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Original Articles
Association between ambient particulate matter levels and hypertension: results from the Korean Genome and Epidemiology Study
Sewhan Na, Jong-Tae Park, Seungbeom Kim, Jinwoo Han, Saemi Jung, Kyeongmin Kwak
Ann Occup Environ Med 2023;35:e51.   Published online December 4, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e51
AbstractAbstract AbstractAbstract in Korean PDFSupplementary MaterialPubReaderePub
Background

Recently, there has been increasing worldwide concern about outdoor air pollution, especially particulate matter (PM), which has been extensively researched for its harmful effects on the respiratory system. However, sufficient research on its effects on cardiovascular diseases, such as hypertension, remains lacking. In this study, we examine the associations between PM levels and hypertension and hypothesize that higher PM concentrations are associated with elevated blood pressure.

Methods

A total of 133,935 adults aged ≥ 40 years who participated in the Korean Genome and Epidemiology Study were analyzed. Multiple linear regression analyses were conducted to investigate the short- (1–14 days), medium- (1 and 3 months), and long-term (1 and 2 years) impacts of PM on blood pressure. Logistic regression analyses were conducted to evaluate the medium- and long-term effects of PM on blood pressure elevation after adjusting for sex, age, body mass index, health-related lifestyle behaviors, and geographic areas.

Results

Using multiple linear regression analyses, both crude and adjusted models generated positive estimates, indicating an association with increased blood pressure, with all results being statistically significant, with the exception of PM levels over the long-term period (1 and 2 years) in non-hypertensive participants. In the logistic regression analyses on non-hypertensive participants, moderate PM10 (particulate matter with diameters < 10 μm) and PM2.5 (particulate matter with diameters < 2.5 μm) levels over the long-term period and all high PM10 and PM2.5 levels were statistically significant after adjusting for various covariates. Notably, high PM2.5 levels of the 1 year exhibited the highest odds ratio of 1.23 (95% confidence interval: 1.19–1.28) after adjustment.

Conclusions

These findings suggest that both short- and long-term exposure to PM is associated with blood pressure elevation.

대기 중 미세먼지 농도와 고혈압과의 연관성: 한국인유전체역학조사사업 자료를 기반으로
목적
환경보건에서 대기 중 미세먼지 농도의 중요성이 갈수록 커지고 있으나 아직 미세먼지 농도와 고혈압과의 연관성에 대한 연구 결과가 충분하지 못하여 확실한 결론을 내리기 어려운 상황에 처해있다. 본 연구는 대기 중 미세먼지 노출과 혈압 상승의 상관관계를 밝히는 데에 목적을 두고 있다.
방법
본 연구는 질병관리청 국립보건연구원에서 담당하고 있는 한국인유전체역학조사사업 코호트와 대기오염 모니터링 자료가 연계된 데이터에서 추출한 133,935 명을 대상으로 하였다. 다중선형 회귀분석과 로지스틱 회귀분석을 수행하여 대기 중 미세먼지 농도와 혈압 수준과의 상관관계를 평가하였다.
결과
다중선형 회귀분석에서는 성별, 나이 등과 같은 공변수들을 보정하기 전과 후 모두 통계적으로 유의하게 미세먼지 농도가 증가할수록, 혈압이 상승하였다. 로지스틱 회귀분석에서 고혈압의 오즈비(odds ratio; OR)는 높은 대기 중 미세먼지 농도에 노출된 참여자들에서 통계적으로 유의하게 증가한 반면, 중등도의 미세먼지 농도에 노출된 참여자들에서는 노출기간에 따라 결과가 달라지는 양상을 보였다.
결론
본 연구의 결과는 대기 중 미세먼지 노출이 고혈압 위험도 증가와 관련될 수 있음을 시사한다.
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Environment-wide association study of elevated liver enzymes: results from the Korean National Environmental Health Survey 2018–2022
Youngchan Chi, Jong-Tae Park, Sewhan Na, Kyeongmin Kwak
Ann Occup Environ Med 2023;35:e27.   Published online July 31, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e27
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background

Environmental exposure is characterized by low concentration, chronic, and complex exposure. Traditional epidemiological studies show limitations in reflecting these characteristics since they usually focus on a single or very limited number of exposure factors at a time. In this study, we adopted the methodology of environment-wide association study (EWAS) to figure out the association of human liver function with various environmentally hazardous substances.

