Background: Mercury, particularly in its methylmercury form, significantly affects neurological and developmental functions. In Gyeongsangbuk-do, Republic of Korea, blood mercury levels are elevated due to high fish consumption, especially shark meat. Vulnerable groups, such as pregnant women, are at increased risk as methylmercury can cross the placenta and accumulate in breast milk. This study aimed to investigate the risks of mercury exposure from shark meat consumption among young and middle-aged women in Gyeongsangbuk-do. Methods: The data of women aged 19–55 years from the 2018 Gyeongsangbuk-do Community Health Survey were included. Survey questions focused on frequency and amount of shark meat consumption, as well as pregnancy status, recent childbirth, and breastfeeding status. The Complex Sample Analysis was used to determine the prevalence and risk of overconsumption. Weekly mercury intake was calculated for respondents who reported their body weight, and the population size exceeding Joint Food and Agriculture Organization/World Health Organization Expert Committee on Food Additives (JECFA) and Ministry of Food and Drug Safety (MFDS)’s threshold was estimated. Results: Regions where the consumption rate of shark meat exceeds the average for Gyeongsangbuk-do are found to be distributed in the southeastern part of the province. Population estimates revealed that approximately 9,895 women aged 19–55, including 255 who had breastfed in the past year, consumed shark meat exceeding the recommended intake. Based on the maximum recorded mercury concentration (8.93 μg/g), an estimated 2,645 women surpassed the JECFA’s mercury exposure threshold, while 845 exceeded the MFDS’s threshold. Conclusions In young and middle-aged women of Gyeongsangbuk-do, approximately 7.1% exceed the single intake limit, while up to 1.9% exceed the JECFA’s provisional tolerable weekly intake (PTWI) and 0.6% exceed the MFDS’s PTWI, suggesting considerable risk that warrants monitoring and guidance. More stringent advisory measures regarding shark meat consumption and updated standards on mercury concentration in shark meat are essential for young and middle-aged women in the province.

OBJECTIVES: This study investigated the impact of the coronavirus disease 2019 (COVID-19) pandemic and associated control strategies on the incidence of appendicitis in Seoul, using data from 2018 to 2020 from Korea’s National Health Insurance. METHODS: We analyzed records of total, complicated, and uncomplicated appendicitis cases, as well as the ratio of complicated to uncomplicated appendicitis, using natural spline and piecewise regression models to identify trends and breakpoints. Bayesian structural time-series (BSTS) models were used to evaluate the causal impact of social distancing on appendicitis incidences. RESULTS: The spline regression analysis indicated decreasing trends in both total and uncomplicated appendicitis cases. Conversely, the incidence of complicated appendicitis and the ratio of complicated to uncomplicated cases increased. Breakpoints for a decline in uncomplicated appendicitis and a rise in the ratio occurred at 31 weeks in 2020 (95% confidence interval [CI], 23.2 to 38.8) and at 33.9 weeks (95% CI, 28.3 to 39.6), respectively. The BSTS model demonstrated a 7.8% reduction in total appendicitis cases (95% credible interval [CrI], -12.1 to -3.3). It also showed a 17.4% decrease in uncomplicated cases (95% CrI, -22.2 to -12.3) and increases of 12.8% (95% CrI, 4.9 to 22.0) in complicated cases and 39.0% (95% CrI, 27.0 to 53.3) in the ratio of complicated to uncomplicated appendicitis. CONCLUSIONS The COVID-19 pandemic resulted in a decrease in both total and uncomplicated appendicitis cases, while the number of complicated cases increased. Reduced medical visits likely accounted for these changes. Strategies are needed to manage changes in disease pathophysiology resulting from altered healthcare utilization during health crises.

OBJECTIVES: This study investigated the impact of the coronavirus disease 2019 (COVID-19) pandemic and associated control strategies on the incidence of appendicitis in Seoul, using data from 2018 to 2020 from Korea’s National Health Insurance. METHODS: We analyzed records of total, complicated, and uncomplicated appendicitis cases, as well as the ratio of complicated to uncomplicated appendicitis, using natural spline and piecewise regression models to identify trends and breakpoints. Bayesian structural time-series (BSTS) models were used to evaluate the causal impact of social distancing on appendicitis incidences. RESULTS: The spline regression analysis indicated decreasing trends in both total and uncomplicated appendicitis cases. Conversely, the incidence of complicated appendicitis and the ratio of complicated to uncomplicated cases increased. Breakpoints for a decline in uncomplicated appendicitis and a rise in the ratio occurred at 31 weeks in 2020 (95% confidence interval [CI], 23.2 to 38.8) and at 33.9 weeks (95% CI, 28.3 to 39.6), respectively. The BSTS model demonstrated a 7.8% reduction in total appendicitis cases (95% credible interval [CrI], -12.1 to -3.3). It also showed a 17.4% decrease in uncomplicated cases (95% CrI, -22.2 to -12.3) and increases of 12.8% (95% CrI, 4.9 to 22.0) in complicated cases and 39.0% (95% CrI, 27.0 to 53.3) in the ratio of complicated to uncomplicated appendicitis. CONCLUSIONS The COVID-19 pandemic resulted in a decrease in both total and uncomplicated appendicitis cases, while the number of complicated cases increased. Reduced medical visits likely accounted for these changes. Strategies are needed to manage changes in disease pathophysiology resulting from altered healthcare utilization during health crises.

