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This paper discussed environmental health policies for the past and coming decade by reviewing the First Comprehensive Environmental Health Plan (2011~2020) and introducing the Second Comprehensive Environmental Health Plan (2021~2030). The major achievement of the First Comprehensive Environmental Health Plan was the establishment of receptor-oriented environmental health policies. However, the main limitations were insufficient policy support for relief and/or recovery from environmental pollution damage and low public awareness of environmental health policies. The Second Comprehensive Environmental Health Plan presents the following major policy tasks: establish an omnidirectional environment health investigation and monitoring system, provide customized environmental health services, improve the environmental health damage relief and recovery system, and promote regional environmental health policies. The Second Plan has a clear distinction from the First Plan in that it expands the field of environmental health from the prevention and management of environmental risk factors to proactive damage response and recovery, which will effectively contribute to alleviating the burden of environmental disease.

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Background: With volatile organic compounds (VOCs) containing aromatic and halogenated hydrocarbons such as benzene, toluene, and xylene that can adversely affect the respiratory and cardiovascular systems when a certain concentration is reached, it is important to accurately evaluate the source and the corresponding health risk effects.
Objectives: The purpose of this study is to provide scientific evidence for the city of Seoul’s VOC reduction measures by confirming the risk of each VOC emission source.
Methods: In 2020, 56 VOCs were measured and analyzed at one-hour intervals using an online flame ionization detector system (GC-FID) at two measuring stations in Seoul (Gangseo: GS, Bukhansan: BHS). The dominant emission source was identified using the Positive Matrix Factorization (PMF) model, and health risk assessment was performed on the main components of VOCs related to the emission source.
Results: Gasoline vapor and vehicle combustion gas are the main sources of emissions in GS, a residential area in the city center, and the main sources are solvent usage and aged VOCs in BHS, a greenbelt area. The risk index ranged from 0.01 to 0.02, which is lower than the standard of 1 for both GS and BHS, and was an acceptable level of 5.71×10^–7 to 2.58×10^–6 for carcinogenic risk.
Conclusions: In order to reduce the level of carcinogenic risk to an acceptable safe level, it is necessary to improve and reduce the emission sources of vehicle combustion and solvent usage, and eco-car policies are judged to contribute to the reduction of combustion gas as well as providing a response to climate change.

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Background: The types and effects of hazardous pollutants in indoor air may vary depending on the characteristics of the sources and pollutants caused by physical and chemical properties of buildings, the influence of outdoor air, and the exposure and use characteristics of residents.
Objectives: This study was conducted to provide basic data on the establish of indoor air quality management for different classes of public-use facilities by presenting the characteristics of concentration distribution of hazardous pollutants by different public-use facilities and the status of the excess proportion of exceeding standards.
Methods: This study analyzed self-measurement data from public-use facilities taken from 2017 to 2019 A total of 133,525 facilities were surveyed. A total of 10 types of pollutants that have maintenance and recommended standards stipulated in the Indoor Air Quality Control Act from the Ministry of Environment were investigated. The excess proportion and the substances exceeding the criteria for each type of public-use facilities for these pollutants were investigated.
Results: As a result of the analysis of the proportion of exceeding the standard for each type of public-use facility, the facilities with the highest excess proportion of the standards for each hazardous pollutant were: PM₁₀ in railway stations (8.93%), PM_2.5 in daycare centers (7.36%), CO₂ in bus terminals (2.37%), HCHO in postpartum care centers (4.11%), total airborne bacteria in daycare centers (0.69%), CO in museums (0.1%), NO₂ in postpartum care centers (1.15%), Rn in museums (0.78%), total volatile organic compounds in postpartum care centers (7.20%) and mold in daycare centers (1.44%).
Conclusions: Although uncertainty may arise because this study is a result of self-measurement, it is considered that this study has significance for providing basic data on the establishment in the future of indoor air quality management measures customized for each type of public-use facility.

