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Original Article Association between seafood consumption and urinary bisphenol concentrations in Korean adults: findings from the Korean National Environmental Health Survey (KoNEHS 2018–2020)
Seong-Ho Moon1orcid, Kwang Hee Jo1orcid, Soonsu Shin1orcid, Jae-Hong Ryoo1,2,*orcid
Annals of Occupational and Environmental Medicine [Epub ahead of print]
DOI: https://doi.org/10.35371/aoem.2026.38.e40
Published online: September 1, 2026

1Department of Occupational and Environmental Medicine, Kyung Hee University Hospital, Seoul, Korea

2Department of Occupational and Environmental Medicine, Kyung Hee University School of Medicine, Seoul, Korea

*Corresponding author Jae-Hong Ryoo Department of Occupational and Environmental Medicine, Kyung Hee University School of Medicine, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea E-mail: armani131@naver.com
• Received: March 30, 2026   • Revised: August 18, 2026   • Accepted: August 18, 2026

© 2026 Korean Society of Occupational & Environmental Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Background
    This study aimed to examine exploratory cross-sectional associations between seafood-consumption frequency and spot urinary concentrations of bisphenol A (BPA), bisphenol F (BPF), and bisphenol S (BPS) in Korean adults and to present descriptive sex-stratified estimates.
  • Methods
    Seafood-consumption frequency was assessed using a semi-quantitative food frequency questionnaire, whereas BPA, BPF, and BPS were measured in a single spot urine sample and dilution-adjusted using covariate-adjusted standardization. We analyzed 4,201 adults from the Korean National Environmental Health Survey 2018–2020. Seafood consumption (six groups) was classified as rarely, ≤once/week, or >once/week. Sex-stratified survey-weighted logistic regression estimated odds ratios (OR) and 95% confidence intervals (CI) for high exposure (≥75th percentile), adjusting for sociodemographic factors, health behaviours, and food-contact behaviours. Sensitivity analyses used survey-weighted linear regression with ln-transformed concentrations.
  • Results
    Median urinary concentrations were higher in men than in women for all three bisphenols. In men, seaweed consumption >once/week was associated with higher odds of high BPA exposure (OR: 2.34; 95% CI: 1.18–4.63), whereas crustacean consumption >once/week was associated with lower odds of high BPA exposure (OR: 0.27; 95% CI: 0.10–0.75). In women, large fish/tuna consumption >once/week (OR: 1.76; 95% CI: 1.00–3.20) and crustacean consumption >once/week (OR: 2.20; 95% CI: 1.09–4.43) were associated with higher odds of high BPA exposure.
  • Conclusions
    Seafood-frequency categories showed associations with spot urinary concentrations of BPA, BPF, and BPS. These cross-sectional findings do not establish a causal relationship or a specific exposure pathway. Longitudinal studies with repeated urinary measurements and more detailed assessment of seafood products, processing, and food-contact materials are needed to clarify these associations.
  • Keywords: Bisphenol A; Bisphenol F; Bisphenol S; Seafood; KoNEHS
Bisphenol A (BPA) is a high-production volume chemical widely utilised in manufacturing polycarbonate plastics and epoxy resins. Since its initial commercial application, BPA has become ubiquitous in modern society and is found in diverse consumer products ranging from food packaging and water pipes to thermal paper and dental sealants.1-4 BPA is an endocrine-disrupting chemical capable of binding oestrogen, androgen, and thyroid receptors. Epidemiological studies have linked BPA exposure to altered reproductive and thyroid hormone levels,5 experimental studies have demonstrated embryotoxic and teratogenic effects,6 and reviews have summarised associations with metabolic disease and developmental outcomes;7 these lines of evidence differ in strength and design and are described as associations rather than established causal effects.
Owing to these concerns, regulatory agencies have implemented restrictions on BPA use. In Korea, the Ministry of Food and Drug Safety tightened regulations and banned the use of BPA in infant feeding bottles, nipples, and specific food packaging materials in 2019.8 More broadly, bisphenol F (BPF) and bisphenol S (BPS) have been used as structural alternatives to BPA, and population biomonitoring studies have documented exposure to these analogues.9,10 These alternatives are increasingly used in “BPA-free” products. Although their relative potency varies according to the assay system, receptor, endpoint, dose range, and exposure context, some in vitro and in vivo studies have reported that BPF and BPS exhibit endocrine-disrupting activities comparable to, or for certain endpoints greater than, those of BPA.9-11
Dietary consumption is the primary route of human exposure to bisphenols, usually through migration from food-contact materials such as canned food linings and plastic containers.12-14 Seafood has been proposed as a potential but incompletely characterised dietary source of bisphenol exposure. Bisphenols can enter aquatic environments through sewage effluents, landfill leachates, and release from plastic materials.15-17 Experimental and environmental studies indicate that aquatic organisms may be exposed to these chemicals, although the extent of uptake, persistence, and transfer varies according to the compound, species, and environmental conditions.18,19 Plastic particles and bisphenol chemicals represent distinct exposure entities. Microplastic formation is a physical fragmentation process, whereas the release of BPA, BPF, or BPS is a chemical process that depends on material composition, residual monomers or additives, and environmental conditions.17 The occurrence or ingestion of microplastics does not by itself demonstrate the release, bioavailability, or human absorption of bisphenols. Given that seafood is a staple component of the Korean diet, seafood has been considered a potential context for studying dietary bisphenol exposure, although direct transfer from seafood consumption to human urinary concentrations has not been established. Urine sampling remains the standard matrix for biological monitoring because these non-persistent chemicals are rapidly metabolised and excreted.19,20
Although previous Korean surveillance examined seafood consumption in relation to BPA, evidence simultaneously evaluating BPA, BPF, and BPS remains limited.21 Therefore, this study investigated the association between seafood consumption patterns and urinary concentrations of BPA, BPF, and BPS in the general Korean adult population using representative data from the Korean National Environmental Health Survey (KoNEHS) Cycle 4 (2018–2020).
Study population
This study utilised data from KoNEHS cycle 4 (2018–2020), a nationally representative biomonitoring survey conducted by the National Institute of Environmental Research under the Ministry of Environment to assess human exposure to environmental pollutants and identify associated risk factors in the general Korean population. The survey used a stratified multistage cluster sampling design based on the 2015 Population and Housing Census.
Of 4,239 adults, 38 were excluded for missing urinary bisphenol concentration (n = 2) or missing essential covariates (defined as age, sex, body mass index [BMI], education, household income, marital status, and the health-behaviour and food-contact behaviours used in the models) (n = 36), leaving 4,201 participants (1,874 men and 2,327 women).
Determination of urinary bisphenols
Urinary BPA, BPF, and BPS were measured at the National Institute of Environmental Research Central Laboratory. Urine samples were collected in sterile cups, protected from light, transported under refrigerated conditions, and stored at −70°C until analysis. Following liquid–liquid extraction, analytes were quantified using high-performance liquid chromatography–tandem mass spectrometry (AB Sciex API Triple Quad 5500, AB Sciex, Framingham, MA, USA). Standard curves showed excellent linearity (R2 ≥ 0.995). The method detection limits were 0.029 μg/L for BPA, 0.036 μg/L for BPF, and 0.022 μg/L for BPS, with recoveries ranging from 85% to 115%.
Concentrations below the method detection limit (MDL) were replaced with the MDL divided by the square root of two. Detection frequencies and the percentages of samples below the MDL for BPA, BPF, and BPS are reported in Supplementary Table 1. Detailed laboratory quality assurance and quality control, sample handling, and biomarker-processing procedures followed the official KoNEHS laboratory protocols described by the National Institute of Environmental Research.22,23 To account for urinary dilution, we applied the covariate-adjusted standardization (CAS) method proposed by O’Brien et al.24
Natural-log-transformed urinary creatinine (g/L) was modelled in the overall analytical sample using survey-weighted linear regression incorporating the KoNEHS survey weights, strata, and cluster variables and the covariates such as age, sex (coded as 0 for men and 1 for women), and BMI. Second, a specific ratio was calculated for each urine sample by dividing the measured Cr level by the predicted Cr level.
Ratio = Measured Cr/Predicted Cr 
This ratio was used to adjust the urinary concentrations of bisphenols (BPA, BPF, and BPS) by dividing the measured concentration by the ratio.
CAS−Urinaryconcentrationµg/L = Measuredbisphenolconcentration/Ratio
The regression coefficients and detailed CAS implementation are provided in Supplementary Table 2.
Assessment of dietary and lifestyle factors
Dietary habits were assessed using a semi-quantitative food frequency questionnaire. Seafood consumption was categorized into six groups: (1) large fish/tuna (e.g., tuna, shark), (2) fish (e.g., mackerel, hairtail, croaker), (3) crustaceans (e.g., crab, shrimp), (4) seaweed (e.g., laver/gim, kelp, wakame), (5) shellfish (e.g., clams, mussels), and (6) other seafood items (e.g., squid, octopus). Each seafood item was originally recorded on a nine-level frequency scale ranging from “rarely/almost never” to “three times a day”. To ensure adequate numbers within strata for survey-weighted analysis, responses were collapsed a priori into three categories (“rarely”, “≤once a week”, and “>once a week”). The questionnaire captured consumption frequency only (Supplementary Table 3).
To account for food-contact behaviors, participants also reported frequency of using rigid clear plastic containers for hot foods, consuming takeaway foods wrapped in plastic films, and consuming canned foods. These variables were categorized as “rarely”, “≤once a week,” and “>once a week.” Participants reported their average frequency of seafood consumption and three food-contact behaviors: using rigid clear plastic containers for hot foods, consuming plastic-wrapped takeaway foods, and consuming canned foods.
Covariates
Sociodemographic and health-related variables were obtained by face-to-face interview. Age was analysed as a continuous variable. BMI was calculated as weight divided by height squared (kg/m²). Education level was categorized as no formal education, ≤high school, and ≥college. Marital status was classified as single, married/cohabiting, and others (divorced or separated). Household income was divided into <1 million KRW, 1–3 million KRW, 3–5 million KRW, and ≥5 million KRW per month. Health behaviors included alcohol consumption (yes/no), physical activity (regular vs. none), and smoking status (none or ex-smoker vs. current smoker).
Statistical analysis
All analyses incorporated the complex sampling design and survey weights of KoNEHS. Baseline characteristics were described as weighted means with standard errors for continuous variables and weighted frequencies with percentages for categorical variables. Differences between men and women were evaluated using survey-weighted linear regression and the Rao-Scott χ² test.
High exposure was defined a priori as a urinary concentration at or above the sex-specific 75th percentile, computed separately within men and within women for BPA, BPF, and BPS. This threshold was used as a pragmatic, exploratory means of identifying a relatively highly exposed subgroup. The sex-specific cutpoint values are reported in Supplementary Table 4. The analyses estimated exploratory associations between reported seafood-frequency categories and one-time bisphenol concentrations. Survey-weighted multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between seafood consumption and high exposure (≥75th percentile). Model 1 adjusted for age, BMI, education level, marital status, household income, alcohol consumption, physical activity, and smoking. Model 2 further adjusted for use of rigid clear plastic containers for hot foods, consumption of takeaway foods wrapped in plastic films, and consumption of canned foods.
As a sensitivity analysis, sex-stratified survey-weighted linear regression was performed using natural-log-transformed CAS-urinary BPA, BPF, and BPS concentrations as continuous outcomes. Seafood-consumption frequency was modelled categorically using indicator variables, with “rarely” as the reference category and separate coefficients estimated for “≤once/week” and “>once/week”. The analyses used the same analytical sample and fully adjusted covariate set as model 2. All analyses were conducted using SAS version 9.4 (SAS Institute Inc., Cary, NC, USA), and p < 0.05 was considered statistically significant.
Ethics statement
The KoNEHS Cycle 4 (2018–2020) was approved by the Institutional Review Board of the National Institute of Environmental Research, Korea (IRB no. NIER-2018-BR-003-02), and written informed consent was obtained from all participants prior to participation in the survey. The present study was conducted using fully anonymized, publicly available data, and ethical approval and the requirement for additional informed consent were waived by the Institutional Review Board of Kyung Hee University Hospital (IRB no. KHUH 2023-05-068).
Data availability statement
The data analyzed in this study are available from the KoNEHS, conducted by the National Institute of Environmental Research, subject to reasonable request and approval in accordance with institutional data access policies.
Baseline characteristics of study participants