OBJECTIVES: This study investigated the impact of the coronavirus disease 2019 (COVID-19) pandemic and associated control strategies on the incidence of appendicitis in Seoul, using data from 2018 to 2020 from Korea’s National Health Insurance. METHODS: We analyzed records of total, complicated, and uncomplicated appendicitis cases, as well as the ratio of complicated to uncomplicated appendicitis, using natural spline and piecewise regression models to identify trends and breakpoints. Bayesian structural time-series (BSTS) models were used to evaluate the causal impact of social distancing on appendicitis incidences. RESULTS: The spline regression analysis indicated decreasing trends in both total and uncomplicated appendicitis cases. Conversely, the incidence of complicated appendicitis and the ratio of complicated to uncomplicated cases increased. Breakpoints for a decline in uncomplicated appendicitis and a rise in the ratio occurred at 31 weeks in 2020 (95% confidence interval [CI], 23.2 to 38.8) and at 33.9 weeks (95% CI, 28.3 to 39.6), respectively. The BSTS model demonstrated a 7.8% reduction in total appendicitis cases (95% credible interval [CrI], -12.1 to -3.3). It also showed a 17.4% decrease in uncomplicated cases (95% CrI, -22.2 to -12.3) and increases of 12.8% (95% CrI, 4.9 to 22.0) in complicated cases and 39.0% (95% CrI, 27.0 to 53.3) in the ratio of complicated to uncomplicated appendicitis. CONCLUSIONS The COVID-19 pandemic resulted in a decrease in both total and uncomplicated appendicitis cases, while the number of complicated cases increased. Reduced medical visits likely accounted for these changes. Strategies are needed to manage changes in disease pathophysiology resulting from altered healthcare utilization during health crises.

OBJECTIVES: This study investigated the impact of the coronavirus disease 2019 (COVID-19) pandemic and associated control strategies on the incidence of appendicitis in Seoul, using data from 2018 to 2020 from Korea’s National Health Insurance. METHODS: We analyzed records of total, complicated, and uncomplicated appendicitis cases, as well as the ratio of complicated to uncomplicated appendicitis, using natural spline and piecewise regression models to identify trends and breakpoints. Bayesian structural time-series (BSTS) models were used to evaluate the causal impact of social distancing on appendicitis incidences. RESULTS: The spline regression analysis indicated decreasing trends in both total and uncomplicated appendicitis cases. Conversely, the incidence of complicated appendicitis and the ratio of complicated to uncomplicated cases increased. Breakpoints for a decline in uncomplicated appendicitis and a rise in the ratio occurred at 31 weeks in 2020 (95% confidence interval [CI], 23.2 to 38.8) and at 33.9 weeks (95% CI, 28.3 to 39.6), respectively. The BSTS model demonstrated a 7.8% reduction in total appendicitis cases (95% credible interval [CrI], -12.1 to -3.3). It also showed a 17.4% decrease in uncomplicated cases (95% CrI, -22.2 to -12.3) and increases of 12.8% (95% CrI, 4.9 to 22.0) in complicated cases and 39.0% (95% CrI, 27.0 to 53.3) in the ratio of complicated to uncomplicated appendicitis. CONCLUSIONS The COVID-19 pandemic resulted in a decrease in both total and uncomplicated appendicitis cases, while the number of complicated cases increased. Reduced medical visits likely accounted for these changes. Strategies are needed to manage changes in disease pathophysiology resulting from altered healthcare utilization during health crises.

Background: Medication-related osteonecrosis of the jaw (MRONJ) is a significant concern, particularly among patients taking bisphosphonates (BPs), denosumab, and selective estrogen receptor modulators (SERMs) for osteoporosis. Despite the known risks, large-scale cohort studies examining the incidence and severity of MRONJ are lacking. We aimed to ascertain the incidence and risk of MRONJ among these patients, whom we stratified by age groups, medication types, and duration of use. Methods: We utilized data from the National Health Insurance Service’s sample cohort database, focusing on patients aged 40 years and above diagnosed with osteoporosis. The patients were divided into three groups: those prescribed BPs only, those prescribed SERMs only, and those prescribed both. Results: The overall incidence rate of MRONJ was 0.17%. A significantly higher incidence rate was observed among those taking osteoporosis medications, particularly among females with a relative risk of 4.99 (95% confidence interval, 3.21–7.74). The SERM group also had an incidence rate comparable to that of the BP group. Severity was assessed based on the invasiveness of the treatment methods, with 71.3% undergoing invasive treatment in the medication group. Conclusion This study provides valuable insights into the incidence and severity of MRONJ among a large cohort of patients with osteoporosis. It underscores the need for comprehensive guidance on MRONJ risks across different medication groups and sets the stage for future research focusing on specific populations and treatment outcomes.

