Objectives:The purpose of this study is to reveal the circumstances under which the cases of harm to health caused by humidifier disinfectant were neglected and show the points where the number of victims and the degree of damage could have been reduced.In addition, it attempts to describe how damage management proceeded immediately after the incident and actually exacerbated the damage.Finally, it explores the unfortunate aspects of the recent trial.By doing so, it attempts to take this as an opportunity to consider whether a tragic event such as the humidifier disinfectant incident could occur in the future. Methods:This study collected and analyzed data on chemical material characteristics related to humidifier disinfectants, data on health effect characteristics, data on related laws and regulations from the Ministry of Environment, data related to the damage investigation by the Korea Environmental Industry and Technology Institute, and current contents. Results:The lack of related systems and laws is the area where the greatest responsibility for the cause of the humidifier disinfectant disaster falls, so it is difficult for the government to escape this responsibility.Establishing a dedicated department to identify the prevalence of certain diseases within the functions of the Health Insurance Review and Assessment Service to monitor health can greatly contribute to the prevention and management of diseases through early detection and management of group outbreaks caused by harmful factors.Humidifier disinfectant damage relief should have been expanded earlier beyond HDLI (humidifier disinfectant lung injury) to include non-specific diseases such as asthma, pneumonia, and interstitial pneumonia.The scope of relief benefits should have also been expanded earlier to include the payment of disability benefits.Fortunately, with the 2020 revision of the Special Act, the conditions for estimating causal relations were eased and individual screening systems such as health impact assessment were reorganized along with the introduction of a rapid screening system. Conclusions:The management system for chemical substances in a country is clearly of paramount importance, and the ministry in charge must have a response system in case of damage to health effects.Administration that looks at the victims' situation from their point of view is needed, and technical countermeasures are required to quickly recognize the prevalence of certain diseases.

Objectives: The lung injuries by exposure to the humidifier disinfectants (HDs) were reported in 2011, Korea. For the HD victims, environmental exposure level and clinical diagnosis were conducted to determine the levels of damage by HDs. Methods: The exposure assessment to the HDs from 1st to 4th q...

Bisphenol S (BPS), an alternative compound of bisphenol A, has been found to affect reproduction, development, and immune system. Although microRNAs (miRNAs) play an important role in many metabolic activities, whether and how they are involved in the process of BPS-induced toxicity is unknown. In the present study, BPS-induced changes in miRNAs and target gene expression in male zebrafish gonad, and the potential mechanism was investigated. Male zebrafish were exposed to 0, 5, and 50μg/L BPS for 21 d. miRNA was isolated from the gonad pool and the expression profiles of 255 known zebrafish miRNAs were analyzed using microarrays. Quantitative real-time polymerase chain reaction was used to validate the expression of several miRNAs in the microarray data. The GO term analysis revealed that miRNAs significantly affected by BPS exposure were involved in hematopoiesis, lymphoid organ development, and immune system development. Among 14 miRNAs that were significantly regulated after exposure to 5 and 50μg/L BPS, six targeted cyp19a1b gene, suggesting the role of BPS-induced toxicity via the interference with the aromatization process. Our findings provide novel insight into the epigenetic regulatory mechanisms of BPS-induced toxicity in male zebrafish, and identification of novel miRNA biomarkers for exposure to BPS.

Health adverse effect such as lung disease caused by chemical substances (PHMG, PGH, CMIT/MIT) used in humidifier disinfectants occurred in Korea. 6,005 of requests have been registered up to March 30, 2018 including 1,320 of the dead since 2011 when environment exposure survey has begun. Ministry of Environment of Korea (ME) has conducted comprehensive judgment including medical and environment exposure assessment for victims to evaluate lung disease and causal relationship by exposure to humidifier disinfectant, and organized the Expert Judgment Committee, and conducted a comprehensive judgment. Relationships between exposure characteristics such as ingredient of product, use amount, and use characteristics and health effects were conducted for 2,203 victims from 2011 to 2017 by using of exposure questionnaire. The categories that recorded in survey such as daily using time, cumulative time, using time during sleep, distance from respiratory organ, spraying direction, concentration in the air, exposure level of humidifier disinfectants were scored and exposure levels were graded. We assessed the characterization of exposure to humidifier disinfectants for victims using questionnaire survey, and classified the exposure levels into 5 grades such as definite, probable, possible, indeterminate and unlikely. As victim register order increase, the rate of victims of grade 'definite' decrease. There were differences between scored exposure grades and final judgements. The statistical test shows differences in results of comprehensive judgment and environment exposure assessment. It can be explained by the records of the questionnaire on past exposures may be uncertain due to recall bias or psychological effects. If the various health effects data of the humidifier disinfectant victims are analyzed, the users with similar conditions of the humidifier usage characteristics might be grouped to inspect the health effect based on the exposure assessment results.