Table 1 presents the baseline characteristics of the 4,201 participants (1,874 men and 2,327 women). Because urinary bisphenol concentrations were right-skewed, they are presented as medians and interquartile ranges, with geometric means and 95% CIs provided in Supplementary Table 1. Median urinary concentrations were significantly higher in men than in women for all three bisphenols: BPA, 1.31 vs. 0.98 μg/L; BPF, 0.20 vs. 0.15 μg/L; and BPS, 0.17 vs. 0.13 μg/L. Men had higher BMI, education level, and household income than women. Current smoking and alcohol consumption were also more common in men. Regarding seafood consumption, men consumed large fish/tuna more frequently than women, whereas women consumed seaweed more frequently. Seafood-consumption categories were modestly to moderately positively correlated, indicating partly overlapping consumption; category-specific estimates are therefore not fully independent (Supplementary Table 5).
Comparison of characteristics by bisphenol concentrations
Table 2 and Supplementary Tables 6 and 7 compare characteristics between the low- and high-exposure groups for BPA, BPF, and BPS. For BPA, the distributions of rigid clear plastic-container use, consumption of takeaway foods wrapped in plastic films, canned-food consumption, large fish/tuna consumption, and crustacean consumption differed between the low- and high-BPA groups among men. Among women, marital status, household income, and physical activity differed between the two BPA groups.
For BPF, men in the high-exposure group were younger than those in the low-exposure group, whereas age did not differ significantly between the groups in women and BMI did not differ in either sex. Among men, the distributions of rigid clear plastic-container use and large fish/tuna consumption differed between the low- and high-BPF groups. Among women, the distributions of takeaway-food consumption and canned-food consumption differed between the two BPF groups.
For BPS, participants in the high-exposure group were younger and had slightly lower BMI in both sexes. Among men, marital status, crustacean consumption, and seaweed consumption differed between the low- and high-BPS groups. Among women, the distributions of rigid clear plastic-container use and takeaway-food consumption differed between the two groups, whereas no statistically significant differences were observed for the seafood-consumption categories.
Association between seafood consumption and urinary bisphenols
Table 3 presents survey-weighted logistic regression results for men. For BPA, seaweed consumption >once/week was associated with higher odds of high urinary BPA concentration in the fully adjusted model (OR: 2.34; 95% CI: 1.18–4.63). By contrast, consumption of crustaceans showed inverse associations; the OR declined to 0.27 (95% CI: 0.10–0.75) for >once a week. Consumption of large fish/tuna at ≤once a week was also associated with higher odds of high BPA exposure (OR: 1.41; 95% CI: 1.04–1.92).
For BPF in men, consumption of fish was associated with higher odds of high exposure, particularly at ≤once a week (OR: 1.88; 95% CI: 1.05–3.36), and consumption of large fish/tuna at ≤once a week was likewise associated with increased odds (OR: 1.45; 95% CI: 1.01–2.08). For BPS, associations were mainly observed at ≤once a week: crustaceans (OR: 1.68; 95% CI: 1.22–2.30), shellfish (OR: 1.34; 95% CI: 1.01–1.80), and other seafood items (OR: 1.41; 95% CI: 1.05–1.89).
Associations in women were less consistent overall (Table 4). For BPA, large fish/tuna consumption >once/week was associated with higher odds of high exposure (OR: 1.76; 95% CI: 1.00–3.20). Crustacean consumption >once/week was also associated with higher odds of high BPA exposure (OR: 2.20; 95% CI: 1.09–4.43), whereas the ≤once/week category was not associated with high BPA exposure. For BPF, women who consumed other seafood items ≤once a week had higher odds of high exposure (OR: 1.38; 95% CI: 1.04–1.84).
The corrected continuous-outcome analyses showed only partial agreement with the primary logistic models. Among men, seaweed consumption ≤once/week and >once/week, and shellfish consumption >once/week, were positively associated with urinary BPA concentrations. Seaweed consumption ≤once/week was also positively associated with urinary BPS concentrations in men. Among women, seaweed consumption ≤once/week and >once/week was positively associated with urinary BPF concentrations. (Supplementary Tables 8–10).
Urinary bisphenol concentrations and the role of CAS
Using nationally representative KoNEHS data, we observed that seafood-consumption frequency was associated with urinary concentrations of BPA, BPF, and BPS. The associations varied descriptively across seafood categories, compounds, and sex strata and should therefore be interpreted as exploratory rather than as evidence of a confirmed dietary exposure pathway.
Our study extends previous Korean surveillance of seafood consumption and BPA by simultaneously evaluating associations with BPA, BPF, and BPS.21 This broader assessment is relevant because population biomonitoring studies have documented exposure to BPF and BPS alongside BPA.10,25,26 A notable finding was that urinary concentrations of all three bisphenols were higher in men than in women. Sex differences in urinary bisphenol concentrations have varied across biomonitoring studies. A previous Korean KoNEHS study using creatinine-corrected BPA concentrations reported higher concentrations in women, whereas U.S. National Health and Nutrition Examination Survey 2013–2014 reported higher urinary BPA and BPF concentrations in men.10,21 A likely explanation is methodological. Conventional creatinine normalisation can be strongly influenced by muscle mass, BMI, age, and sex, and may underestimate concentrations in men while overestimating them in women.24,27,28 By applying CAS, which models expected creatinine excretion using demographic and anthropometric predictors, we aimed to reduce this source of bias and obtain a more comparable estimate of internal burden across sexes.24 Because no confirmatory contrast was prespecified and multiple seafood–bisphenol comparisons were examined, the nominal associations should be interpreted as hypothesis-generating rather than confirmed findings.
Environmental and food-contact context
Environmental studies have reported bisphenol exposure or detection in aquatic organisms, although uptake, persistence, and transfer differ according to compound, species, and environmental conditions.15-19,29,30 Previous studies have also identified food-contact materials, including canned-food linings and plastic containers, as important sources of dietary bisphenol exposure.12-14,31-36 These findings provide general background context but do not establish the source of the urinary concentrations observed in the present study. Adjustment for general food-contact behaviours did not substantially alter some estimates. However, these variables did not capture seafood-specific product form, processing, preparation, or packaging. The adjusted estimates should therefore not be interpreted as demonstrating that the observed associations were independent of packaging-related exposure.
Environmental and market studies have reported plastic-particle contamination or bisphenol detection in some aquatic organisms and commercial seafood products.29,30,37,38 However, these findings do not demonstrate that consumption of seaweed or large fish/tuna caused the urinary concentrations observed in the present study. We did not assess product-specific contamination, recent intake, processing, preparation, or seafood-specific packaging; therefore, the observed estimates cannot be attributed to a particular environmental or food-contact source.
Findings for BPF and BPS
The simultaneous assessment of BPA, BPF, and BPS allowed exploratory comparison of associations across bisphenol compounds. However, our cross-sectional data cannot demonstrate industrial substitution or product-level “BPA-free” replacement, and the seafood–BPS associations in men should not be interpreted as evidence of such substitution. Nevertheless, these findings are relevant to the broader context of increasing concern regarding BPA analogues. Multi-country and U.S. biomonitoring data indicate diverging temporal trends, with BPA decreasing while BPF and/or BPS exposure has increased, and toxicological and mechanistic literature cautions that “BPA-free” does not equate to risk-free when analogues are widely used.10,11,25,26 Therefore, the key contribution of the present study is that, within a single national survey cycle, we characterised associations for BPA, BPF, and BPS simultaneously. This broader assessment may better reflect contemporary manufacturing and consumption patterns than a BPA-only approach, although the present data cannot identify specific product-level sources of exposure.
Interpretation of sex-stratified findings
Several estimates differed in direction or statistical significance between men and women. However, these differences do not demonstrate effect modification because no formal interaction analysis was performed. The sex-stratified estimates should therefore be interpreted descriptively. Chance arising from multiple comparisons, sparse observations in higher-frequency categories, and exposure misclassification may also have contributed to the observed differences. Therefore, the findings in women should be interpreted as exploratory associations observed mainly in higher consumption categories, rather than as definitive evidence of sex-specific biological mechanisms. Before invoking biological mechanisms, chance from multiple comparisons, unstable estimates from sparse upper-frequency cells, and exposure misclassification should be considered, and the inverse crustacean–BPA association in men should not be interpreted as a protective effect.
For consumption of crustaceans >once/week, the BPA estimates were in opposite directions in men and women. This contrast is descriptive and should not be interpreted as evidence of sex interaction. Product form, processing, consumption context, and seafood-specific packaging were not measured and therefore cannot explain the observed estimates. Previous analyses of Korean seafood consumer behaviour suggest that consumption context, convenience-seeking patterns, and household food purchasing may differ across population subgroups.39 In addition, the growing home meal replacement market may increase the availability and consumption of semi-processed or fully processed seafood products, including crustacean-based products.40 These patterns could influence the degree of contact with food packaging and other food-contact materials.
Therefore, even within the same crustacean category, differences in processing level, product form, and packaging contact may partly contribute to sex-specific exposure patterns. Fresh crustacean intake may involve relatively limited packaging contact, whereas processed, frozen, or packaged crustacean products may involve greater contact with food-contact materials. Because the KoNEHS questionnaire did not distinguish fresh, frozen, processed, canned, restaurant-prepared, or packaged crustacean products, this explanation remains a hypothesis for future studies.
The corrected continuous-outcome analyses did not uniformly reproduce the primary logistic regression findings. Among men, the positive association between seaweed consumption >once/week and BPA was observed in both the logistic and continuous analyses. However, the continuous analysis did not reproduce the positive large fish/tuna association or the inverse crustacean association observed in the BPA logistic models. Shellfish consumption >once/week was positively associated with continuous BPA concentrations despite the absence of a corresponding association in the BPA logistic model. Similarly, the positive continuous associations of seaweed consumption with BPF in women and with BPS in men did not correspond to the principal associations identified in the logistic models. Accordingly, the continuous-outcome analyses should be interpreted as complementary exploratory analyses rather than as confirmation of the dichotomized-outcome findings.
Strengths and limitations
This study has several strengths. It was based on a large, nationally representative biomonitoring survey with complex sampling weights, allowing inference to the Korean adult population. Seafood was separated into multiple categories rather than treated as one aggregate exposure, which reduced exposure dilution across heterogeneous food types. We also incorporated food-contact behaviors into multivariable models, improving interpretation of seafood-specific associations in the context of well-established packaging pathways. This study extends previous Korean research by simultaneously evaluating seafood consumption in relation to urinary BPA, BPF, and BPS in a nationally representative adult population.
Several limitations should also be considered. First, the cross-sectional design precludes causal inference. Secondly, seafood consumption represented broad self-reported average frequency during the preceding year, whereas each bisphenol outcome was based on a single spot urine sample reflecting a much shorter exposure period. Spot urinary BPA concentrations may also vary substantially within and across days.41 This temporal mismatch and within-person variability may have introduced exposure misclassification. Information on serving size, recent intake, detailed seafood species, product form, preparation, and seafood-specific packaging was unavailable. Thirdly, despite adjustment for several sociodemographic, behavioral, and food-contact variables, residual confounding cannot be excluded. Fourthly, the food frequency questionnaire grouped seafood into broad categories, and we lacked detailed information on species, wild versus farmed origin, processing level, specific cooking methods, and packaging materials for each item. As a result, mechanistic interpretation remains limited. Finally, the study assessed internal exposure rather than clinical endpoints, and some nominal associations may reflect chance because of the large number of comparisons. These exploratory findings do not establish specific exposure pathways or health effects and require confirmation in longitudinal studies with repeated biomarker measurements and in other populations.
Despite these limitations, the nationally representative design and simultaneous assessment of BPA, BPF, and BPS provide useful exploratory evidence to inform future research.
This analysis of KoNEHS 2018–2020 data suggests that selected seafood-consumption categories are associated with urinary concentrations of BPA and its analogues, BPF and BPS, in Korean adults. The observed associations varied across seafood categories, compounds, and sex strata. These sex-stratified differences are descriptive and should not be interpreted as evidence of effect modification. Longitudinal studies with repeated urinary measurements and detailed information on recent seafood intake, product form, processing, preparation, and packaging are needed to clarify these associations.