Methods

We analyzed 2,961 participants from the Korean National Environmental Health Survey Cycle 4 (2018–2020). Using generalized linear model (GLM) analysis, we analyzed the association of 72 variables with 3 liver function indices (aspartate aminotransferase [AST], alanine aminotransferase [ALT], and gamma glutamyl transferase [GGT]). Finally, we visualized our results with Manhattan plot.

Results

In GLM analysis, perfluorooctanesulfonate were positively associated with ALT (odds ratio [OR]: 2.2; 95% confidence interval [CI]: 1.39–3.46; p adjusted = 0.0147) and perfluorodecanoic acid showed positive association with GGT (OR: 2.73; 95% CI: 1.36–5.5; p adjusted = 0.0256). Plasma mercury showed positive association with GGT (OR: 1.45; 95% CI: 1.14–1.84; p adjusted = 0.0315). Using a plastic container while keeping food in the refrigerator was associated with elevated GGT compared to using a glass container (OR: 1.51; 95% CI: 1.16–1.95; p adjusted = 0.0153). 2-ethyl-5-oxohexyl phthalate, showed a negative trend with all 3 indices, with AST (OR: 0.54; 95% CI: 0.39–0.73; p adjusted = 0.00357), ALT (OR: 0.5; 95% CI: 0.34–0.75; p adjusted = 0.036), GGT (OR: 0.55; 95% CI: 0.4–0.76; p adjusted = 0.00697). Bisphenol S and frequent use of sunblock cream showed negative association with ALT (OR: 0.77; 95% CI: 0.66–0.89), and GGT (OR: 0.25; 95% CI: 0.11–0.55), respectively.

Conclusions

We conducted an exploratory study on environmental exposure and human liver function. By using EWAS methodology, we identified 7 factors that could have potential association with liver function.


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Association between physical hazardous agent exposure and mental health in the Korean working population: the 5th Korean Working Conditions Survey
Daeil Kwon, Kyeongmin Kwak, Kiook Baek, Youngchan Chi, Sewhan Na, Jong-Tae Park
Ann Occup Environ Med 2021;33:e33.   Published online November 8, 2021
DOI: https://doi.org/10.35371/aoem.2021.33.e33
AbstractAbstract AbstractAbstract in Korean PDFSupplementary MaterialPubReaderePub
Background

Mental health problems are emerging issues in occupational safety and health, whereas the findings on the relationship between physical hazards and mental health are not consistent. The aim of our study was to investigate the association between physical hazard exposure and mental health outcomes including depression and anxiety.

Methods

We included 48,476 participants from the fifth Korean Working Conditions Survey (KWCS) in this study. The χ2 test and logistic regression analyses were conducted to assess the association between physical hazard exposures and mental health. All statistical analyses were performed sex-specifically.

Results

In logistic regression analysis, the odds ratios (ORs) of depression were significantly increased in male workers who were exposed to vibration (severe OR: 1.54, 95% confidence interval [CI]: 1.21–1.95) and noise (severe OR: 1.93, 95% CI: 1.49–2.48) whereas the ORs of depression were not significant in female workers from vibration (severe OR: 0.86, 95% CI: 0.50–1.38) or noise exposure (severe OR: 1.39, 95% CI: 0.84–2.17). The ORs of anxiety were significantly increased in male workers with vibration (severe OR: 1.76, 95% CI: 1.43–2.15) and noise exposure (severe OR: 2.12, 95% CI: 1.69–2.63) whereas the OR between vibration and anxiety (severe OR: 1.45, 95% CI: 0.91–2.21) was not significant in female workers. High or low temperature exposure had significant associations with depression and anxiety in both male and female subjects.

