4 times/wk | 99 (8.6) | 81 (8.5) | 18 (8.8) | |||
No response | 0 (0.0) | 0 (0.0) | 0 (0.0) | |||
Seafood intake frequency (usually) | None | 155 (13.4) | 119 (12.5) | 36 (17.6) | 0.006 |
|
≤3 times/wk | 846 (73.1) | 692 (72.6) | 154 (75.5) | |||
≥4 times/wk | 151 (13.1) | 137 (14.4) | 14 (6.9) | |||
No response | 5 (0.4) | 5 (0.5) | 0 (0.0) | |||
Seafood intake within the last 1 day | Yes | 515 (44.5) | 421 (44.2) | 94 (46.1) | 0.034 |
|
No | 640 (55.3) | 532 (55.8) | 108 (52.9) | |||
No response | 2 (0.2) | 0 (0.0) | 2 (1.0) | |||
Local food self-sufficiency (%) | Rice | ≥50 | 256 (22.1) | 199 (20.9) | 57 (27.9) | 0.027 |
<50 | 901 (77.9) | 754 (79.1) | 147 (72.1) | |||
Vegetables | ≥50 | 528 (45.6) | 400 (42.0) | 128 (62.7) | <0.001 |
|
<50 | 629 (54.4) | 553 (58.0) | 76 (37.3) | |||
(Sweet and) Potatoes | ≥50 | 304 (26.3) | 211 (22.1) | 93 (45.6) | <0.001 |
|
<50 | 853 (73.7) | 742 (77.9) | 111 (54.4) | |||
Nuts and seeds | ≥50 | 270 (23.3) | 199(20.9) | 71(34.8) | <0.001 |
|
<50 | 887 (76.7) | 754 (79.1) | 133 (65.2) |
Variables | Total | Exposure area | Control area | p-value |
---|---|---|---|---|
Total | 1,157 (100) | 953 (82.4) | 204 (17.6) | |
Hypertension | 0.011 | |||
Yes | 553 (47.8) | 472 (49.5) | 81 (39.7) | |
No | 604 (52.2) | 481 (50.5) | 123 (60.3) | |
Diabetes | 0.733 | |||
Yes | 237 (20.5) | 197 (20.7) | 40 (19.6) | |
No | 920 (79.5) | 756 (79.3) | 164 (80.4) | |
Chronic obstructive pulmonary disease | 0.019 | |||
Yes | 53 (4.6) | 50 (5.2) | 3 (1.5) | |
No | 1,104 (95.4) | 903 (94.8) | 201 (98.5) | |
Asthma | 0.049 | |||
Yes | 53 (4.6) | 49 (5.1) | 4 (2.0) | |
No | 1,104 (95.4) | 904 (94.9) | 200 (98.0) | |
Allergic disease (dermatitis/rhinitis) | 0.042 | |||
Yes | 77 (6.7) | 70 (7.3) | 7 (3.4) | |
No | 1,080 (93.3) | 883 (92.7) | 197 (96.6) | |
Kidney disease | 0.109 | |||
Yes | 38 (3.3) | 35 (3.7) | 3 (1.5) | |
No | 1,119 (96.7) | 918 (96.3) | 201 (98.5) | |
Arthritis | 0.015 | |||
Yes | 306 (26.4) | 266 (27.9) | 40 (19.6) | |
No | 851 (73.6) | 687 (72.1) | 164 (80.4) | |
Lung/Bronchial/Laryngeal cancer | 0.093 | |||
Yes | 13 (1.1) | 13 (1.4) | 0 (0.0) | |
No | 1,144 (98.9) | 940 (98.6) | 204 (100) | |
Other cancers | 0.917 | |||
Yes | 110 (9.5) | 91 (9.5) | 19 (9.3) | |
No | 1,047 (90.5) | 862 (90.5) | 185 (90.7) |
VOCs, volatile organic compounds; PAHs, polycyclic aromatic hydrocarbons; PM, particulate matter; POPs, persistence organic pollutants.
Pb, lead; Cd, cadmium; Hg, mercury; POPs, persistence organic pollutants; beta-HCH, beta-Hexachlorocyclohexane; gamma-HCH, gamma-hexachlorocyclohexane; HCB, hexachlorobenzene; p,p’-DDE, p,p’-dichlorodiphenyldichloroethylene; p,p’-DDT, p,p’-dichlorodiphenyltrichloroethane; 4CB-52, 2,2’,5,5’-tetrachlorobiphenyl; 4CB-56, 2,3,3’,4’-tetrachlorobiphenyl; 4CB-74, 2,4,4’,5-tetrachlorobiphenyl; 5CB-101, 2,2’,4,5,5’-pentachlorobiphenyl; 5CB-105, 2,3,3’,4,4’-pentachlorobiphenyl; 5CB-118, 2,3’,4,4’,5-pentachlorobiphenyl; 5CB-123, 2,3’,4,4’,5’-pentachlorobiphenyl; 5CB-126, 3,3’,4,4’,5-pentachlorobiphenyl; 6CB-138, 2,2’,3,4,4’,5’-hexachlorobiphenyl; 6CB-153, 2,2’,4,4’,5,5’-hexachlorobiphenyl; 6CB-157, 2,3,3’,4,4’,5’-hexachlorobiphenyl; 6CB-167, 2,3’,4,4’,5,5’-hexachlorobiphenyl; 7CB-180, 2,2’,3,4,4’,5,5’-heptachlorobiphenyl; 7CB-187, 2,2’,3,4’,5,5’,6-heptachlorobiphenyl; 3BDE-28, 2,4,4’-tribromodiphenyl ether; 4BDE-47, 2,2’,4,4’-tetrabromodiphenyl ether; 5BDE-99, 2,2’,4,4’,5-pentabromodiphenyl ether; 5BDE-100, 2,2’,4,4’,6-pentabromodiphenyl ether; 6BDE-153, 2,2’,4,4’,5,5’-hexabromodiphenyl ether; 6BDE-154, 2,2’,4,4’,5,6’-hexabromodiphenyl ether; PFCs, perfluorinated compounds; As, arsenic; VOCs, volatile organic compounds; PGA, phenylglyoxylic acid; tt-MA, trans, trans-muconic acid; MHA, methylhippuric acid; BMA, benzyl-mercapturic acid; PAHs, polycyclic aromatic hydrocarbons; 8-OHdG, 8-hydroxy-2’-deoxyguanosine; MDA, Malondialdehyde; b2-MG, beta 2-microglobulin; NAG, N-acetyl-beta-D-glucosaminidase.
Values are presented as number (%). SD, standard deviation. Using the Student t-test. Using the chi-square test. Using the Fisher’s exact test.
Values are presented as number (%). Using the chi-square test.