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Background: Subway stations have the characteristics of being located underground and are a representative public-use facility used by an unspecified number of people. As concerns about indoor air quality (IAQ) increase, various management measures are being implemented. However, there are few systematic studies and cases of long-term continuous measurement of underground station air quality.
Objectives: The purpose of this study is to analyze changes and factors influencing IAQ in subway stations through real-time continuous long-term measurement using IoT-based IAQ sensing equipment, and to evaluate the IAQ improvement effect of a bio-filter system.
Methods: The IAQ of a subway station in Seoul was measured using IoT-based sensing equipment. A biofilter system was installed after collecting the background concentrations for about five months. Based on the data collected over about 21 months, changes in indoor air quality and influencing factors were analyzed and the reduction effect of the bio-filter system was evaluated.
Results: As a result of the analysis, PM₁₀, PM_2.5, and CO₂ increased during rush hour according to the change in the number of passengers, and PM₁₀ and PM_2.5 concentrations were high when a PM warning/watch was issued. There was an effect of improving IAQ with the installation of the bio-filter system. The reduction rate of a new-bio-filter system with improved efficiency was higher than that of the existing bio-filter system. Factors affecting PM_2.5 in the subway station were the outdoor PM_2.5, platform PM_2.5, and the number of passengers.
Conclusions: The IAQ in a subway station is affected by passengers, ventilation through the air supply and exhaust, and the spread of particulate matter generated by train operation. Based on these results, it is expected that IAQ can be efficiently improved if a bio-filter system with improved efficiency is developed in consideration of the factors affecting IAQ and proper placement.

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Background: This study evaluated the radon contribution rate through an evaluation of the exhalation rate of radon from building materials.
Objectives: This study compared and evaluated the computation of the radon contribution rate based on each different exhalation rate in a building.
Methods: The six demonstration houses that are the subject of this study are wall structures or Rahmen structures, and include demonstration houses similar to general residential environments and non-finishing houses with some walls exposed.
Results: The highest exhalation rate was found at 62.98 Bq/m² per day from the non–finishing floor, and the second highest exhalation rate was from stone materials at 58.76 Bq/m² per day. Based on this result, investigating the contribution rate of building materials derived from building materials among indoor radon concentrations, house three was the highest at 81.7%, and house one was confirmed to be 33.96%.
Conclusions: It can be judged that the effect of exposed concrete and stone is high, and that it is possible to reduce radon emitted from indoor building structures by controlling the indoor materials.

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Background: The European Centre for Ecotoxicology and Toxicology of Chemicals’ Targeted Risk Assessment (ECETOC TRA) tool has been recognized by EU REACH as a preferred approach for calculating worker health risks from chemicals.
Objectives: The applicability of the ECETOC TRA to occupational exposure estimation from industrial uses of methanol was studied by inputting surveyed and varied parameters for TRA estimation as well as through comparison with measured data.
Methods: Information on uses of methanol was collected from seven working environment monitoring reports along with the measured exposure data. Input parameters for TRA estimation such as operating conditions (OCs), risk management measures (RMMs) and process categories (PROCs) were surveyed. To compare with measured exposures, parameters from the surveyed conditions of ventilation but no use of respiratory protection were applied.
Results: PROCs 4, 5, 8a, 10, and 15 were assigned to ten uses of methanol. The uses include as a solvent for manufacturing sun cream, surfactants, dyestuffs, films and adhesives. Methanol was also used as a component in a release agent, hardening media and mold wash for cast products as well as a component of hard-coating solution and a viscosity-controlling agent for manufacturing glass lenses. PROC 8a and PROC 10 of a cast product manufacturer without LEV (local exhaust ventilation) and general ventilation as well as no respiratory protection resulted in the highest exposure to methanol. Assuming the identical worst OCs and RMMs for all uses, exposures from PROC 5, 8a, and 10 were the same and the highest followed by PROC 4 and 15. The estimation resulted in higher exposures in nine uses except one use where measured exposure approximated exposures without RMMs.
Conclusions: The role of ECETOC TRA as a conservative exposure assessment tool was confirmed by comparison with measured data. Moreover, it can guide which RMMs should be applied for the safe use of methanol.

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Background: Plastic particles less than 5 mm in diameter (microplastics) are well-known for causing various toxicities such as lung inflammation, oxidative stress, genotoxicity, and reproductive toxicity. As microplastics become smaller, they can move across cell membranes, the placenta, and the blood-brain barrier.
Objectives: We evaluated the toxicities of polyethylene microplastics (PE-PMs) in dams and neonates through intragastric intubation of pregnant ICR mice.
Methods: Low concentrations (0.01 mg/mouse/day) and high concentrations (0.1 mg/mouse/day) of polyethylene microplastics were administered from the ninth day of pregnancy to postnatal day seven. The control group was administered with distilled water. On the day of sacrifice, the weight of dams and neonates and the organ weight of neonates was measured. Further, acetylcholinesterase levels and glutathione peroxidase levels were evaluated by using a blood sample obtained on the sacrifice day.
Results: No significant difference in the number of neonates was found, but the body weight gain of dams was seen to be lower in the low-dose group. On the other hand, we observed a consecutively declining trend in the weight gain and organ weight of neonates among the high-, control, and low-dose groups. Meanwhile, the serum acetylcholinesterase and glutathione peroxidase level were higher in the low-dose group compared to the control group. Further, the dose-dependent accumulation of microplastics in the organs of neonates revealed the transport of plastic particles from dams to their offspring.
Conclusions: Although the exact mechanism of toxicity caused by microplastics could not be confirmed, it was validated that exposure to microplastics during pregnancy and lactation causes its migration between generations and accumulation throughout the body. Hence, it is necessary to evaluate the systemic toxicity of microplastics and assessment of co-morbidities such as second-generation toxicity, neurotoxicity, and depression following long-term exposure.