Conclusions

Results of our study suggest that physical hazard exposures may be associated with increased risk of mental health problems including depression and anxiety. These associations are more prominent in male workers in comparison with female workers.

한국 노동인구에서 물리적 위험요인 노출과 정신건강의 연관: 제5차 근로환경조사 자료
목적
산업보건에서 정신건강 문제가 새롭게 대두되고 있으나 물리적 위험요인과 정신건강의 관련성에 대한 일치된 결과는 없었다. 본 연구는 물리적 위험요인 노출과 우울 및 불안의 상관관계를 밝히는 데에 목적을 두고 있다.
방법
본 연구는 제5차 근로환경조사에서 추출한 48,476명을 대상으로 수행하였다. 카이제곱 검정과 로지스틱 회귀분석을 수행하여 물리적 유해인자 노출과 정신건강의 상관관계를 평가하였다. 모든 통계 분석은 성별에 따라 각각 이루어졌다.
결과
로지스틱 회귀분석에서 우울의 오즈비(odds ratio; OR)는 진동(심한 노출 OR: 1.54, 95% 신뢰구간 [confidence interval; CI]: 1.21, 1.95) 및 소음(심한 노출 OR: 1.93, 95% CI: 1.49, 2.48) 노출이 있는 남성 근로자에서 통계적으로 유의하게 증가한 반면 여성 근로자에서는 진동(심한 노출 OR: 0.86, 95% CI: 0.50, 1.38) 및 소음(심한 노출 OR: 1.39, 95% CI: 0.84, 2.17) 모두 통계적 유의성이 나타나지 않았다. 불안의 오즈비는 남성 근로자에서 진동(심한 노출 OR: 1.76, 95% CI: 1.43, 2.15) 및 소음(심한 노출 OR: 2.12, 95% CI: 1.69, 2.63)이 있는 경우 통계적으로 유의한 상승을 보였으나 여성 근로자에서 진동과 불안 간의 오즈비(심한 노출 OR: 1.45, 95% CI: 0.91, 2.21)는 유의하지 않았다. 고온 및 저온 노출의 경우 남녀 모두에서 우울, 불안과 유의한 상관관계가 확인되었다.
결론
본 연구의 결과는 물리적 유해인자 노출이 우울, 불안 등의 정신건강 문제 위험의 증가와 관련이 될 수 있음을 시사한다. 이러한 관계는 여성 근로자보다 남성 근로자에서 더 두드러지게 나타났다.

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Research Articles
Association of phthalates and early menarche in Korean adolescent girls from Korean National Environmental Health Survey (KoNEHS) 2015–2017
One Park, Jong-Tae Park, Youngchan Chi, Kyeongmin Kwak
Ann Occup Environ Med 2021;33:e4.   Published online February 1, 2021
DOI: https://doi.org/10.35371/aoem.2021.33.e4
AbstractAbstract PDFPubReaderePub
Background

Phthalates are one of renowned endocrine-disrupting chemicals, although inconsistent results are present around their effect on onset of menarche. Our hypothesis is that pre-pubertal exposure to phthalates is associated with acceleration of menarche.

Methods

We analyzed a total of 236 middle school (7th to 9th grade) girls from Korean National Environmental Health Survey 20152017. We used multiple linear regression to investigate impact of eight phthalate metabolites on age of menarche. We also conducted logistic regression to evaluate association between phthalate metabolite concentrations and early onset of menarche, adjusting for grade, maternal age of menarche and body mass index (BMI).

Results

In linear regression analysis, no significant association was found for any phthalate metabolites. In logistic regression analysis, however, odds ratios (ORs) of early menarche were significantly increased for mono-n-butyl phthalate (MnBP) and for sum of all phthalates. When compared to group with the lowest level, high concentration group for MnBP presented significantly increased odds of early menarche (OR: 2.09; 95% confidence interval [CI]: 1.03, 4.23) after adjusting for grade, maternal age of menarche and BMI. Furthermore, high concentrations of sum of all phthalates were associated with significant increase of OR of early menarche (OR: 2.22; 95% CI: 1.10, 4.49) after adjustment, compared to the lowest concentration group.