Background: In the early stage of the coronavirus disease 2019 (COVID-19) epidemic, small- and mid-sized enterprises (SMEs) may be an important transmission consideration. The study aimed to identify the pattern of COVID-19 prevention measures during the outbreaks in Daegu and Gyeongsangbuk-do at the early stage of COVID-19. Moreover, we investigated whether SME size and past experiences affected the preventive measures implemented in the region. Methods: A survey detailing the general characteristics and implementation of 12 preventive activities was conducted in 122 SMEs in Daegu and Gyeongsangbuk-do. The survey was analyzed by size and operation period. Results: The study subjects consisted of 53 (43.4%) workplaces with 1–5 employees, 50 (40.9%) workplaces with 6–30 employees, and 19 (15.6%) workplaces with 31–49 employees. The lowest three items among those surveyed were ‘symptomatic workers to stay home for 3–4 days’ (17.2%), ‘work remotely’ (18.9%), and ‘video meetings’ (20.5%). There were significant differences in the rate of several preventive measures implemented. The larger sized SMEs, the higher the number of implementations (p < 0.01). The operation period had no significant relationship with the implementation of preventive measures. The same pattern was observed in multiple generalized linear regression with covariate adjustment. Conclusion Preventive measures among SMEs with fewer than 50 employees were identified. Even within SMEs, a gap in preventive measures according to size was confirmed. To prevent the spread of infection and protect workers' right to health, different support for different sized SMEs is necessary.

Background: High concentrations of mercury intake from seafood are known to cause various side effects in humans, including on the nervous system. Various studies have reported the effects of mercury concentrations in humans; however, the association between dyslipidemia, a cardiovascular disease risk factor, and mercury remains controversial.Therefore, this study aimed to investigate the association between mercury accumulation and cholesterol concentrations in a Korean population. Methods: We analyzed data of a sample of 3,228 respondents obtained from the Korean National Environmental Health Survey cycle 3, surveyed between 2015 and 2017, to determine how lipid profiles changed according to the blood mercury concentrations (BHg) and urine mercury concentrations (UHg). Multiple regression analysis was used to determine the effects of mercury concentrations among various factors affecting blood cholesterol levels. Results: The arithmetic mean (AM) of BHg was 2.91 (2.81–3.02) μg/L, and the geometric mean (GM) was 2.71 (2.59–2.85) μg/L. The AM of UHg was 0.52 (0.48–0.56) μg/L, and the GM was 0.35 (0.33–0.38) μg/L. Lipid profiles were more related to the BHg than to the UHg. Total cholesterol (total-C), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels increased significantly as BHg increased in males, and total-C, triglyceride, and LDL-C levels increased significantly in females. Multiple regression analysis indicated that BHg were significantly associated with total-C, HDL-C, and LDL-C levels. Conclusions We found an association between mercury exposure and the risk of dyslipidemia; however, further studies are required to elucidate a causal association.

There has been a growing concern and subsequent interest surrounding numerous reproductive toxic agents found in various working and non-working environments. Meanwhile, there have been many efforts in medical fields such as toxicology and epidemiology applying experimental studies to elucidate reproductive toxic agents’ characterization and health effects. However, there remains insufficient research data and inadequate evidence in humans. Adverse reproductive outcomes vary from transient, moderate health effects to severely detrimental consequences, such as permanent infertility or childhood cancer of one’s offspring. Furthermore, upon exposure to toxic agents, the latent period before reproductive health effects are observed is relatively short compared to other occupational diseases (e.g., occupational cancer); instant action is required once exposure to reproductive toxic agents is detected. Therefore, it is very important for workers and healthcare professionals to know about the reproductive toxic agents they are likely to be exposed to. In this review, we discuss the general epidemiology of reproductive health in Korea, and the information regarding these reproductive toxic agents.

Background: High concentrations of mercury intake from seafood are known to cause various side effects in humans, including on the nervous system. Various studies have reported the effects of mercury concentrations in humans; however, the association between dyslipidemia, a cardiovascular disease risk factor, and mercury remains controversial.Therefore, this study aimed to investigate the association between mercury accumulation and cholesterol concentrations in a Korean population. Methods: We analyzed data of a sample of 3,228 respondents obtained from the Korean National Environmental Health Survey cycle 3, surveyed between 2015 and 2017, to determine how lipid profiles changed according to the blood mercury concentrations (BHg) and urine mercury concentrations (UHg). Multiple regression analysis was used to determine the effects of mercury concentrations among various factors affecting blood cholesterol levels. Results: The arithmetic mean (AM) of BHg was 2.91 (2.81–3.02) μg/L, and the geometric mean (GM) was 2.71 (2.59–2.85) μg/L. The AM of UHg was 0.52 (0.48–0.56) μg/L, and the GM was 0.35 (0.33–0.38) μg/L. Lipid profiles were more related to the BHg than to the UHg. Total cholesterol (total-C), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels increased significantly as BHg increased in males, and total-C, triglyceride, and LDL-C levels increased significantly in females. Multiple regression analysis indicated that BHg were significantly associated with total-C, HDL-C, and LDL-C levels. Conclusions We found an association between mercury exposure and the risk of dyslipidemia; however, further studies are required to elucidate a causal association.