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Background: Fish and fishery products (FFPs) unintentionally contaminated with various environmental pollutants are major exposure pathways for humans. To protect human health from the consumption of contaminated FFPs, it is essential to develop a systematic tool for evaluating exposure and risks.
Objectives: To regularly, accurately, and quickly evaluate adverse health outcomes due to FFPs contamination, we developed an automated dietary exposure and risk assessment system called HERA (the Human Exposure and Risk Assessment system for chemicals in FFPs). The aim of this study was to develop an overall architecture design and demonstrate the major features of the HERA system.
Methods: For the HERA system, the architecture framework consisted of multi-layer stacks from infrastructure to fish exposure and risk assessment layers. To compile different contamination levels and types of seafood consumption datasets, the data models were designed for the classification codes of FFP items, contaminants, and health-based guidance values (HBGVs). A systematic data pipeline for summarizing exposure factors was constructed through down-scaling and preprocessing the 24-hour dietary recalls raw dataset from the Korea National Health and Nutrition Examination Survey (KNAHES).
Results: According to the designed data models for the classification codes, we standardized 167 seafood items and 2,741 contaminants. Subsequently, we implemented two major functional workflows: 1) preparation and 2) main process. The HERA system was developed to enable risk assessors to accumulate the concentration databases sustainably and estimate exposure levels for several populations linked to seafood consumption data in KNAHES in a user-friendly manner and in a local PC environment.
Conclusions: The HERA system will support policy-makers in making risk management decisions based on a nation-wide risk assessment for FFPs.

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Background: The number of synthesized chemicals has rapidly increased over the past decade. For many chemicals, there is a lack of information on toxicity. With the current movement toward reducing animal testing, the use of toxicity big data and deep learning could be a promising tool to screen potential toxicants.
Objectives: This study identified potential chemicals related to reproductive and estrogen receptor (ER)- mediated toxicities for 1135 cleaning products and 886 laundry products.
Methods: We listed chemicals contained in cleaning and laundry products from a publicly available database. Then, chemicals that potentially exhibited reproductive and ER-mediated toxicities were identified using the European Union Classification, Labeling and Packaging classification and ToxCast database, respectively. For chemicals absent from the ToxCast database, ER activity was predicted using deep learning models.
Results: Among the 783 listed chemicals, there were 53 with potential reproductive toxicity and 310 with potential ER-mediated toxicity. Among the 473 chemicals not tested with ToxCast assays, deep learning models indicated that 42 chemicals exhibited ER-mediated toxicity. A total of 13 chemicals were identified as causing reproductive toxicity by reacting with the ER.
Conclusions: We demonstrated a screening method to identify potential chemicals related to reproductive and ER-mediated toxicities utilizing chemical toxicity big data and deep learning. Integrating toxicity data from in vivo , in vitro , and deep learning models may contribute to screening chemicals in consumer products.

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Background: The Legionella case detection and notification rate have increased in public artificial water environments where people visit, including large buildings, public baths, and hospitals.
Objectives: In this study, the distribution of Legionella and its epidemiologic characteristics were analyzed in the water systems of public facilities in Chungcheongnam-do Province in South Korea.
Methods: Culture and PCR analysis were performed on 2,991 environmental water system samples collected from 2017 to 2019, and associations with year, facilities, seasons, and temperature of water system were statistically analyzed by using R-Studio for Windows. Descriptive data was compared using chi-square tests and independent t-tests.
Results: The detection rate of Legionella increased from 3.1% in 2017 to 10.3% in 2019, appearing most frequently in the order of public baths, large-scale buildings, hospitals, and apartments. It was detected mainly in summer from June to August, over 1.0×10³ CFU/L on average in 133 cases (66.5%). Lots of germs were detected in bathtub water, cooling tower water, and warm water (p<0.001), and it was detected at higher rates in the cities where multipurpose facilities were concentrated than in rural areas (p=0.018).
Conclusions: This study suggests that continuous monitoring and control are required for Legionella in the water system environment of high risk facilities. Moreover, these results will be helpful to prepare efficient management plans to prevent the Legionellosis that occurs in Chungcheongnam-do Province.