Conclusions

Results of our study suggest that exposure to phthalates around puberty may be associated with increased risk of early menarche.


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    The European Journal of Contraception & Reproductive Health Care.2024; : 1.     CrossRef
  • PFAS and Phthalate/DINCH Exposure in Association with Age at Menarche in Teenagers of the HBM4EU Aligned Studies
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  • Persistent high exposure to exogenous phthalates and endogenous sex hormones associated with early pubertal onset among children: A 3.5-year longitudinal cohort study in China
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Association between use of humidifier disinfectant and allergic rhinitis in Korean children: a cross-sectional study based on the eighth Panel Study on Korean Children (PSKC)
Tae Hwan Koh, Jong-Tae Park, Daeil Kwon, Kyeongmin Kwak
Ann Occup Environ Med 2020;32:e9.   Published online February 17, 2020
DOI: https://doi.org/10.35371/aoem.2020.32.e9
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background

Rhinitis was the most frequently diagnosed disorder among users of humidifier disinfectants (HDs). The aim of our study was to investigate on the relationship between allergic rhinitis (AR) and HD uses.

Methods

Our study used the data from the eighth Panel Study on Korean Children; a total of 1,540 participants were enrolled. The χ2 test and multiple logistic regression analyses were conducted to debunk the association between AR and HD uses.

Results

In our analysis, odds ratios (ORs) of doctor-diagnosed AR increased significantly when simply the response of whether HDs were used in the past was considered. When the brands of HD were considered, ORs of doctor-diagnosed AR were found to be increased significantly for those who have used polyhexamethylene guanidine phosphate/oligo(2-[2-ethoxy]-ethoxyethyl)guanidinium-containing HDs (model 3: 1.41, 95% confidence interval [CI]: 1.02–1.95). However, once duration of usage was additionally considered, ORs of doctor-diagnosed AR increased significantly only for those who have used chloromethylisothiazolinone/methylisothiazolinone-containing HDs for more than or equal to 3 months (model 3: 2.08, 95% CI: 1.17–3.69). Further, past use of HD was associated with significantly increased ORs of AR diagnosed before 2013 (model 3: 1.35, 95% CI: 1.02–1.79).

Conclusions

Results of our study suggest that past uses of HDs may be associated with an increased risk of AR.


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Association between depression and cardiovascular disease risk in general population of Korea: results from the Korea National Health and Nutrition Examination Survey, 2016
Jinho Song, Tae Hwan Koh, One Park, Daeil Kwon, Seonghoon Kang, Kyeongmin Kwak, Jong-Tae Park
Ann Occup Environ Med 2019;31:e10.   Published online June 20, 2019
DOI: https://doi.org/10.35371/aoem.2019.31.e10
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background

Depression is considered as a risk factor for cardiovascular disease (CVD) and associated with changes in individuals' health status that might influence CVD risk. However, most studies have scrutinized this relationship on a rather narrower and specific study population. By focusing on general population of Korea, we sought to inspect the association of depression with CVD risk and cardiovascular risk factors.

Methods

The data from the first year (2016) of the 7th Korea National Health and Nutrition Examination Survey was used. Participants were classified by the Patient Health Questionnaire-9 (PHQ-9) score as such: normal group (PHQ-9 score 0–4), mild depression (MD) group (PHQ-9 score 5–9) and moderate and severe depression (MSD) group (PHQ-9 score 10–27). General linear model was used to analyze differences and the trend of mean CVD risk according to depression level. Adjusted odds ratios (AORs) were calculated by logistic regression to identify the association between depression and cardiovascular risk factors after adjusting for age.