Objectives: Because the amount of medical waste (i.e., health-care waste) generated in Korea is rapidly increasing and social concern against its safety is widespread, a number of issues related with medical wastes are being discussed. The purpose of this study is to compare diverse medical waste management systems worldwide and propose future directions of a medical waste management system in Korea. Methods: Literature review was conducted mainly on the WHO, and developed countries such as the European Union (Germany, Belgium and UK), Japan and the United States. For these countries, the data with respect to their systems for medical waste management ranging from the definition of medical waste to the whole processes of collection, transportation and disposal were summarized and compared. Results: The terminology and classification of medical wastes were not consistent for WHO recommendation, EU, Japan, US and Korea. Comparison of the collection, storage, transportation and disposal of medical waste showed that Korea had rather stronger regulations for medical waste management compared to developed countries including Belgium (Flanders region), Germany, Japan and the US. Considering that developed countries adopt rather flexible disposal system especially for general medical wastes which pose lower possibility of infection, Korean government could consider diversifying disposal methods other than incineration. It may also be very important to try to reduce the amount of medical wastes and enough capacity for off-site incineration are secured. Conclusion: Our study of international comparisons suggests that it is necessary to continue to identify advantages and disadvantages of the current medical waste management systems and establish more effective one in Korea.

Thyroid endocrine disruption by bisphenol AF (BPAF) alone or in combination with sulfamethoxazole (SMX) exposure was evaluated in adult male zebrafish. Changes in thyroid gene transcription were examined using microarrays and were linked to effects on thyroxine hormone production and transcription of genes related to the hypothalamic-pituitary-thyroid axis. BPAF alone or in combination with SMX affected genes related to thyroid hormone production and receptor activity, thyroid gland development, and deiodinase activity. Increases in thyroxine levels, and gene transcription were more pronounced in the BPAF and SMX mixture group than in the BPAF group. Significant down-regulation of trh and tshβ genes in the brain suggested a negative feedback response resulting in increased thyroxine levels. The present study indicated that BPAF exposure alone alters transcription of genes associated with the thyroid endocrine system, and combination with SMX could increase the endocrine disrupting effect of BPAF.

Perfluorinated compounds (PFCs) are linked to adverse effect on human healths, therefore, the aim of this study was to determine the levels of PFCs in prepared food. One hundred and fifty-one samples of six prepared food groups were purchased from retail food establishments in Korea. Twelve PFCs were detected in the sample, the accuracy ranged between 80.8-119.4% and precision ranged between 2.2-2.89% high and low concentrations in PFCs spiked samples. The detection frequency of perfluoro-pentanoic acid (PFPeA) was and perfluorooctanoic acid (PFOA) above the limit of detection, which was 84.1 and 82.8%, respectively, but positive detection frequency of perfluorooctanesulphonic acid (PFOS) was as shown as low as 29.1%. Residual PFOA levels in most of the samples were higher than the PFOS levels. The average concentration of total PFCs in the samples was 1.68±1.79 ng/g, and PFPeA and PFOA were the predominant PFCs.

Objectives: In Korea, the system of management of medical waste largely relies on the incineration method. Our study aimed to identify any regional imbalances between the generation and treatment of medical waste, and provide reference data for future policy in Korea. Methods: We analyzed data on the amount of medical waste from 2,000 hospitals in 2012, 2013, and 2014 obtained from the Korea Environment Corporation. In the Arc GIS program (version 10.2.3), the addresses of hospitals and incinerators were transformed into map coordinates. The amount of waste generated by each hospital and the amount incinerated were represented by density and size of a triangle symbol, respectively. Results: As of 2014, the total amount of medical waste from the top 2,000 hospitals was 136,073 tons, out of which about half (49%) was generated in the capital area. Eleven incineration companies (three in the capital area, two in the Chungcheong Provinces area, one in the Jeolla Provinces area, and five in the Gyeongsang Provinces area) treated this waste. For the years 2012, 2013, and 2014, about 60% of the medical waste generated from the hospitals in the capital area was treated within the capital area and about 40% was transported to other areas, especially the Gyeongsang Provinces area, for treatment. On the other hand, about 90% of the medical waste incinerated in the capital area originated from the capital area. Conclusion: Our results suggest a spatial imbalance between the generation and treatment of medical waste in Korea and warrants multilateral policies, including the expansion of on-site treatment, strengthening regulation of the containment of medical wastes, promoting reductions in medical waste and more.