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Background: Vibrio vulnificus has been frequently detected in seawater, fish, and shellfish mainly in the coastal areas of Chungcheongnam-do Province.
Objectives: This study was conducted to investigate the analyzed biochemical properties, genetic characteristics, and distribution of Vibrio vulnificus isolated from environmental sources in coastal areas of Chungcheongnam-do Province from 2019 to 2020.
Methods: A total of 1,510 samples were obtained from six different sites in Chungcheongnam-do Province. Isolated strains from the samples were identified by a VITEK 2 system and MALDI-TOF. Antibiotic susceptibility testing for 85 isolates was done by microdilution minimum inhibitory concentration methods, and 11 isolates were analyzed for 16s rRNA sequences in multiple alignments.
Results: Among the 1,510 samples taken during the investigation period, 306 strains were isolated and the detection rate of V. vulnificus was 20.3%. One hundred eighty-eight strains (24.6%) from seawater and 118 strains (15.8%) from mud flats were isolated. It was mainly detected in July (17.3%), August (36.5%), and September (28.8%), and the proportion was 82.0%. Based on the CLSI-recommended breakpoints, V. vulnificus isolates were all susceptible to amoxicillin/clavulanic acid, amikacin, gentamicin, ciprofloxacin and trimethoprim/sulfamethoxazole. However, nonsusceptible isolates to ampicillin, ampicillin/sulbactam, cefazolin, cefoxitin, imipenem, tetracycline and chloramphenicol were identified. In the analysis of the nucleotide sequences for 16s rRNA of V. vulnificus isolates, it was confirmed that mutations frequently occurred between nucleotide number 922 and 952, and 98.2% to 100% nucleotide identities between isolates was verified.
Conclusions: The results of this study can be used as a basic data for infection control and prevention of Vibrio vulnificus infection by describing the distribution and characteristics of Vibrio vulnificus strains isolated in coastal areas of Chungcheongnam-do Province.

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Background: Particulate matter (PM) is one of the leading causes of premature death worldwide. Previous studies in South Korea have applied a relative risk calculated from Western populations when estimating the disease burden attributable to PM. However, the relative risk of PM on health outcomes may not be the same across different countries or regions.
Objectives: This study aimed to estimate the premature deaths and socioeconomic costs attributable to longterm exposure to PM in South Korea. We considered not only the difference in PM concentration between regions, but also the difference in relative risk.
Methods: National monitoring data of PM concentrations was obtained, and missing values were imputed using the AERMOD model and linear regression model. As a surrogate for relative risk, hazard ratios (HRs) of PM for cardiovascular and respiratory mortality were estimated using the National Health Insurance Service- National Sample Cohort. The nation was divided into five areas (metropolitan, central, southern, southeastern, and Gangwon-do Province regions). The number of PM attributable deaths in 2018 was calculated at the district level. The socioeconomic cost was derived by multiplying the number of deaths and the statistical value of life.
Results: The average PM₁₀ concentration for 2014~2018 was 45.2 μg/m³. The association between long-term exposure to PM₁₀ and mortality was heterogeneous between areas. When applying area-specific HRs, 23,811 premature deaths from cardiovascular and respiratory disease in 2018 were attributable to PM₁₀ (reference level 20 μg/m³). The corresponding socioeconomic cost was about 31 trillion won. These estimated values were higher than that when applying nationwide HRs.
Conclusions: This study is the first research to estimate the premature mortality caused by long-term exposure to PM using relative risks derived from the national population. This study will help precisely identify the national and regional health burden attributed to PM and establish the priorities of air quality policy.