BMI

body mass index

BPA

bisphenol A

BPF

bisphenol F

BPS

bisphenol S

CAS

covariate-adjusted standardization

CI

confidence interval

KoNEHS

Korean National Environmental Health Survey

MDL

method detection limit

OR

odds ratio

Funding

This study was supported by a grant from the National Bio Big Data Project, funded by four ministries (Ministry of Health and Welfare, Ministry of Science and ICT, Ministry of Trade, Industry and Energy, and Korea Disease Control and Prevention Agency) of Korea (RS-2024-00509118). The funding organization had no role in the design or performance of this study.

Competing interests

The authors declare that they have no competing interests.

Author contributions

Conceptualization: Moon SH. Methodology: Moon SH, Jo KH, Ryoo JH. Formal analysis: Moon SH, Shin S. Data curation: Ryoo JH. Visualization: Moon SH. Funding acquisition: Ryoo JH. Supervision: Ryoo JH. Writing - original draft: Moon SH, Shin S, Jo KH, Ryoo JH. Writing - review & editing: Moon SH, Shin S, Jo KH, Ryoo JH.

Acknowledgments

This study used Korean National Environmental Health Survey Cycle 4 (2018-2020) data, made by the National Institute of Environmental Research (NIER-2018-01-01-001).

Supplementary Table 1.
Detection frequencies, proportion below the MDL, and geometric means.
aoem-2026-38-e40_Supplementary-Table-1.pdf
Supplementary Table 2.
Covariate-adjusted standardization creatinine prediction model.
aoem-2026-38-e40_Supplementary-Table-2.pdf
Supplementary Table 3.
Original KoNEHS food frequency questionnaire seafood items and recoding scheme.
aoem-2026-38-e40_Supplementary-Table-3.pdf
Supplementary Table 4.
Sex-specific 75th-percentile cutpoints used to define high urinary exposure.
aoem-2026-38-e40_Supplementary-Table-4.pdf
Supplementary Table 5.
Spearman correlations among seafood-consumption categories.
aoem-2026-38-e40_Supplementary-Table-5.pdf
Supplementary Table 6.
Comparison of baseline characteristics of the participants according to urinary concentration of BPF.
aoem-2026-38-e40_Supplementary-Table-6.pdf
Supplementary Table 7.
Comparison of baseline characteristics of the participants according to urinary concentration of BPS.
aoem-2026-38-e40_Supplementary-Table-7.pdf
Supplementary Table 8.
Sex-stratified survey-weighted linear regression of ln-transformed CAS-urinary BPA concentrations according to seafood-consumption frequency.
aoem-2026-38-e40_Supplementary-Table-8.pdf
Supplementary Table 9.
Sex-stratified survey-weighted linear regression of ln-transformed CAS-urinary BPF concentrations according to seafood-consumption frequency.
aoem-2026-38-e40_Supplementary-Table-9.pdf
Supplementary Table 10.
Sex-stratified survey-weighted linear regression of ln-transformed CAS-urinary BPS concentrations according to seafood-consumption frequency.
aoem-2026-38-e40_Supplementary-Table-10.pdf
Table 1.
Comparison of baseline characteristics of participants
Characteristic Total (n = 4,201) Men (n = 1,874) Women (n = 2,327) p-value
Urinary BPA (μg/L) 1.13 (0.51–2.18) 1.31 (0.63–2.47) 0.98 (0.44–1.87) <0.001
Urinary BPF (μg/L) 0.17 (0.06–0.43) 0.20 (0.07–0.50) 0.15 (0.06–0.38) <0.001
Urinary BPS (μg/L) 0.15 (0.07–0.38) 0.17 (0.08–0.42) 0.13 (0.06–0.32) <0.001
Age (years) 47.59 ± 0.71 46.61 ± 0.76 48.56 ± 0.83 <0.001
BMI (kg/m2) 24.75 ± 0.10 25.40 ± 0.12 24.10 ± 0.13 <0.001
Education <0.001
 No formal education 56 (1.3) 11 (0.7) 45 (1.7)
 ≤High school 2316 (55.1) 972 (43.0) 1,344 (51.3)
 ≥College 1829 (43.6) 891 (56.3) 938 (47.0)
Marital status <0.001
 Single 579 (23.1) 298 (26.8) 281 (19.5)
 Married, cohabiting 3,127 (67.0) 1,441 (67.8) 1,686 (66.3)
 Others (divorce, separation) 495 (9.9) 135 (5.4) 360 (14.2)
Household income (million KRW)a <0.001
 <1 590 (10.8) 243 (8.8) 347 (12.8)
 1–3 1,340 (29.8) 594 (28.9) 746 (30.7)
 3–5 1,136 (29.5) 530 (32.0) 606 (27.0)
 ≥5 1,135 (29.9) 507 (30.3) 628 (29.5)
Alcohol consumption <0.001
 No 837 (17.8) 189 (9.2) 648 (26.4)
 Yes 3,364 (82.2) 1,685 (90.8) 1,679 (73.6)
Physical activity 0.093
 None 2,123 (51.3) 909 (49.6) 1,214 (53.0)
 Regular 2,078 (48.7) 965 (50.4) 1,113 (47.0)
Smoking <0.001
 None or ex 3,516 (81.3) 1,257 (65.6) 2,259 (96.8)
 Current 685 (18.7) 617 (34.4) 68 (3.2)
Use of rigid clear plastic containers for hot foods 0.872
 Rarely 3,306 (76.8) 1,482 (76.9) 1,824 (76.8)
 ≤Once a week 509 (12.6) 219 (12.3) 290 (12.8)
 >Once a week 386 (10.6) 173 (10.8) 213 (10.4)
Consumption of takeaway foods wrapped in plastic films 0.002
 Rarely 2,428 (51.2) 1,046 (48.3) 1,382 (54.1)
 ≤Once a week 1,530 (40.8) 702 (42.0) 828 (39.5)
 >Once a week 243 (8.0) 126 (9.7) 117 (6.4)
Consumption of canned food <0.001
 Rarely 1,769 (35.6) 729 (31.1) 1,040 (39.9)
 ≤Once a week 1,912 (48.6) 845 (47.9) 1,067 (49.4)
 >Once a week 520 (15.8) 300 (20.9) 220 (10.7)
Consumption of large fish/tuna 0.003
 Rarely 2,478 (55.0) 1,067 (52.3) 1,411 (57.7)
 ≤Once a week 1,577 (40.9) 728 (42.6) 849 (39.2)
 >Once a week 146 (4.1) 79 (5.1) 67 (3.1)
Consumption of fish 0.226
 Rarely 413 (11.1) 176 (11.3) 237 (11.0)
 ≤Once a week 2,787 (66.8) 1,237 (65.1) 1,550 (68.3)
 >Once a week 1,001 (22.1) 461 (23.6) 540 (20.7)
Consumption of crustaceans 0.306
 Rarely 2,150 (47.8) 935 (46.5) 1,215 (49.2)
 ≤Once a week 1,935 (48.7) 886 (50.1) 1,049 (47.3)
 >Once a week 116 (3.4) 53 (3.4) 63 (3.5)
Consumption of seaweed 0.002
 Rarely 250 (6.7) 134 (8.5) 116 (4.9)
 ≤Once a week 1,868 (45.6) 843 (45.5) 1,025 (45.7)
 >Once a week 2,083 (47.7) 897 (46.0) 1,186 (49.4)
Consumption of shellfish 0.524
 Rarely 1,970 (44.6) 860 (43.8) 1,110 (45.4)
 ≤Once a week 2,074 (51.7) 949 (52.7) 1,125 (50.7)
 >Once a week 157 (3.7) 65 (4.5) 92 (3.9)
Consumption of other seafood items 0.041
 Rarely 1,643 (37.0) 695 (34.4) 948 (39.6)
 ≤Once a week 2,389 (58.5) 1,104 (60.8) 1,285 (56.3)
 >Once a week 169 (4.5) 75 (4.8) 94 (4.1)

Urinary BPA, BPF, and BPS are covariate-adjusted standardization (CAS) concentrations. Data are presented as the weighted mean (±standard error), n (weighted %), and median (IQR).

Continuous variables were compared using survey-weighted linear regression, and categorical variables were compared using the Rao-Scott χ² test.

BPA: bisphenol A, BPF: bisphenol F, BPS: bisphenol S; BMI: body mass index; IQR: interquartile range.

a1 million KRW = 714 US dollars, 3 million KRW = 2,142 US dollars, 5 million KRW = 3,570 US dollars (exchange rate: 1 US dollar = 1,400 KRW).

Table 2.
Comparison of baseline characteristics of the participants according to urinary concentration of BPA
Characteristic Men Women
Low (n = 1,406) High (n = 468) p-valuea Low (n = 1,745) High (n = 582) p-valuea
Age (years) 47.12 ± 0.91 45.10 ± 0.92 0.090 48.53 ± 0.96 48.67 ± 1.10 0.911
BMI (kg/m2) 25.35 ± 0.14 25.57 ± 0.32 0.560 23.98 ± 0.16 24.44 ± 0.24 0.121
Education level
 No formal education 8 (0.7) 3 (0.5) 0.727 39 (2.0) 6 (0.9) 0.340
 ≤ High school 737 (43.6) 235 (41.4) 1015 (52.0) 329 (49.3)
 ≥ College 661 (55.7) 230 (58.1) 691 (46.0) 247 (49.8)
Marital status 0.278 0.002
 Single 221 (27.9) 77 (23.7) 221 (21.3) 60 (14.0)
 Married, cohabiting 1,092 (67.1) 349 (69.8) 1,256 (64.0) 430 (73.2)
 Others (divorce, separation) 93 (5.0) 42 (6.5) 268 (14.7) 92 (12.8)
Household income (million KRW)b 0.663 0.047
 <1 185 (9.1) 58 (7.9) 284 (14.2) 63 (8.6)
 1–3 437 (28.1) 157 (31.5) 546 (29.4) 200 (34.6)
 3–5 395 (32.6) 135 (30.1) 441 (26.1) 165 (29.8)
 ≥5 389 (30.2) 118 (30.5) 474 (30.3) 154 (27.0)
Alcohol consumption 0.356 0.077
 No 140 (8.7) 49 (10.6) 500 (27.8) 148 (22.2)
 Yes 1,266 (91.3) 419 (89.4) 1,245 (72.2) 434 (77.8)
Physical activity 0.275 0.017
 None 664 (48.4) 245 (53.1) 907 (52.8) 307 (53.3)
 Regular 742 (51.6) 223 (46.9) 838 (47.2) 275 (46.7)
Smoking 0.500 0.804
 None or ex 950 (65.0) 307 (67.4) 1694 (96.7) 565 (97.0)
 Current 456 (35.0) 161 (32.6) 51 (3.3) 17 (3.0)
Use of rigid clear plastic containers for hot foods 0.044 0.122
 Rarely 1,115 (77.7) 367 (74.4) 1,360 (76.1) 464 (78.7)
 ≤Once a week 158 (10.9) 61 (16.7) 220 (12.5) 70 (14.0)
 >Once a week 133 (11.4) 40 (8.9) 165 (11.4) 48 (7.3)
Consumption of takeaway foods wrapped in plastic films 0.045 0.652
 Rarely 809 (50.3) 237 (42.4) 1027 (53.8) 355 (55.3)
 ≤Once a week 497 (39.6) 205 (49.3) 628 (40.2) 200 (37.3)
 >Once a week 100 (10.1) 26 (8.3) 90 (6.0) 27 (7.4)
Consumption of canned food 0.036 0.135
 Rarely 584 (33.2) 145 (25.4) 791 (40.4) 249 (38.3)
 ≤Once a week 616 (47.7) 229 (48.4) 803 (50.0) 264 (47.7)
 >Once a week 206 (19.1) 94 (26.2) 151 (9.6) 69 (14.0)
Consumption of large fish/tuna 0.019 0.088
 Rarely 828 (54.9) 239 (44.6) 1,063 (58.1) 348 (56.6)
 ≤Once a week 519 (40.0) 209 (50.4) 639 (39.5) 210 (38.4)
 >Once a week 59 (5.1) 20 (5.0) 43 (2.4) 24 (5.0)
Consumption of fish 0.156 0.794
 Rarely 131 (11.1) 45 (12.0) 183 (11.2) 54 (10.2)
 ≤Once a week 912 (63.7) 325 (69.3) 1,154 (67.8) 396 (70.0)
 >Once a week 363 (25.2) 98 (18.7) 408 (21.0) 132 (19.8)
Consumption of crustaceans 0.048 0.132
 Rarely 704 (46.1) 231 (47.6) 911 (49.4) 304 (48.6)
 ≤Once a week 654 (49.7) 232 (51.3) 792 (47.9) 257 (45.8)
 >Once a week 48 (4.2) 5 (1.1) 42 (2.8) 21 (5.6)
Consumption of seaweed 0.072 0.924
 Rarely 113 (9.6) 21 (5.2) 89 (4.9) 27 (4.8)
 ≤Once a week 642 (46.0) 201 (44.3) 773 (46.0) 252 (44.7)
 >Once a week 651 (44.4) 246 (50.5) 883 (49.1) 303 (50.5)
Consumption of shellfish 0.748 0.907
 Rarely 641 (43.2) 219 (45.5) 840 (45.1) 270 (46.5)
 ≤Once a week 715 (53.4) 234 (50.7) 841 (51.1) 284 (49.7)
 >Once a week 50 (3.4) 15 (3.8) 64 (3.8) 28 (3.8)
Consumption of other seafood items 0.483 0.552
 Rarely 529 (34.6) 166 (34.0) 719 (39.1) 229 (41.1)
 ≤Once a week 814 (60.1) 290 (62.7) 954 (56.5) 331 (55.7)
 >Once a week 63 (5.3) 12 (3.3) 72 (4.4) 22 (3.2)