Results

Mean CVD risk of MSD group was higher than that of normal group (p < 0.05). There was a tendency of CVD risk to increase as depression worsened (p < 0.01). Among men, MSD group was associated with current smoking (AOR, 2.97; 95% confidence interval [CI], 1.78–4.97), taking antihypertensive medications (AOR, 2.42; 95% CI, 1.26–4.66), increased fasting blood sugar (> 125 mg/dL; AOR, 2.37; 95% CI, 1.25–4.50) and taking diabetes medications (AOR, 3.08; 95% CI, 1.65–5.72). MD group was associated with current smoking (AOR, 1.60; 95% CI, 1.18–2.17). Among women, MSD group was associated with high body mass index (≥ 25 kg/m2; AOR, 1.61; 95% CI, 1.11–2.32), large waist circumference (≥ 85 cm; AOR, 1.63; 95% CI, 1.12–2.37), current smoking (AOR, 5.11; 95% CI, 3.07–8.52) and taking diabetes medications (AOR, 2.62; 95% CI, 1.68–4.08). MD group was associated with current smoking (AOR, 1.86; 95% CI, 1.18–2.93).

Conclusions

We suggest that depression is associated with increased risk for CVD occurrence in general population of Korea.


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Association between shift work and hyperhomocysteinemia in male workers
Dukyun Kang, Seong-Kyu Kang, Won-Jun Choi, Sang Ha Lee, Jun-Hyung Lee, Kyeongmin Kwak
Ann Occup Environ Med 2019;31:e1.   Published online May 1, 2019
DOI: https://doi.org/10.35371/aoem.2019.31.e1
AbstractAbstract PDFPubReaderePub
Background

Shift work is associated with a higher risk of cardiovascular diseases. Here, we sought to assess the relationship between shift work and plasma homocysteine levels. Determining the correlations between shift work and homocysteine levels may provide a better understanding of the mechanisms underlying cardiovascular diseases.

Methods

This study was performed using data from routine health examinations of steel workers in 2017. In total, 431 male workers (70 daytime workers and 361 shift workers) employed on a rolling departure schedule were recruited. Plasma homocysteine levels > 15 μmol/L were considered elevated. The χ2, analysis of variance, and multiple logistic regression analyses were used to examine the association between shift work and plasma homocysteine levels.

Results

In comparison to daytime workers, the odds ratio (OR) of hyperhomocysteinemia in individuals with < 10 years of shift work was 1.14 (95% confidence interval [CI]: 0.64–2.03), compared to 2.01 (95% CI: 1.14–3.54) for workers with ≥ 10 years of experience. After adjusting for confounding variables, the adjusted OR for shift workers with < 10 years of experience was 0.95 (95% CI: 0.50–1.80), compared to 2.00 (95% CI: 1.07–3.74) for workers with ≥ 10 years of experience.

Conclusions

The risk of hyperhomocysteinemia was significantly higher in shift workers compared to those working normal daytime hours, particularly among long-term shift workers.


Citations

Citations to this article as recorded by  
  • Shift work is significantly and positively associated with dementia: A meta-analysis study
    Kuo-Wei Lee, Chen-Cheng Yang, Chun-Hung Chen, Chih-Hsing Hung, Hung-Yi Chuang
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • Association between shift work and serum homocysteine level in female electronic manufacturing services workers
    Jae Won Lim, Chan Woo Kim, Hyoung Ouk Park, Eui Yup Chung, Changho Chae, JunSeok Son, Young Hoo Shin, Seung Hyun Park, Sang Moon Choi
    Annals of Occupational and Environmental Medicine.2023;[Epub]     CrossRef
  • Consequences of Shift Work and Night Work: A Literature Review
    Isabel Silva, Daniela Costa
    Healthcare.2023; 11(10): 1410.     CrossRef
  • Different exposure metrics of rotating night shift work and hyperhomocysteinaemia among Chinese steelworkers: a cross-sectional study
    Shengkui Zhang, Yongbin Wang, Qinglin Li, Zhende Wang, Han Wang, Chao Xue, Ying Zhu, Weijun Guan, Juxiang Yuan
    BMJ Open.2020; 10(12): e041576.     CrossRef
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