Representative levels of blood lead, mercury, and urinary cadmium in youth: Korean Environmental Health Survey in Children and Adolescents (KorEHS-C), 2012-2014.
This study examined levels of blood lead and mercury, and urinary cadmium, and associated sociodemographic factors in 3-18 year-old Korean children and adolescents.



We used the nationally representative Korean Environmental Health Survey in Children and Adolescents data for 2012-2014 and identified 2388 children and adolescents aged 3-18 years. The median and 95th percentile exposure biomarker levels with 95% confidence intervals (CIs) were calculated. Multivariate regression analyses were performed on log transformed exposure biomarker levels adjusted for age, sex, area, household income, and father's education level. The median exposure biomarker levels were compared with data from Germany, the US, and Canada, as well as the levels of Korean children measured at different times.



The median levels of blood lead and mercury, as well as urinary cadmium were 1.23μg/dL, 1.80μg/L, and 0.40μg/L (95% CIs, 1.21-1.25, 1.77-1.83, and 0.39-0.41, respectively). The blood lead levels were significantly higher in boys and younger children (p<0.0001) and children with less educated fathers (p=0.004) after adjusting for covariates. Urinary cadmium level increased with age (p<0.0001). The median levels of blood mercury and urinary cadmium were much higher in Korean children and adolescents than those in their peers in Germany, the US, and Canada. Blood lead levels tended to decrease with increasing age and divergence between the sexes, particularly in the early teen years. Median levels of blood lead and urinary cadmium decreased since 2010.



Sociodemographic factors, including age, sex, and father's education level were associated with environmental exposure to heavy metals in Korean children and adolescents. These biomonitoring data are valuable for ongoing surveillance of environmental exposure in this vulnerable population.
Department of Public Health, Graduate School of Dankook University, Cheonan, Republic of Korea; Department of Nursing, Munkyung College, Mungyeong, Republic of Korea.
Eunae
E
Burm
Division of Risk Assessment and International Cooperation, Korea Centers for Disease Control and Prevention, Cheongju, Republic of Korea.
Inmyung
I
Song
Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea. Electronic address: minaha@dku.edu.
Mina
M
Ha
Department of Preventive Medicine, School of Medicine, Dong-A University, Busan, Republic of Korea.
Yu-Mi
YM
Kim
Department of Information Statistics, College of Natural Science, Korean National Open University, Seoul, Republic of Korea.
Kee Jae
KJ
Lee
Department of Occupational and Environmental Medicine, School of Medicine, Inha University, Incheon, Republic of Korea.
Hwan-Cheol
HC
Kim
Department of Occupational and Environmental Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
Sinye
S
Lim
Department of Occupational and Environmental Medicine, School of Medicine, Eulji University, Daejeon, Republic of Korea.
Soo-Young
SY
Kim
Department of Occupational and Environmental Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea.
Chul-Gab
CG
Lee
Department of Preventive Medicine, School of Medicine, Jeju University, Jeju, Republic of Korea.
Su Young
SY
Kim
Department of Social and Preventive Medicine, School of Medicine, Sungkyunkwan University, Suwon, Republic of Korea.
Hae-Kwan
HK
Cheong
Department of Preventive Medicine and Public Health, College of Medicine, Yeungnam University, Daegu, Republic of Korea.
Joon
J
Sakong
Department of Occupational and Environmental Medicine, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea.
Hee-Tae
HT
Kang
Department of Preventive Medicine, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea.
Mia
M
Son
Department of Preventive Medicine, School of Medicine, Wonkang University, Iksan, Republic of Korea.
Gyung-Jae
GJ
Oh
Department of Child and Adolescent Psychiatry, National Center for Mental Health, Seoul, Republic of Korea.
Yeni
Y
Kim
Institute for Environmental Research, Yonsei University College of Medicine, Seoul, Republic of Korea.
Ji-Yeon
JY
Yang
Department of Pediatrics, Childhood Asthma Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Soo-Jong
SJ
Hong
Department of Pediatrics, Dankook University College of Medicine, Cheonan, Republic of Korea.
Ju-Hee
JH
Seo
Molecular Epidemiology Branch, National Cancer Center, Goyang, Republic of Korea.
Jeongseon
J
Kim
Department of Food and Nutrition, College of Human Ecology, Kyung Hee University, Seoul, Republic of Korea.
Seyong
S
Oh
Department of Pediatrics, Dankook University College of Medicine, Cheonan, Republic of Korea.
Jeesuk
J
Yu
Department of Occupational and Environmental Medicine, School of Medicine, Eulji University, Daejeon, Republic of Korea.
Seong-Sil
SS
Chang
Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea.
Ho-Jang
HJ
Kwon
Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea.
Youn-Hee
YH
Choi
Environmental Health Research Department, National Institute of Environmental Research, Incheon, Republic of Korea.
Wookhee
W
Choi
Environmental Health Research Department, National Institute of Environmental Research, Incheon, Republic of Korea.
Suejin
S
Kim
Environmental Health Research Department, National Institute of Environmental Research, Incheon, Republic of Korea.
Seung Do
SD
Yu
D000293:Adolescent; D002104:Cadmium / Q000652:urine*; D002648:Child; D002675:Child, Preschool; D004784:Environmental Monitoring; D004785:Environmental Pollutants / Q000097:blood* / Q000652:urine*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007854:Lead / Q000097:blood*; D008297:Male; D008628:Mercury / Q000097:blood*; D056910:Republic of Korea; D012959:Socioeconomic Factors
D004785:Environmental Pollutants; D002104:Cadmium; D007854:Lead; D008628:Mercury
Blood lead; Blood mercury; Children and adolescents; National sample; Urinary cadmium