Urinary BPA is covariate-adjusted standardization concentration. Categorical variables are presented as number (weighted percentage), and continuous variables as weighted mean ± standard error.

BPA: bisphenol A; BMI: body mass index.

ap-values for continuous variables were obtained using survey-weighted linear regression, and p-values for categorical variables were calculated using the Rao-Scott χ² test;

b1 million KRW = 714 US dollars, 3 million KRW = 2,142 US dollars, 5 million KRW = 3,570 US dollars (based on an exchange rate of 1 US dollar = 1,400 KRW).

Table 3.
ORs and 95% CIs of seafood consumption in men with high urinary concentration of bisphenols (BPA, BPF, and BPS) compared with those with low concentration
Category BPA (urine, µg/L) BPF (urine, µg/L) BPS (urine, µg/L)
Unadjusted (95% CI) Multivariable adjusted model 1a (95% CI) Multivariable adjusted model 2b (95% CI) Unadjusted (95% CI) Multivariable adjusted model 1a (95% CI) Multivariable adjusted model 2b (95% CI) Unadjusted (95% CI) Multivariable adjusted model 1a (95% CI) Multivariable adjusted model 2b (95% CI)
Consumption of large fish/tuna
 Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
 ≤Once a week 1.56 (1.15–2.09) 1.50 (1.09–2.01) 1.41 (1.04–1.92) 1.41 (1.01–1.96) 1.35 (0.97–1.89) 1.45 (1.01–2.08) 0.99 (0.72–1.37) 0.90 (0.64–1.26) 0.90 (0.62–1.30)
 >Once a week 1.18 (0.59–2.40) 1.20 (0.58–2.46) 1.02 (0.50–2.10) 0.41 (0.14–1.21) 0.38 (0.13–1.10) 0.45 (0.15–1.40) 0.65 (0.29–1.47) 0.58 (0.26–1.29) 0.61 (0.25–1.46)
Consumption of fish
 Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
 ≤Once a week 1.00 (0.62–1.61) 1.07 (0.65–1.77) 1.06 (0.64–1.76) 1.61 (0.91–2.85) 1.82 (1.05–3.17) 1.88 (1.05–3.36) 1.09 (0.66–1.79) 1.14 (0.68–1.91) 1.15 (0.68–1.94)
 >Once a week 0.68 (0.37–1.27) 0.79 (0.42–1.48) 0.76 (0.40–1.45) 1.30 (0.69–2.41) 1.55 (0.84–2.84) 1.64 (0.87–3.10) 0.78 (0.44–1.39) 0.88 (0.50–1.56) 0.90 (0.51–1.61)
Consumption of crustaceans
 Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
 ≤Once a week 1.00 (0.72–1.39) 0.97 (0.70–1.36) 0.94 (0.66–1.33) 0.93 (0.70–1.24) 0.92 (0.69–1.23) 0.99 (0.74–1.31) 1.62 (1.22–2.15) 1.63 (1.19–2.23) 1.68 (1.22–2.30)
 >Once a week 0.25 (0.10–0.71) 0.26 (0.09–0.75) 0.27 (0.10–0.75) 1.27 (0.41–3.93) 1.27 (0.43–3.73) 1.10 (0.37–3.30) 0.90 (0.37–2.15) 0.94 (0.38–2.37) 0.89 (0.35–2.24)
Consumption of seaweed
 Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
 ≤Once a week 1.78 (0.90–3.50) 2.01 (0.98–4.15) 1.98 (0.97–4.06) 1.37 (0.80–2.35) 1.58 (0.90–2.80) 1.65 (0.95–2.87) 1.06 (0.62–1.83) 1.21 (0.68–2.15) 1.20 (0.66–2.16)
 >Once a week 2.10 (1.08–4.04) 2.47 (1.25–4.91) 2.34 (1.18–4.63) 1.28 (0.74–2.22) 1.51 (0.85–2.67) 1.67 (0.94–2.98) 0.70 (0.40–1.23) 0.84 (0.46–1.52) 0.85 (0.46–1.57)
Consumption of shellfish
 Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
 ≤Once a week 0.90 (0.66–1.23) 0.90 (0.67–1.23) 0.87 (0.64–1.19) 1.05 (0.76–1.46) 1.06 (0.76–1.48) 1.13 (0.82–1.56) 1.30 (0.98–1.72) 1.31 (0.98–1.77) 1.34 (1.01–1.80)
 >Once a week 1.08 (0.51–2.32) 1.11 (0.53–2.30) 1.03 (0.50–2.10) 1.39 (0.63–3.05) 1.43 (0.66–3.10) 1.65 (0.73–3.73) 0.60 (0.24–1.49) 0.65 (0.26–1.64) 0.68 (0.27–1.72)
Consumption of other seafood items
 Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
 ≤Once a week 1.06 (0.81–1.40) 1.03 (0.77–1.38) 1.00 (0.76–1.32) 1.31 (0.94–1.83) 1.31 (0.94–1.84) 1.36 (0.96–1.94) 1.37 (1.05–1.80) 1.38 (1.03–1.84) 1.41 (1.05–1.89)
 >Once a week 0.66 (0.26–1.63) 0.64 (0.26–1.60) 0.65 (0.26–1.60) 0.76 (0.31–1.90) 0.75 (0.29–1.98) 0.76 (0.30–1.94) 0.96 (0.43–2.16) 0.93 (0.42–2.08) 0.91 (0.41–2.00)

OR: odds ratio; CI: confidence interval; BPA: bisphenol A, BPF: bisphenol F, BPS: bisphenol S.

Urinary BPA, BPF, and BPS are covariate-adjusted standardization concentrations.

aMultivariable adjusted model 1: adjusted for age, BMI, education level, marital status, household income, alcohol consumption, physical activity and smoking;

bMultivariable adjusted model 2: Multivariable adjusted model 1 + use of rigid clear plastic containers for hot foods, consumption of takeaway foods wrapped in plastic films, and consumption of canned food.