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Background: Considering the expenses of and difficulties in arsenic speciation by high performance liquid chromatography-inductively coupled plasma-mass spectrometry (HPLC-ICP-MS), alternative measurement methods should be useful, especially for large-scale research and projects.
Objectives: A measurement method was developed for arsenic speciation using HPLC-atomic fluorescence spectrometry (HPLC-AFS) as an alternative to HPLC-ICP-MS.
Methods: Total arsenic and toxic arsenic species in some seafoods were determined by atomic absorption spectrometry coupled with hydride vapor generation (AAS-HVG) and HPLC-AFS, respectively. Recovery rate of arsenic species in seafood was evaluated by ultra sonication, microwave and enzyme (pepsin) for the optimal extraction method.
Results: Limits of detection of HPLC-AFS for As³⁺, dimethylarsinate (DMA), monomethylarsonate (MMA) and As⁵⁺ were 0.39, 0.53, 0.60 and 0.64 μg/L, respectively. The average accuracy ranged from 97.5 to 108.7%, and the coefficient of variation was in the range of 1.2~16.7%. As³⁺, DMA, MMA and As⁵⁺ were detected in kelp, the sum of toxic arsenic in kelp was 40.4 mg/kg. As³⁺, DMA, MMA and As⁵⁺ were not detected in shrimp and squid, but total arsenic (iAS and oAS) content in shrimp and squid analyzed by AAS-HVG were 18.1 and 24.7 mg/kg, respectively.
Conclusions: HPLC-AFS was recommendable for the quantitative analysis method of arsenic species. As toxic arsenic species are detected in seaweeds, further researches are needed for the contribution degree of seafood in arsenic exposure.

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Background: Considering the expenses of and difficulties in arsenic speciation by high performance liquid chromatography-inductively coupled plasma-mass spectrometry (HPLC-ICP-MS), alternative measurement methods should be useful, especially for large-scale research and projects.
Objectives: A measurement method was developed for arsenic speciation using HPLC-atomic fluorescence spectrometry (HPLC-AFS) as an alternative to HPLC-ICP-MS.
Methods: Total arsenic and toxic arsenic species in some seafoods were determined by atomic absorption spectrometry coupled with hydride vapor generation (AAS-HVG) and HPLC-AFS, respectively. Recovery rate of arsenic species in seafood was evaluated by ultra sonication, microwave and enzyme (pepsin) for the optimal extraction method.
Results: Limits of detection of HPLC-AFS for As³⁺, dimethylarsinate (DMA), monomethylarsonate (MMA) and As⁵⁺ were 0.39, 0.53, 0.60 and 0.64 μg/L, respectively. The average accuracy ranged from 97.5 to 108.7%, and the coefficient of variation was in the range of 1.2~16.7%. As³⁺, DMA, MMA and As⁵⁺ were detected in kelp, the sum of toxic arsenic in kelp was 40.4 mg/kg. As³⁺, DMA, MMA and As⁵⁺ were not detected in shrimp and squid, but total arsenic (iAS and oAS) content in shrimp and squid analyzed by AAS-HVG were 18.1 and 24.7 mg/kg, respectively.
Conclusions: HPLC-AFS was recommendable for the quantitative analysis method of arsenic species. As toxic arsenic species are detected in seaweeds, further researches are needed for the contribution degree of seafood in arsenic exposure.

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Background: Considering the expenses of and difficulties in arsenic speciation by high performance liquid chromatography-inductively coupled plasma-mass spectrometry (HPLC-ICP-MS), alternative measurement methods should be useful, especially for large-scale research and projects.
Objectives: A measurement method was developed for arsenic speciation using HPLC-atomic fluorescence spectrometry (HPLC-AFS) as an alternative to HPLC-ICP-MS.
Methods: Total arsenic and toxic arsenic species in some seafoods were determined by atomic absorption spectrometry coupled with hydride vapor generation (AAS-HVG) and HPLC-AFS, respectively. Recovery rate of arsenic species in seafood was evaluated by ultra sonication, microwave and enzyme (pepsin) for the optimal extraction method.
Results: Limits of detection of HPLC-AFS for As³⁺, dimethylarsinate (DMA), monomethylarsonate (MMA) and As⁵⁺ were 0.39, 0.53, 0.60 and 0.64 μg/L, respectively. The average accuracy ranged from 97.5 to 108.7%, and the coefficient of variation was in the range of 1.2~16.7%. As³⁺, DMA, MMA and As⁵⁺ were detected in kelp, the sum of toxic arsenic in kelp was 40.4 mg/kg. As³⁺, DMA, MMA and As⁵⁺ were not detected in shrimp and squid, but total arsenic (iAS and oAS) content in shrimp and squid analyzed by AAS-HVG were 18.1 and 24.7 mg/kg, respectively.
Conclusions: HPLC-AFS was recommendable for the quantitative analysis method of arsenic species. As toxic arsenic species are detected in seaweeds, further researches are needed for the contribution degree of seafood in arsenic exposure.