Objectives: The internal dose of ethyl parabens is important in order to evaluate the risk of this chemical. However, there are little PK model data for parabens to apply this. This experiment attempted PK modeling to ascertain PK values. Methods: Twenty mg/kg ethyl paraben was administered orally to Sprague-Dawley rats at the same point in time. The rats were sacrificed at times 0, 15, 30 and minutes, and 1, 2, 4, 8, 12, 24 hours after oral gavage. Blood and urine were collected and pretreated for analysis. Accuracy, precision and LOD (limit of detection) were calculated for this analysis. Ethyl paraben, detected by HPLC-MS, was applied to PK modeling using Berkeley Madonna. Results: This study showed 100.1-103.7% accuracy, 1.4-3.7% precision and a 1.0 ng/mL limit of detection. Orally administered ethyl paraben reached maximum concentration after 30 minutes of dosing in serum and urine of rats. The concentrations were 2,354 ng/mL in serum and 386,000 ng/mL in urine samples. These peak concentrations were excreted after one hour of intubation over 12 hours. For the pharmacokinetic parameters of ethyl paraben revealed using Berkeley Madonna, the absorption rate was 5.539/hour, the excretion rate was 0.048/hour, the half-life was 14.441 hours and AUC was 481,186 ng hour/mL. Conclusion: Orally administered ethyl paraben was absorbed rapidly in rats and excreted in urine. This chemical, ethyl paraben, accumulated in the body but was excreted over 12 hours after dosing.

Objectives: Phthalates are used as plasticizers in polyvinyl chloride (PVC) plastics. As phthalate plasticizers are not chemically bound to the PVC, they can leach, migrate or evaporate into indoor air and atmosphere, foodstuffs, other materials, etc. Therefore, humans are exposed through ingestion, inhalation, and dermal exposure over their entire lifetime, including during intrauterine development. In particular, university students have a great number of opportunities to contact products including phthalates during campus life (food packaging, body care products, cosmetic, lotions, aftershave, perfume etc.). The purpose of this study was to examine levels of phthalate exposure as undergraduate students begin to use pharmaceuticals and personal care products including phthalates. Methods: Phthalate metabolites, mono-ethyl phthalate (MEP), mono-n-butyl phthalate (MnBP), mono-isobutyl phthalate (MiBP), mono-2- ethylhexyl phthalate (MEHP), {(mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP}, and mono-(2-ethlyl-5-oxohexyl) phthalate (MEOHP} were examined. 80 urine samples collected from university students were analyzed using LC/MS/MS(API 4000, Applied Bioscience) with on-line enrichment and columnswitching techniques. This study was carried out at Y university located in Gyonggi Province from 2008 to 2011. Results: The detection limit of phthalate metabolites were 0.03 ng/mL for MEP, 0.11 ng/mL for MnBP, 0.08 ng/mL for MiBP, 0.93 ng/mL for MEHP, 0.19 ng/mL for MEOHP and 0.16ng/mL for MEHHP. MnBP showed the highest urinary levels (median: 31.6 ㎍/L, 24.8 ug/g creatinine (cr)). Concentrations were also high for MEHHP (median: 24.1 ㎍/L, 19.0 ㎍/g cr), followed by MEOHP (median: 22.8 ㎍/L, 17.9 ㎍/g cr). In individual cases, the maximum level reached up to 348 ㎍/L, and 291 ㎍/g cr, respectively. The urinary and creatinine adjusted levels of MEP were lower than those for DBP and DEHP metabolites, but were higher in 95th percentiles. As a result, the mean daily DEP intake value was 2.3 ㎍/㎏ bw/day, 3.5 ㎍/㎏ bw/day for DEHP and 4.9 ㎍/㎏ bw/day for DBP. Conclusion: These students’ phthalate exposure levels were below the international safe level set by the EU, but higher than the 2012 KFDA survey of the age group from 3 to 18.

Chronic toxicity of acetaminophen and lincomycin were evaluated using freshwater organisms including two crustaceans (Daphnia magna and Moina macrocopa) and a fish (Oryzias latipes). H295R, a human adrenal cell was also used to understand the effects on steroidogenesis. In 21d D. magna exposure, survival NOEC was found at 5.72mgL−1 and no reproduction related effects were noted at this level of exposure to acetaminophen, while 21d survival or growth effects were not observed even at the highest exposure levels (153mgL−1) for lincomycin. In the chronic fish toxicity test, significant reduction in juvenile survival was observed at 30d post-hatch (dph) at 95mgL−1 of acetaminophen, and 0.42mgL−1 of lincomycin. After the exposure to both pharmaceuticals, vitellogenin levels tended to increase in male fish at 90dph. In the eggs which were prenatally exposed to 9.5mgL−1 of acetaminophen, reduced hatchability was observed. The results of H295R cell assay showed that both pharmaceuticals could alter steroidogenic pathway and increase estrogenicity. Endocrine disruption potentials and their ecological implication may deserve further studies. Our observations suggest however that ecological risks of both pharmaceuticals are negligible at the concentrations currently found in the environment.