Table 4.
ORs and 95% CIs of seafood consumption in women with high urinary concentration of bisphenols (BPA, BPF, and BPS) compared with those with low concentration
Category BPA (urine, µg/L) BPF (urine, µg/L) BPS (urine, µg/L)
Unadjusted (95% CI) Multivariable adjusted model 1a (95% CI) Multivariable adjusted model 2b (95% CI) Unadjusted (95% CI) Multivariable adjusted model 1a (95% CI) Multivariable adjusted model 2b (95% CI) Unadjusted (95% CI) Multivariable adjusted model 1a (95% CI) Multivariable adjusted model 2b (95% CI)
Consumption of large fish/tuna
 Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
 ≤Once a week 1.00 (0.74–1.35) 0.96 (0.71–1.29) 0.89 (0.65–1.21) 0.96 (0.75–1.24) 0.93 (0.71–1.22) 1.08 (0.80–1.47) 1.02 (0.79–1.31) 0.90 (0.68–1.19) 0.91 (0.67–1.24)
 >Once a week 2.13 (1.12–4.05) 1.98 (1.07–3.65) 1.76 (1.00–3.20) 0.48 (0.22–1.07) 0.46 (0.20–1.06) 0.62 (0.26–1.47) 1.66 (0.82–3.35) 1.45 (0.69–3.05) 1.38 (0.64–2.96)
Consumption of fish
 Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
 ≤Once a week 1.13 (0.71–1.81) 1.07 (0.67–1.71) 1.05 (0.66–1.68) 1.10 (0.74–1.64) 1.12 (0.75–1.70) 1.17 (0.78–1.77) 1.06 (0.75–1.51) 1.06 (0.74–1.53) 1.06 (0.73–1.53)
 >Once a week 1.03 (0.62–1.72) 1.01 (0.61–1.67) 0.99 (0.60–1.63) 1.09 (0.70–1.69) 1.14 (0.72–1.79) 1.19 (0.75–1.89) 0.87 (0.54–1.39) 0.94 (0.59–1.49) 0.95 (0.60–1.50)
Consumption of crustaceans
 Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
 ≤Once a week 0.97 (0.74–1.28) 0.94 (0.71–1.24) 0.93 (0.70–1.22) 1.01 (0.78–1.32) 1.03 (0.78–1.35) 1.07 (0.81–1.43) 1.04 (0.80–1.36) 0.95 (0.71–1.27) 0.92 (0.69–1.22)
 >Once a week 2.04 (0.92–4.50) 2.07 (1.01–4.23) 2.20 (1.09–4.43) 1.60 (0.77–3.30) 1.66 (0.76–3.63) 1.64 (0.83–3.23) 1.95 (0.88–4.30) 1.91 (0.86–4.22) 1.71 (0.77–3.79)
Consumption of seaweed
 Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
 ≤Once a week 1.00 (0.56–1.81) 0.96 (0.54–1.71) 0.93 (0.51–1.68) 0.97 (0.56–1.68) 0.97 (0.55–1.70) 1.03 (0.58–1.83) 1.35 (0.77–2.38) 1.36 (0.78–2.38) 1.37 (0.77–2.43)
 >Once a week 1.07 (0.59–1.94) 1.01 (0.57–1.80) 0.96 (0.53–1.76) 1.12 (0.63–1.98) 1.14 (0.63–2.06) 1.27 (0.68–2.36) 1.23 (0.68–2.22) 1.28 (0.71–2.29) 1.29 (0.72–2.33)
Consumption of shellfish
 Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
 ≤Once a week 0.94 (0.72–1.23) 0.92 (0.70–1.22) 0.93 (0.71–1.24) 1.13 (0.87–1.47) 1.15 (0.88–1.51) 1.16 (0.89–1.51) 1.04 (0.79–1.36) 0.98 (0.73–1.32) 0.93 (0.69–1.25)
 >Once a week 0.97 (0.72–1.23) 1.00 (0.51–1.93) 0.99 (0.51–2.00) 1.56 (0.79–3.08) 1.60 (0.81–3.17) 1.60 (0.80–3.21) 0.92 (0.47–1.80) 0.92 (0.48–1.76) 0.93 (0.48–1.81)
Consumption of other seafood items
 Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
 ≤Once a week 0.94 (0.73–1.21) 0.91 (0.68–1.20) 0.87 (0.66–1.21) 1.28 (0.98–1.70) 1.31 (0.98–1.74) 1.38 (1.04–1.84) 1.28 (1.01–1.64) 1.19 (0.92–1.54) 1.15 (0.89–1.48)
 >Once a week 0.70 (0.34–1.42) 0.69 (0.33–1.41) 0.66 (0.31–1.41) 1.17 (0.62–2.20) 1.20 (0.63–2.26) 1.27 (0.63–2.54) 0.81 (0.43–1.52) 0.74 (0.40–1.37) 0.74 (0.40–1.34)

OR: odds ratio; CI: confidence interval; BPA: bisphenol A, BPF: bisphenol F, BPS: bisphenol S.

Urinary BPA, BPF, and BPS are covariate-adjusted standardization concentrations.

aMultivariable adjusted model 1: adjusted for age, BMI, education level, marital status, household income, alcohol consumption, physical activity and smoking;

bMultivariable adjusted model 2: Multivariable adjusted model 1 + use of rigid clear plastic containers for hot foods, consumption of takeaway foods wrapped in plastic films, and consumption of canned food.