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Background: Considering the expenses of and difficulties in arsenic speciation by high performance liquid chromatography-inductively coupled plasma-mass spectrometry (HPLC-ICP-MS), alternative measurement methods should be useful, especially for large-scale research and projects.
Objectives: A measurement method was developed for arsenic speciation using HPLC-atomic fluorescence spectrometry (HPLC-AFS) as an alternative to HPLC-ICP-MS.
Methods: Total arsenic and toxic arsenic species in some seafoods were determined by atomic absorption spectrometry coupled with hydride vapor generation (AAS-HVG) and HPLC-AFS, respectively. Recovery rate of arsenic species in seafood was evaluated by ultra sonication, microwave and enzyme (pepsin) for the optimal extraction method.
Results: Limits of detection of HPLC-AFS for As³⁺, dimethylarsinate (DMA), monomethylarsonate (MMA) and As⁵⁺ were 0.39, 0.53, 0.60 and 0.64 μg/L, respectively. The average accuracy ranged from 97.5 to 108.7%, and the coefficient of variation was in the range of 1.2~16.7%. As³⁺, DMA, MMA and As⁵⁺ were detected in kelp, the sum of toxic arsenic in kelp was 40.4 mg/kg. As³⁺, DMA, MMA and As⁵⁺ were not detected in shrimp and squid, but total arsenic (iAS and oAS) content in shrimp and squid analyzed by AAS-HVG were 18.1 and 24.7 mg/kg, respectively.
Conclusions: HPLC-AFS was recommendable for the quantitative analysis method of arsenic species. As toxic arsenic species are detected in seaweeds, further researches are needed for the contribution degree of seafood in arsenic exposure.

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Background: Humidifier disinfectant is a biocidal product used in the water tanks of humidifiers to prevent the growth of microorganisms. Although there are a huge number of cases of reported humidifier disinfectant-related health effects across the entire Korean population, their numbers are distributed differently depending on the region.
Objectives: This study aimed to investigate the regional distribution of enrollment cases who reported humidifier disinfectant-related health effects.
Methods: This study used data on 6,240 subjects who experienced humidifier disinfectant-related health effects and who enrolled their cases which is conducted by the Korea Ministry of Environment. We examined the regional distribution of the enrolled cases based on sixteen administrative divisions and assessed the: 1) crude number; 2) proportional rate; and 3) age-standardized proportional rate of enrollment by region.
Results: When we examined the crude number of enrollments by region, the highest number were in Gyeonggi-do Province (n=1,896), followed in order by Seoul (n=1,405), Incheon (n=436) Busan, Daegu, Gyeongsangnam-do Province, Daejeon, Chungcheongnam-do Province, Gyeongsangbuk-do Province, Jeollabuk-do Province, Gwangju, Chungcheongbuk-do Province, Gangwon-do Province, Jeollanamdo Province, Ulsan, and Jeju-do. When we examined proportional rate of the regional enrollment (cases per 100,000 population), Daejeon (n=16.2) was the region with the highest rate, followed in order by Gyeonggi-do Province (n=16.1), Incheon-do Province (n=15.9), Seoul, Daegu, Gwangju, Jeollabuk-do Province, Chungcheongnam-do Province, Busan, Chungcheongbuk-do Province, Gangwon-do Province, Gyeongsanbuk-do Province, Gyeongsangnam-do Province, Ulsan, Jeju-do, and Jeollanam-do Province, which is inconsistent with the order in terms of crude numbers. However, when we examined the age-standardized proportional rate of regional enrollment (cases per 100,000 population), their ranked distribution is consistent with the crude rate.
Conclusions: This study observed that the regional distribution of the enrolled cases who reported humidifier disinfectant-related health effects is inconsistent with the regional distribution of the proportional rate of enrollment cases, which may be caused in part by the volume of the inherent population of each region.

