Epidemiology and Health

Kyung-Hwa Choi

4 Articles

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

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

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

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

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

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Abstract

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

Summary

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

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

Citations

Citations to this article as recorded by

Heavy metal exposure and its effects on APOC3, CFAI, and ZA2G
Nam-Eun Kim, Min Heo, Hyeongyu Shin, Ah Ra Do, Jeeyoung Kim, Hee-Gyoo Kang, Sora Mun, Hyun Ju Yoo, Mi Jeong Kim, Jung-Woong Kim, Chul-Hong Kim, Young-Seoub Hong, Yong Min Cho, Heejin Jin, Kyungtaek Park, Woo Jin Kim, Sungho Won
Journal of Hazardous Materials.2025; 482: 136574. CrossRef
A Comparative Study on the Paradoxical Relationship Between Heavy Metal Exposure and Kidney Function
Jee Hyun Rho, Seungho Lee, Jung-Yeon Kwon, Young-Seoub Hong
Diagnostics.2025; 15(1): 86. CrossRef
Levels of exposure markers among residents in environmentally vulnerable areas in Korea, the general population in Korea, and Asians in the United States
Kyung-Hwa Choi, Dahee Han, Sang-Yong Eom, Yong Min Cho, Young-Seoub Hong, Woo Jin Kim
Epidemiology and Health.2025; 47: e2025007. CrossRef

Adverse health effects of climate change and air pollution in people with disabilities: a systematic review: Nakyung Rhim, Seohyun Lee, Kyung-Hwa Choi; Epidemiol Health. 2024;46:e2024080. Published online September 27, 2024; DOI: https://doi.org/10.4178/epih.e2024080

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Abstract

Global warming and air pollution adversely affect the health of the entire human population, particularly older adults, people with disabilities (PWDs), and children. In this systematic review, we investigated the adverse health effects of climate change and air pollution in PWDs. We conducted a comprehensive literature search of the PubMed database using the terms “disab*,” “air pollution,” and “climate change” on July 4, 2023, and August 8, 2023 and searched the Web of Science (WOS) database on December 28, 2023. We identified 425 and 1,169 studies on climate change cited in PubMed and WOS, respectively, as well as 333 studies on air pollution in PubMed and 495 studies on air pollution in WOS. The studies were classified by type of exposure, and full-text screening was conducted to confirm that the population, intervention or exposure, comparator, outcome statement, and inclusion and exclusion criteria were met. The Newcastle-Ottawa Scale was used to assess the quality of the included cohort and case-control studies and for data analysis. In extreme temperatures, PWDs experienced higher rates of injury, heat-related illness, functional impairment, heart disease, mental disorders, and mortality than people who were non-disabled (ND). Exposure to air pollution resulted in higher rates of obesity, cardiovascular disease, poststroke neurological and functional disability, and mortality in PWDs than in people who were ND. Therefore, because PWDs were more affected by climate change and air pollution than people who were ND, sensitive policies and preparedness measures should be developed for PWDs.

Summary

Korean summary
전체 인구, 특히 취약 계층의 건강은 기후 변화와 대기 오염으로 인해 부정적인 영향을 받을 수 있습니다. 본 체계적 고찰 연구는 장애인이 비장애인에 비해 환경적 요인에 노출되어 더 심각한 신체적, 정신적 건강 문제를 겪는다는 것을 보여줍니다.

Key Message
The health of the entire human population, especially vulnerable people, might be negatively impacted by climate change and air pollution. This systematic review study implies that people with disabilities (PWDs) suffer more severe physical and mental health consequences from exposure to environmental challenges compared to non-disabled individuals.

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Mediation of Fine Particulate Matter on the Association Between Daily Temperature and Mortality
Dajeong Ham, Youn-Hee Lim, Soontae Kim, Ho-Jang Kwon, Sanghyuk Bae
Journal of Korean Medical Science.2025;[Epub] CrossRef
Ambient fine particulate matter and mortality risk among people with disability in Korea based on the National Health Insurance database: a retrospective cohort study
Jonghyuk Choi, Hyungryul Lim, Ho-Jang Kwon, Mina Ha, Soontae Kim, Kyung-Hwa Choi
BMC Public Health.2025;[Epub] CrossRef

Effect modification of consecutive high concentration days on the association between fine particulate matter and mortality: a multi-city study in Korea: Hyungryul Lim, Sanghyuk Bae, Jonghyuk Choi, Kyung-Hwa Choi, Hyun-Joo Bae, Soontae Kim, Mina Ha, Ho-Jang Kwon; Epidemiol Health. 2022;44:e2022052. Published online June 9, 2022; DOI: https://doi.org/10.4178/epih.e2022052

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Although there is substantial evidence for the short-term effect of fine particulate matter (PM2.5) on daily mortality, few epidemiological studies have explored the effect of prolonged continuous exposure to high concentrations of PM2.5. This study investigated how the magnitude of the mortality effect of PM2.5 exposure is modified by persistent exposure to high PM2.5 concentrations.

METHODS

We analyzed data on the daily mortality count, simulated daily PM2.5 level, mean daily temperature, and relative humidity level from 7 metropolitan cities from 2006 to 2019. Generalized additive models (GAMs) with quasi-Poisson distribution and random-effects meta-analyses were used to pool city-specific effects. To investigate the effect modification of continuous exposure to prolonged high concentrations, we applied categorical consecutive-day variables to the GAMs as effect modification terms for PM2.5.

RESULTS

The mortality risk increased by 0.33% (95% confidence interval [CI], 0.16 to 0.50), 0.47% (95% CI, -0.09 to 1.04), and 0.26% (95% CI, -0.08 to 0.60) for all-cause, respiratory, and cardiovascular diseases, respectively, with a 10 μg/m3 increase in PM2.5 concentration. The risk of all-cause mortality per 10 μg/m3 increase in PM2.5 on the first and fourth consecutive days significantly increased by 0.63% (95% CI, 0.20 to 1.06) and 0.36% (95% CI, 0.01 to 0.70), respectively.

CONCLUSIONS

We found increased risks of all-cause, respiratory, and cardiovascular mortality related to daily PM2.5 exposure on the day when exposure to high PM2.5 concentrations began and when exposure persisted for more than 4 days with concentrations of ≥35 μg/m3. Persistently high PM2.5 exposure had a stronger effect on seniors.

Summary

Korean summary
한국의 7개 대도시를 배경으로 수행한 본 시계열 연구를 통하여 2006년부터 2019년까지의 기간 동안에 초미세먼지의 단기 노출이 일별 사망률을 증가시키며, 교호작용모형을 통해 일평균 35 μg/m3 이상의 고농도 지속기간이 처음 시작되는 날과 넷째 지속일에 이러한 사망효과가 커짐을 보고하였다. 이러한 고농도 지속기간의 교호작용은 65세 이상 연령군에서 더욱 두드러졌다.

Key Message
With our Korean multi-city study design from 2006 to 2019, the short-term effects of PM2.5 on mortality were greater when the high PM2.5 concentration duration began during the day and lasted for approximately 4 days, and the elderly may be more affected by persistently high PM2.5.

Citations

Citations to this article as recorded by

Estimating Health and Economic Benefits from PM2.5 Reduction in Fishery-Based Communities: A Sector-Specific Approach to Sustainable Air Quality Management in the Philippines
James Roy Lesidan, Nadine Grace Caido, Oliver Semblante, Floro Junior Roque, Jejomar Bulan, Jumar Cadondon, Maria Cecilia Galvez, Edgar Vallar
Sustainability.2025; 17(3): 1316. CrossRef

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