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        Association between seafood consumption and urinary bisphenol concentrations in Korean adults: findings from the Korean National Environmental Health Survey (KoNEHS 2018–2020)
        Korean Journal of Occupational and Environmental Medicine. 2026;e40  Published online September 1, 2026
        DOI: https://doi.org/10.35371/aoem.2026.38.e40
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      Association between seafood consumption and urinary bisphenol concentrations in Korean adults: findings from the Korean National Environmental Health Survey (KoNEHS 2018–2020)
      Association between seafood consumption and urinary bisphenol concentrations in Korean adults: findings from the Korean National Environmental Health Survey (KoNEHS 2018–2020)
      Characteristic Total (n = 4,201) Men (n = 1,874) Women (n = 2,327) p-value
      Urinary BPA (μg/L) 1.13 (0.51–2.18) 1.31 (0.63–2.47) 0.98 (0.44–1.87) <0.001
      Urinary BPF (μg/L) 0.17 (0.06–0.43) 0.20 (0.07–0.50) 0.15 (0.06–0.38) <0.001
      Urinary BPS (μg/L) 0.15 (0.07–0.38) 0.17 (0.08–0.42) 0.13 (0.06–0.32) <0.001
      Age (years) 47.59 ± 0.71 46.61 ± 0.76 48.56 ± 0.83 <0.001
      BMI (kg/m2) 24.75 ± 0.10 25.40 ± 0.12 24.10 ± 0.13 <0.001
      Education <0.001
       No formal education 56 (1.3) 11 (0.7) 45 (1.7)
       ≤High school 2316 (55.1) 972 (43.0) 1,344 (51.3)
       ≥College 1829 (43.6) 891 (56.3) 938 (47.0)
      Marital status <0.001
       Single 579 (23.1) 298 (26.8) 281 (19.5)
       Married, cohabiting 3,127 (67.0) 1,441 (67.8) 1,686 (66.3)
       Others (divorce, separation) 495 (9.9) 135 (5.4) 360 (14.2)
      Household income (million KRW)a <0.001
       <1 590 (10.8) 243 (8.8) 347 (12.8)
       1–3 1,340 (29.8) 594 (28.9) 746 (30.7)
       3–5 1,136 (29.5) 530 (32.0) 606 (27.0)
       ≥5 1,135 (29.9) 507 (30.3) 628 (29.5)
      Alcohol consumption <0.001
       No 837 (17.8) 189 (9.2) 648 (26.4)
       Yes 3,364 (82.2) 1,685 (90.8) 1,679 (73.6)
      Physical activity 0.093
       None 2,123 (51.3) 909 (49.6) 1,214 (53.0)
       Regular 2,078 (48.7) 965 (50.4) 1,113 (47.0)
      Smoking <0.001
       None or ex 3,516 (81.3) 1,257 (65.6) 2,259 (96.8)
       Current 685 (18.7) 617 (34.4) 68 (3.2)
      Use of rigid clear plastic containers for hot foods 0.872
       Rarely 3,306 (76.8) 1,482 (76.9) 1,824 (76.8)
       ≤Once a week 509 (12.6) 219 (12.3) 290 (12.8)
       >Once a week 386 (10.6) 173 (10.8) 213 (10.4)
      Consumption of takeaway foods wrapped in plastic films 0.002
       Rarely 2,428 (51.2) 1,046 (48.3) 1,382 (54.1)
       ≤Once a week 1,530 (40.8) 702 (42.0) 828 (39.5)
       >Once a week 243 (8.0) 126 (9.7) 117 (6.4)
      Consumption of canned food <0.001
       Rarely 1,769 (35.6) 729 (31.1) 1,040 (39.9)
       ≤Once a week 1,912 (48.6) 845 (47.9) 1,067 (49.4)
       >Once a week 520 (15.8) 300 (20.9) 220 (10.7)
      Consumption of large fish/tuna 0.003
       Rarely 2,478 (55.0) 1,067 (52.3) 1,411 (57.7)
       ≤Once a week 1,577 (40.9) 728 (42.6) 849 (39.2)
       >Once a week 146 (4.1) 79 (5.1) 67 (3.1)
      Consumption of fish 0.226
       Rarely 413 (11.1) 176 (11.3) 237 (11.0)
       ≤Once a week 2,787 (66.8) 1,237 (65.1) 1,550 (68.3)
       >Once a week 1,001 (22.1) 461 (23.6) 540 (20.7)
      Consumption of crustaceans 0.306
       Rarely 2,150 (47.8) 935 (46.5) 1,215 (49.2)
       ≤Once a week 1,935 (48.7) 886 (50.1) 1,049 (47.3)
       >Once a week 116 (3.4) 53 (3.4) 63 (3.5)
      Consumption of seaweed 0.002
       Rarely 250 (6.7) 134 (8.5) 116 (4.9)
       ≤Once a week 1,868 (45.6) 843 (45.5) 1,025 (45.7)
       >Once a week 2,083 (47.7) 897 (46.0) 1,186 (49.4)
      Consumption of shellfish 0.524
       Rarely 1,970 (44.6) 860 (43.8) 1,110 (45.4)
       ≤Once a week 2,074 (51.7) 949 (52.7) 1,125 (50.7)
       >Once a week 157 (3.7) 65 (4.5) 92 (3.9)
      Consumption of other seafood items 0.041
       Rarely 1,643 (37.0) 695 (34.4) 948 (39.6)
       ≤Once a week 2,389 (58.5) 1,104 (60.8) 1,285 (56.3)
       >Once a week 169 (4.5) 75 (4.8) 94 (4.1)
      Characteristic Men Women
      Low (n = 1,406) High (n = 468) p-valuea Low (n = 1,745) High (n = 582) p-valuea
      Age (years) 47.12 ± 0.91 45.10 ± 0.92 0.090 48.53 ± 0.96 48.67 ± 1.10 0.911
      BMI (kg/m2) 25.35 ± 0.14 25.57 ± 0.32 0.560 23.98 ± 0.16 24.44 ± 0.24 0.121
      Education level
       No formal education 8 (0.7) 3 (0.5) 0.727 39 (2.0) 6 (0.9) 0.340
       ≤ High school 737 (43.6) 235 (41.4) 1015 (52.0) 329 (49.3)
       ≥ College 661 (55.7) 230 (58.1) 691 (46.0) 247 (49.8)
      Marital status 0.278 0.002
       Single 221 (27.9) 77 (23.7) 221 (21.3) 60 (14.0)
       Married, cohabiting 1,092 (67.1) 349 (69.8) 1,256 (64.0) 430 (73.2)
       Others (divorce, separation) 93 (5.0) 42 (6.5) 268 (14.7) 92 (12.8)
      Household income (million KRW)b 0.663 0.047
       <1 185 (9.1) 58 (7.9) 284 (14.2) 63 (8.6)
       1–3 437 (28.1) 157 (31.5) 546 (29.4) 200 (34.6)
       3–5 395 (32.6) 135 (30.1) 441 (26.1) 165 (29.8)
       ≥5 389 (30.2) 118 (30.5) 474 (30.3) 154 (27.0)
      Alcohol consumption 0.356 0.077
       No 140 (8.7) 49 (10.6) 500 (27.8) 148 (22.2)
       Yes 1,266 (91.3) 419 (89.4) 1,245 (72.2) 434 (77.8)
      Physical activity 0.275 0.017
       None 664 (48.4) 245 (53.1) 907 (52.8) 307 (53.3)
       Regular 742 (51.6) 223 (46.9) 838 (47.2) 275 (46.7)
      Smoking 0.500 0.804
       None or ex 950 (65.0) 307 (67.4) 1694 (96.7) 565 (97.0)
       Current 456 (35.0) 161 (32.6) 51 (3.3) 17 (3.0)
      Use of rigid clear plastic containers for hot foods 0.044 0.122
       Rarely 1,115 (77.7) 367 (74.4) 1,360 (76.1) 464 (78.7)
       ≤Once a week 158 (10.9) 61 (16.7) 220 (12.5) 70 (14.0)
       >Once a week 133 (11.4) 40 (8.9) 165 (11.4) 48 (7.3)
      Consumption of takeaway foods wrapped in plastic films 0.045 0.652
       Rarely 809 (50.3) 237 (42.4) 1027 (53.8) 355 (55.3)
       ≤Once a week 497 (39.6) 205 (49.3) 628 (40.2) 200 (37.3)
       >Once a week 100 (10.1) 26 (8.3) 90 (6.0) 27 (7.4)
      Consumption of canned food 0.036 0.135
       Rarely 584 (33.2) 145 (25.4) 791 (40.4) 249 (38.3)
       ≤Once a week 616 (47.7) 229 (48.4) 803 (50.0) 264 (47.7)
       >Once a week 206 (19.1) 94 (26.2) 151 (9.6) 69 (14.0)
      Consumption of large fish/tuna 0.019 0.088
       Rarely 828 (54.9) 239 (44.6) 1,063 (58.1) 348 (56.6)
       ≤Once a week 519 (40.0) 209 (50.4) 639 (39.5) 210 (38.4)
       >Once a week 59 (5.1) 20 (5.0) 43 (2.4) 24 (5.0)
      Consumption of fish 0.156 0.794
       Rarely 131 (11.1) 45 (12.0) 183 (11.2) 54 (10.2)
       ≤Once a week 912 (63.7) 325 (69.3) 1,154 (67.8) 396 (70.0)
       >Once a week 363 (25.2) 98 (18.7) 408 (21.0) 132 (19.8)
      Consumption of crustaceans 0.048 0.132
       Rarely 704 (46.1) 231 (47.6) 911 (49.4) 304 (48.6)
       ≤Once a week 654 (49.7) 232 (51.3) 792 (47.9) 257 (45.8)