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Background: Humidifier disinfectant exposure is an ongoing issue, and there is still considerable related controversy. Various approaches are needed to secure scientific evidence on the extent of the victims’ damages and for the determination of appropriate compensation.
Objectives: The purpose of this study was to assess the association between humidifier disinfectant (HD) use and academic achievement in Korean children.
Methods: This study used data from the 8th Panel Study on Korean Children in 2015. For the final study, 1,598 cases were used. T-tests and multiple linear regression analyses were conducted to determine whether the use of humidifier disinfectant is a factor that affects academic ability.
Results: Children in groups using humidifier disinfectant showed statistically significantly lower scores in all areas of language, including reading, speaking and writing, and statistically lower scores in all areas of mathematics, including counting, addition and subtraction. In the multiple regression analysis results, which control for the effects of various demographic/social variables, the use of humidifier disinfectants showed statistically significant beta coefficients (β: –0.357, p<0.001), negatively affecting children's language ability. As for the ‘math’ variable, which was created by combining counting, addition, and subtraction scores, the use of humidifier disinfectants as independent variables also showed statistically significant beta coefficients (β: –0.200, p<0.001), negatively affecting children’s math ability.
Conclusions: The results of the study showed that depending on whether or not humidifier disinfectants were used, there are differences in children’s language abilities, such as reading, speaking, and writing, as well as in their mathematical abilities, such as counting, adding, and subtracting numbers. These findings are thought to serve as a scientific basis for extending the perspective from health effects to more diverse areas of demographic and social impact related to humidifier disinfectant damage and compensation.

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Background: Smoking exposure may be objectively assessed through specific biomarkers. The most common biomarker for smoking is cotinine concentration in urine, and setting an optimal cut-off point can accurately classify smoking status. Such a cut-off point for Korean adolescents has never been studied.
Objectives: The aim of this study was to determine a cut-off point for urinary cotinine concentration for the discrimination of smoking in adolescents.
Methods: Participants were adolescents aged 13~18 years who participated in the third cycle of the Korean National Environmental Health Survey. We used urine samples to confirm the level of cotinine concentrations. Smoking status was determined by self-reported questionnaire. We identified the optimal cotinine cut-off point for discriminating smoking status using receiver operating characteristic curve analysis.
Results: Of the 904 participants, 28 (3.1%) were smokers, among whom 20 (71.4%) were male. The median urinary cotinine concentrations in smokers was 218 μg/L (male: 215 μg/L, female: 303 μg/L), and that in non-smokers was 1.31 μg/L (male: 1.46 μg/L, female: 1.18 μg/L). We found significant differences in urinary cotinine concentration according to smoking status and sex (p<0.001). Urinary cotinine concentrations performed well for identifying smoking adolescents [area under the curve: 0.954 (male: 0.963, female: 0.908)]. The cut-off that optimally distinguished smokers from non-smokers was 39.85 μg/L (sensitivity: 89.3%, specificity: 97.4%). Male [39.85 μg/L (sensitivity: 90.0%, specificity: 94.9%)] had a different optimal cut-off point than female [26.26 μg/L (sensitivity: 87.5%, specificity: 99.6%)].
Conclusions: This study determined a cut-off point for urinary cotinine of 39.85 μg/L (male: 39.85 μg/L, female: 26.26 μg/L) to distinguish smokers from non-smokers in adolescents.

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Background: This study was conducted to provide background information for the proper management of radon contamination in apartments using mechanical ventilation facilities in residential environments.
Objectives: To this end, this study compared and evaluated changes in radon concentrations based on different operating intensities of mechanical ventilation with or without natural ventilation.
Methods: For the continuous measurement of radon concentrations, an RAD7 instrument was installed in four apartments equipped with a ventilation system. The measurements were done for comparison of ventilation types and different ventilation intensities (“high”, “middle”, “low”).
Results: The results confirmed that both mechanical and natural ventilation sufficiently reduced the radon concentration in the apartments. In particular, mechanical ventilation at “high” intensity was the most effective. Natural ventilation combined with mechanical ventilation and then natural ventilation alone were the second and the third most effective, respectively.
Conclusions: When using ventilation to reduce indoor radon concentrations, it is most effective to operate mechanical ventilation (“high”) or natural ventilation and mechanical ventilation at the same time. In cases where mechanical ventilation is available alone, it is recommended to operate it at a minimum of “middle” intensity.

