OBJECTIVE
To examine the association between alcohol consumption and incident osteoarthritis (OA) and whether it persists after restriction for liver-related and weight-related factors.
DESIGN
We analyzed South Korean National Health Insurance Service data for adults aged ≥40 years who underwent health screening in 2009-2011 and had no recorded OA at baseline. Alcohol consumption was assessed by self-reported drinking frequency and estimated daily ethanol intake. Participants were followed until first claims-based OA diagnosis (ICD-10 M15-M19, excluding traumatic OA), death, or December 31, 2023. Multivariable Cox models estimated adjusted hazard ratios (HRs). Prespecified restricted analyses were conducted in participants with normal liver function and no liver disease history and in participants with normal weight and no obesity history.
RESULTS
Among 1,233,179 participants with drinking-amount data (mean age, 50.8 years), the mean follow-up period was 9.9 years, during which 571,077 cases of OA occurred. Compared with non-drinkers, the light-drinking group had an adjusted HR of 1.037 (95% CI, 1.030-1.045), the moderate-drinking group had an adjusted HR of 1.081 (95% CI, 1.072-1.091), and the heavy-drinking group had an adjusted HR of 1.186 (95% CI, 1.174-1.197). A similar dose-response pattern was observed for drinking frequency and across sensitivity analyses. The pattern also persisted in the normal liver function and normal weight cohorts, and women showed elevated OA risk at lower levels of alcohol consumption than men.
CONCLUSIONS
Alcohol consumption was associated with incident OA in a dose-dependent manner that persisted after liver-related and weight-related restrictions, suggesting that this association is unlikely to be explained solely by hepatic dysfunction or obesity. These findings identify alcohol consumption as a factor associated with incident OA, warranting further investigation as a potentially modifiable contributor to OA risk.
Seoyeon Cho, Sang-Min Yong, Eunhee Ha et al.· Osteoarthritis and Cartilage· 0 citations
BACKGROUND
Bisphenol exposure remains a public health concern, particularly as the use of bisphenol analogues such as bisphenol S (BPS) has increased. In the post-pandemic period, delivery-food consumption has become routine in South Korea and may represent an important behavioral pathway for bisphenol exposure. This study examined whether delivery-food consumption in plastic containers is associated with urinary bisphenols among Korean adults.
METHODS
This study used adult data from the Korean National Environmental Health Survey (KoNEHS) cycle 5 (2021-2023). Delivery-food consumption frequency (nine categories) was modeled per 1-time-per-month increase. Outcomes were urinary bisphenol A (BPA), BPS, and bisphenol F (BPF). Creatinine-adjusted concentrations were analyzed on the natural log scale using multivariable regression models. Model 1 adjusted for sociodemographic factors, and model 2 additionally adjusted for plastic-related behavioral variables.
RESULTS
Among 4,275 adults with complete bisphenol and urinary creatinine data, delivery-food consumption frequency was positively associated with creatinine-adjusted urinary BPS concentrations (1.49% increase per 1-time-per-month increase; 95% confidence interval [CI]: 0.74-2.24; p < 0.001) after sociodemographic adjustment, whereas associations with BPA (0.32% increase; 95% CI, -0.45 to 1.09; p = 0.416) and BPF (-0.14% change; 95% CI: -1.18 to 0.90; p = 0.787) were not statistically significant. After additional adjustment for plastic-related behavioral variables in model 2, the association remained statistically significant for BPS (1.54%; 95% CI, 0.76-2.33; p < 0.001), whereas the associations with BPA and BPF remained non-significant.
CONCLUSIONS
More frequent consumption of delivery foods packaged in plastic containers was independently associated with higher creatinine-adjusted urinary BPS concentrations. Given that common delivery container polymers in Korea are generally bisphenol-free, this association suggests that delivery-related behavior serves as a behavioral surrogate for a bundled exposure scenario. The observed BPS signal may partly reflect cumulative exposure from ancillary materials, such as thermal receipts and labels. Future studies should identify specific delivery-associated sources and migration pathways of bisphenols.
Gwisang Park, Hyeyun Lee, Inchul Jeong et al.· Annals of Occupational and E...· 0 citations
Long-term exposure to fine particulate matter (PM2.5) has been suggested as an environmental risk factor for childhood leukemia. This study examined the association between time-varying PM2.5 exposure and leukemia incidence in a nationwide cohort of Korean children and adolescents. We used data from the National Health Insurance Service-National Sample Cohort (2002-2020), including beneficiaries aged 0-18 years at enrollment who were followed until leukemia onset, death, or study end. Leukemia onset was defined as the first hospital visit with a primary diagnostic code from the 10th revision of the International Classification of Diseases. Annual PM2.5 concentrations were assigned to all 226 inland districts in South Korea using mean predictions from a machine learning-based ensemble model. Cox regression models with time-varying exposures and confounders were applied. Two-pollutant models incorporating NO2 and O3 were conducted as sensitivity analyses. Among 384,606 individuals aged 0-18 at enrollment, 272 developed leukemia during follow-up, including 83 who were diagnosed after the age of 18 years. The cohort's average annual PM2.5 concentration was 29.6 μg/m3 (standard deviation: 3.1). Each 5 μg/m3 increase in annual PM2.5 was associated with a hazard ratio of 1.40 (95% confidence interval: 1.04-1.90) for leukemia. The effect estimate remained comparable when follow-up was censored at age 18 years, suggesting that the findings were not materially influenced by the inclusion of diagnoses occurring after age 18. Long-term PM2.5 exposure was associated with increased leukemia incidence in this national cohort. These findings underscore the importance of reducing air pollution to protect the health of children and adolescents.
Y. Choi, Hyemin Jang, Whanhee Lee et al.· Environmental Research· 0 citations
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