       >Once a week 48 (4.2) 5 (1.1) 42 (2.8) 21 (5.6)
      Consumption of seaweed 0.072 0.924
       Rarely 113 (9.6) 21 (5.2) 89 (4.9) 27 (4.8)
       ≤Once a week 642 (46.0) 201 (44.3) 773 (46.0) 252 (44.7)
       >Once a week 651 (44.4) 246 (50.5) 883 (49.1) 303 (50.5)
      Consumption of shellfish 0.748 0.907
       Rarely 641 (43.2) 219 (45.5) 840 (45.1) 270 (46.5)
       ≤Once a week 715 (53.4) 234 (50.7) 841 (51.1) 284 (49.7)
       >Once a week 50 (3.4) 15 (3.8) 64 (3.8) 28 (3.8)
      Consumption of other seafood items 0.483 0.552
       Rarely 529 (34.6) 166 (34.0) 719 (39.1) 229 (41.1)
       ≤Once a week 814 (60.1) 290 (62.7) 954 (56.5) 331 (55.7)
       >Once a week 63 (5.3) 12 (3.3) 72 (4.4) 22 (3.2)
      Category BPA (urine, µg/L) BPF (urine, µg/L) BPS (urine, µg/L)
      Unadjusted (95% CI) Multivariable adjusted model 1a (95% CI) Multivariable adjusted model 2b (95% CI) Unadjusted (95% CI) Multivariable adjusted model 1a (95% CI) Multivariable adjusted model 2b (95% CI) Unadjusted (95% CI) Multivariable adjusted model 1a (95% CI) Multivariable adjusted model 2b (95% CI)
      Consumption of large fish/tuna
       Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
       ≤Once a week 1.56 (1.15–2.09) 1.50 (1.09–2.01) 1.41 (1.04–1.92) 1.41 (1.01–1.96) 1.35 (0.97–1.89) 1.45 (1.01–2.08) 0.99 (0.72–1.37) 0.90 (0.64–1.26) 0.90 (0.62–1.30)
       >Once a week 1.18 (0.59–2.40) 1.20 (0.58–2.46) 1.02 (0.50–2.10) 0.41 (0.14–1.21) 0.38 (0.13–1.10) 0.45 (0.15–1.40) 0.65 (0.29–1.47) 0.58 (0.26–1.29) 0.61 (0.25–1.46)
      Consumption of fish
       Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
       ≤Once a week 1.00 (0.62–1.61) 1.07 (0.65–1.77) 1.06 (0.64–1.76) 1.61 (0.91–2.85) 1.82 (1.05–3.17) 1.88 (1.05–3.36) 1.09 (0.66–1.79) 1.14 (0.68–1.91) 1.15 (0.68–1.94)
       >Once a week 0.68 (0.37–1.27) 0.79 (0.42–1.48) 0.76 (0.40–1.45) 1.30 (0.69–2.41) 1.55 (0.84–2.84) 1.64 (0.87–3.10) 0.78 (0.44–1.39) 0.88 (0.50–1.56) 0.90 (0.51–1.61)
      Consumption of crustaceans
       Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
       ≤Once a week 1.00 (0.72–1.39) 0.97 (0.70–1.36) 0.94 (0.66–1.33) 0.93 (0.70–1.24) 0.92 (0.69–1.23) 0.99 (0.74–1.31) 1.62 (1.22–2.15) 1.63 (1.19–2.23) 1.68 (1.22–2.30)
       >Once a week 0.25 (0.10–0.71) 0.26 (0.09–0.75) 0.27 (0.10–0.75) 1.27 (0.41–3.93) 1.27 (0.43–3.73) 1.10 (0.37–3.30) 0.90 (0.37–2.15) 0.94 (0.38–2.37) 0.89 (0.35–2.24)
      Consumption of seaweed
       Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
       ≤Once a week 1.78 (0.90–3.50) 2.01 (0.98–4.15) 1.98 (0.97–4.06) 1.37 (0.80–2.35) 1.58 (0.90–2.80) 1.65 (0.95–2.87) 1.06 (0.62–1.83) 1.21 (0.68–2.15) 1.20 (0.66–2.16)
       >Once a week 2.10 (1.08–4.04) 2.47 (1.25–4.91) 2.34 (1.18–4.63) 1.28 (0.74–2.22) 1.51 (0.85–2.67) 1.67 (0.94–2.98) 0.70 (0.40–1.23) 0.84 (0.46–1.52) 0.85 (0.46–1.57)
      Consumption of shellfish
       Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
       ≤Once a week 0.90 (0.66–1.23) 0.90 (0.67–1.23) 0.87 (0.64–1.19) 1.05 (0.76–1.46) 1.06 (0.76–1.48) 1.13 (0.82–1.56) 1.30 (0.98–1.72) 1.31 (0.98–1.77) 1.34 (1.01–1.80)
       >Once a week 1.08 (0.51–2.32) 1.11 (0.53–2.30) 1.03 (0.50–2.10) 1.39 (0.63–3.05) 1.43 (0.66–3.10) 1.65 (0.73–3.73) 0.60 (0.24–1.49) 0.65 (0.26–1.64) 0.68 (0.27–1.72)
      Consumption of other seafood items
       Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
       ≤Once a week 1.06 (0.81–1.40) 1.03 (0.77–1.38) 1.00 (0.76–1.32) 1.31 (0.94–1.83) 1.31 (0.94–1.84) 1.36 (0.96–1.94) 1.37 (1.05–1.80) 1.38 (1.03–1.84) 1.41 (1.05–1.89)
       >Once a week 0.66 (0.26–1.63) 0.64 (0.26–1.60) 0.65 (0.26–1.60) 0.76 (0.31–1.90) 0.75 (0.29–1.98) 0.76 (0.30–1.94) 0.96 (0.43–2.16) 0.93 (0.42–2.08) 0.91 (0.41–2.00)
      Category BPA (urine, µg/L) BPF (urine, µg/L) BPS (urine, µg/L)
      Unadjusted (95% CI) Multivariable adjusted model 1a (95% CI) Multivariable adjusted model 2b (95% CI) Unadjusted (95% CI) Multivariable adjusted model 1a (95% CI) Multivariable adjusted model 2b (95% CI) Unadjusted (95% CI) Multivariable adjusted model 1a (95% CI) Multivariable adjusted model 2b (95% CI)
      Consumption of large fish/tuna
       Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
       ≤Once a week 1.00 (0.74–1.35) 0.96 (0.71–1.29) 0.89 (0.65–1.21) 0.96 (0.75–1.24) 0.93 (0.71–1.22) 1.08 (0.80–1.47) 1.02 (0.79–1.31) 0.90 (0.68–1.19) 0.91 (0.67–1.24)
       >Once a week 2.13 (1.12–4.05) 1.98 (1.07–3.65) 1.76 (1.00–3.20) 0.48 (0.22–1.07) 0.46 (0.20–1.06) 0.62 (0.26–1.47) 1.66 (0.82–3.35) 1.45 (0.69–3.05) 1.38 (0.64–2.96)
      Consumption of fish
       Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
       ≤Once a week 1.13 (0.71–1.81) 1.07 (0.67–1.71) 1.05 (0.66–1.68) 1.10 (0.74–1.64) 1.12 (0.75–1.70) 1.17 (0.78–1.77) 1.06 (0.75–1.51) 1.06 (0.74–1.53) 1.06 (0.73–1.53)
       >Once a week 1.03 (0.62–1.72) 1.01 (0.61–1.67) 0.99 (0.60–1.63) 1.09 (0.70–1.69) 1.14 (0.72–1.79) 1.19 (0.75–1.89) 0.87 (0.54–1.39) 0.94 (0.59–1.49) 0.95 (0.60–1.50)
      Consumption of crustaceans
       Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
       ≤Once a week 0.97 (0.74–1.28) 0.94 (0.71–1.24) 0.93 (0.70–1.22) 1.01 (0.78–1.32) 1.03 (0.78–1.35) 1.07 (0.81–1.43) 1.04 (0.80–1.36) 0.95 (0.71–1.27) 0.92 (0.69–1.22)
       >Once a week 2.04 (0.92–4.50) 2.07 (1.01–4.23) 2.20 (1.09–4.43) 1.60 (0.77–3.30) 1.66 (0.76–3.63) 1.64 (0.83–3.23) 1.95 (0.88–4.30) 1.91 (0.86–4.22) 1.71 (0.77–3.79)
      Consumption of seaweed
       Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
       ≤Once a week 1.00 (0.56–1.81) 0.96 (0.54–1.71) 0.93 (0.51–1.68) 0.97 (0.56–1.68) 0.97 (0.55–1.70) 1.03 (0.58–1.83) 1.35 (0.77–2.38) 1.36 (0.78–2.38) 1.37 (0.77–2.43)
       >Once a week 1.07 (0.59–1.94) 1.01 (0.57–1.80) 0.96 (0.53–1.76) 1.12 (0.63–1.98) 1.14 (0.63–2.06) 1.27 (0.68–2.36) 1.23 (0.68–2.22) 1.28 (0.71–2.29) 1.29 (0.72–2.33)
      Consumption of shellfish
       Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
       ≤Once a week 0.94 (0.72–1.23) 0.92 (0.70–1.22) 0.93 (0.71–1.24) 1.13 (0.87–1.47) 1.15 (0.88–1.51) 1.16 (0.89–1.51) 1.04 (0.79–1.36) 0.98 (0.73–1.32) 0.93 (0.69–1.25)
       >Once a week 0.97 (0.72–1.23) 1.00 (0.51–1.93) 0.99 (0.51–2.00) 1.56 (0.79–3.08) 1.60 (0.81–3.17) 1.60 (0.80–3.21) 0.92 (0.47–1.80) 0.92 (0.48–1.76) 0.93 (0.48–1.81)
      Consumption of other seafood items
       Rarely 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference) 1 (reference)
       ≤Once a week 0.94 (0.73–1.21) 0.91 (0.68–1.20) 0.87 (0.66–1.21) 1.28 (0.98–1.70) 1.31 (0.98–1.74) 1.38 (1.04–1.84) 1.28 (1.01–1.64) 1.19 (0.92–1.54) 1.15 (0.89–1.48)
       >Once a week 0.70 (0.34–1.42) 0.69 (0.33–1.41) 0.66 (0.31–1.41) 1.17 (0.62–2.20) 1.20 (0.63–2.26) 1.27 (0.63–2.54) 0.81 (0.43–1.52) 0.74 (0.40–1.37) 0.74 (0.40–1.34)
      Table 1. Comparison of baseline characteristics of participants