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Background: Particulate matter (PM₁₀, PM_2.5) and black carbon contribute to poor air quality in urban areas, and can also affect indoor environments. Exposure to PM can be associated with respiratory and lung diseases.
Objectives: This study investigated the indoor and outdoor concentration distribution patterns of PM₁₀, PM_2.5, and black carbon at an apartment building, a typical residential space in the metropolitan areas of South Korea, by season, day of the week (weekday vs. weekend), and time of the day. It aims to obtain foundational data for the effective management of pollutants and investigate the difference in pollution levels between indoor and outdoor environments.
Methods: Indoor and outdoor concentrations of PM and black carbon were measured at an apartment building located in Namyangju, Gyeonggi-do Province, using dust sensors and an Aethalometer AE51 (AethLabs, San Francisco, CA, USA) over the course of a year from June 2020 to May 2021. The concentration distribution patterns were analyzed by season and time of day.
Results: PM₁₀ and PM_2.5 concentrations in the outdoor environment were higher than those in the indoor environment, regardless of the season. By contrast, the indoor black carbon concentration was higher than that in the outdoor environment during summer and autumn. The concentrations of PM₁₀, PM_2.5 and black carbon were found to be higher on weekdays than during weekends, especially during rush hour, with concentrations of 25.92~56.58 mg/m³, 21.12~44.82 mg/m³, 0.63~3.40 mg/m³.
Conclusions: The outdoor concentrations of PM₁₀, PM_2.5, and black carbon were higher during the weekdays, especially during rush hour, than during weekends. This study is expected to provide basic data for the health management of apartment occupants because it is measured over a period of more than one year.

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Background: Concerns have been raised regarding the criteria of groundwater, in particular in Gwangwondo Province where many residents drink groundwater due to the poor supply of tap water and a high nonconformity rate with water quality criteria nationwide.
Objectives: Water quality monitoring and risk assessment were conducted for groundwater in Hoengseong, Gangwon-do Province.
Methods: A total of 46 items required for meeting drinking water criteria were analyzed from 258 samples collected from March 2017 through August 2018 (152 sites in 2017 and 106 sites in 2018). Risk assessment was conducted for two non-carcinogens (F– and NO₃-N), and one carcinogen (i.e., arsenic) based on their high nonconformity to water quality criteria.
Results: Water quality analysis revealed that the total proportion of nonconformities was determined to be 27.9%. The nonconformity rate for each content item is as follows: total colony counts (1.6%), total coliform (6.2%), Escherichia coli (1.2%), F– (8.1%), arsenic (4.7%), NO₃-N (8.1%), pH (1.2%), manganese (0.4%), and turbidity (5.8%). Risk assessment indicated that fluoride induced a hazard quotient greater than 1 with the 95% UCL (Upper Confidence Limit) concentration of the total 258 sites and average, median, and 95% UCL concentrations of nonconformity sites. For NO₃-N, there was no human health risk. For arsenic, the excess cancer risk exceeded the acceptable cancer risk of 1×10^–6 with the average and 95% UCL concentrations of total 258 sites and average, median, and 95% UCL concentrations of nonconformity sites.
Conclusions: This study suggests that it is necessary to expand water quality monitoring of groundwater and conduct a more detailed risk assessment in order to establish a health care plan for the residents of Hoengseong, Gangwon-do Province.

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Background: Polycyclic aromatic hydrocarbons (PAHs) are generated in petrochemical complexes, can spread to residential areas and affect the health of residents. Although harmful PAHs are mainly present in particle phase, gas phase PAHs can generate stronger toxic substances through photochemical reaction. Therefore, the risk assessment for PAHs around the petrochemical complex should consider both particle and gas phase concentrations.
Objectives: This study aimed to investigate the concentration characteristics of particle and gas phase PAHs by season in residential areas around petrochemical complexes, and to assess the risk of PAHs.
Methods: Samples were collected for 7 days by seasons in 2014~2015 using a high volume air sampler. Particle and gas phase PAHs were sampled using quartz filter and polyurethane foam, respectively, analyzed by GCMS. Chronic toxicity and probabilistic risk assessment were performed on 14 PAHs. For chronic toxicity risk assessment, inhalation unit risk was used. Monte-Carlo simulation was performed for probabilistic risk assessment using the mean and standard deviation of measured PAHs.
Results: The concentration of particle total PAHs was highest in autumn. The gas phase concentration was highest in autumn. The average gas phase distribution ratio of low molecular weight PAHs composed of 2~3 benzene rings was 85%. The average of the medium molecular weight composed of 4 benzene rings was 53%, and the average of the high molecular weight composed of 5 or more benzene rings was 9%. In the chronic toxicity risk assessment, 7 of the 14 PAHs exceeded the excess carcinogenic risk of 1.00×10^–6. In the Monte-Carlo simulation, Benzo[a]pyrene had the highest probability of exceeding 1.00×10^–6, which was 100%.
Conclusions: The concentration of PAHs in the residential area around the petrochemical complex exceeded the standard, and the excess carcinogenic risk was evaluated to be high. Therefore, it is necessary to manage the air environment around the petrochemical complex.