      Urinary BPA, BPF, and BPS are covariate-adjusted standardization (CAS) concentrations. Data are presented as the weighted mean (±standard error), n (weighted %), and median (IQR).

      Continuous variables were compared using survey-weighted linear regression, and categorical variables were compared using the Rao-Scott χ² test.

      BPA: bisphenol A, BPF: bisphenol F, BPS: bisphenol S; BMI: body mass index; IQR: interquartile range.

      1 million KRW = 714 US dollars, 3 million KRW = 2,142 US dollars, 5 million KRW = 3,570 US dollars (exchange rate: 1 US dollar = 1,400 KRW).

      Table 2. Comparison of baseline characteristics of the participants according to urinary concentration of BPA

      Urinary BPA is covariate-adjusted standardization concentration. Categorical variables are presented as number (weighted percentage), and continuous variables as weighted mean ± standard error.

      BPA: bisphenol A; BMI: body mass index.

      p-values for continuous variables were obtained using survey-weighted linear regression, and p-values for categorical variables were calculated using the Rao-Scott χ² test;

      1 million KRW = 714 US dollars, 3 million KRW = 2,142 US dollars, 5 million KRW = 3,570 US dollars (based on an exchange rate of 1 US dollar = 1,400 KRW).

      Table 3. ORs and 95% CIs of seafood consumption in men with high urinary concentration of bisphenols (BPA, BPF, and BPS) compared with those with low concentration

      OR: odds ratio; CI: confidence interval; BPA: bisphenol A, BPF: bisphenol F, BPS: bisphenol S.

      Urinary BPA, BPF, and BPS are covariate-adjusted standardization concentrations.

      Multivariable adjusted model 1: adjusted for age, BMI, education level, marital status, household income, alcohol consumption, physical activity and smoking;

      Multivariable adjusted model 2: Multivariable adjusted model 1 + use of rigid clear plastic containers for hot foods, consumption of takeaway foods wrapped in plastic films, and consumption of canned food.

      Table 4. ORs and 95% CIs of seafood consumption in women with high urinary concentration of bisphenols (BPA, BPF, and BPS) compared with those with low concentration

      OR: odds ratio; CI: confidence interval; BPA: bisphenol A, BPF: bisphenol F, BPS: bisphenol S.

      Urinary BPA, BPF, and BPS are covariate-adjusted standardization concentrations.

      Multivariable adjusted model 1: adjusted for age, BMI, education level, marital status, household income, alcohol consumption, physical activity and smoking;

      Multivariable adjusted model 2: Multivariable adjusted model 1 + use of rigid clear plastic containers for hot foods, consumption of takeaway foods wrapped in plastic films, and consumption of canned food.

      Table 1.

      Table 2.

      Table 3.

      Table 4.

      Ann Occup Environ Med : Annals of Occupational and Environmental Medicine
      © Korean Society of Occupational & Environmental Medicine.
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