Journal of Preventive Medicine and Public Health

Original Articles

Exposure to Benzene, Toluene, Ethylbenzene, and Xylenes and Risk of Depression: A Cross-sectional Study of a National Sample of Korean Adults: Hyun-Wook Park, Byung-Sun Choi, Bomi Park, Wanhyung Lee, Weon-Young Lee; J Prev Med Public Health. 2026;59(1):95-104. Published online November 6, 2025; DOI: https://doi.org/10.3961/jpmph.25.522

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Abstract Summary PDF Supplementary Material: Objectives
Benzene, toluene, ethylbenzene, and xylenes (BTEX) are co-occurring neurotoxicants that are structurally similar aromatic hydrocarbons sharing common metabolic pathways and mechanisms of toxicity. This study investigated the effects of BTEX exposure on depression and aimed to identify the primary contributors to depression risk.
Methods
We conducted a cross-sectional analysis of 1733 adults from the 2020–2021 Korea National Health and Nutrition Examination Survey. BTEX exposure was quantified based on urinary metabolite concentrations: S-phenylmercapturic acid (SPMA) for benzene, benzylmercapturic acid for toluene, the sum of phenylglyoxylic acid and mandelic acid for ethylbenzene, and methylhippuric acid for xylenes. Depression was defined according to self-reported physician diagnosis. Logistic regression was used to estimate the risk associated with individual chemicals, while weighted quantile sum (WQS) regression was employed to assess mixture effects and identify the primary toxicant. Sensitivity analyses were performed to address potential confounding by tobacco smoke.
Results
Urinary SPMA concentrations were significantly higher in individuals with depression. Logistic regression revealed a significant association between SPMA levels and depression (odds ratio, 2.62; 95% confidence interval, 1.34 to 5.13). Although the overall BTEX mixture was not significantly associated with depression after covariate adjustment in WQS models, SPMA consistently emerged as the major contributor. The association between SPMA and depression remained robust in sensitivity analyses excluding participants exposed to tobacco smoke.
Conclusions
Benzene exposure was associated with an increased risk of depression in the general Korean adult population. Therefore, strengthened environmental regulations on benzene could help reduce the public health burden of depression.; Summary

Korean summary
본 연구는 2020–2021년 국민건강영양조사 자료를 활용하여 한국 성인에서 요중 벤젠, 톨루엔, 에틸벤젠, 자일렌 대사체 농도와 우울증 위험 간의 연관성을 분석하였다. 분석 결과, 벤젠의 대사체인 요중 S-phenyl-mercapturic acid는 우울증 위험 증가와 연관성을 보였다. 흡연 요인을 제외한 민감도 분석에서도 연관성은 일관되게 유지되어, 벤젠 노출 저감을 위한 환경적 관리 강화가 우울증 예방에 기여할 수 있음을 시사한다.

Key Message
This study investigated the association between urinary metabolites of benzene, toluene, ethylbenzene, and xylene and depression risk among Korean adults, using data from the Korea National Health and Nutrition Examination Survey 2020–2021. The findings indicated a significant association between urinary S-phenyl-mercapturic acid, a metabolite of benzene, and an increased risk of depression. This association remained robust after excluding smoking factors, underscoring the potential benefits of improved environmental management in reducing benzene exposure to prevent depression.

Prevalence and Severity of Depression Among Patients With Anemia Attending a Rural Outpatient Clinic in Faridabad, India: A Cross-sectional Study: Prince , Urvashi , Rajat Sharma, Jubair Shamsi, Satya Vir Singh; J Prev Med Public Health. 2025;58(6):629-634. Published online August 9, 2025; DOI: https://doi.org/10.3961/jpmph.25.363

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Abstract Summary PDF: Objectives
This study was performed to determine the prevalence and severity of depression among patients previously diagnosed with anemia and to explore associated clinical and socio-demographic factors.
Methods
This cross-sectional study was conducted from October 2024 to February 2025, among 300 patients with anemia attending the outpatient clinic at the Rural Health Training Centre, Amrita School of Medicine, Faridabad, Haryana. Data on socio-demographic and clinical variables were collected using a structured questionnaire. Depression was evaluated using the Patient Health Questionnaire-9 (PHQ-9). Associations of anemia severity with depression presence and severity were analyzed using the chi-square test, logistic regression, and ordinal logistic regression, with adjustment for potential confounders.
Results
The prevalence of depression (PHQ-9 score>9) among patients with anemia was 31.3%. Severe anemia was significantly associated with higher odds of depression (adjusted odds ratio [aOR], 3.02; 95% confidence interval [CI], 1.13 to 8.07; p=0.027) and more severe depression (aOR, 2.87; 95% CI, 1.14 to 7.27; p=0.026). Symptoms such as weakness (aOR, 3.57) and shortness of breath (aOR, 2.71) were also significantly associated with depression. Moderate anemia displayed a non-significant trend.
Conclusions
Severe anemia is independently associated with both the presence and severity of depression. Routine mental health screening should be integrated into anemia management protocols, especially in rural healthcare settings.; Summary

Key Message
Anemia is a common problem in India, whereas there is a growing awareness about mental health issues like depression. This study was conducted at a Rural Health Training Centre in India, to estimate the prevalence and severity of depression among patients with anemia. The prevalence of anemia was found to be 31.3% (PHQ-9 score > 9), and severe anemia was associated with higher odds of depression and more severe depression. Our study indicated a need of routine mental health screening in patients with anemia.

Predictors and Prevalence of Alcohol and Cannabis Co-use Among Filipino Adolescents: Evidence From a School-based Student Health Survey: Yusuff Adebayo Adebisi, Don Eliseo Lucero-Prisno III, Jerico B. Ogaya, Victor C. Cañezo Jr., Roland A. Niez, Florante E. Delos Santos, Melchor M. Magramo, Ann Rosanie Yap-Tan, Francis Ann R. Sy, Omar Kasimieh; J Prev Med Public Health. 2024;57(3):288-297. Published online May 9, 2024; DOI: https://doi.org/10.3961/jpmph.24.052

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Abstract Summary PDF

Objectives
This study explored the prevalence and predictors of alcohol and cannabis co-use among 9263 Filipino adolescents, using data from the 2019 Global School-based Student Health Survey (GSHS).
Methods
We conducted a cross-sectional secondary analysis of the GSHS, targeting adolescents aged 13-17 years and excluding cases with incomplete data on alcohol and cannabis use. Our analysis employed the bivariate chi-square test of independence and multivariable logistic regression using Stata version 18 to identify significant predictors of co-use, with a p-value threshold set at 0.05.
Results
The weighted prevalence of co-users was 4.2% (95% confidence interval [CI], 3.4 to 5.3). Significant predictors included male sex (adjusted odds ratio [aOR], 4.50; 95% CI, 3.31 to 6.10; p<0.001) and being in a lower academic year, specifically grade 7 (aOR, 4.08; 95% CI, 2.39 to 6.99; p<0.001) and grade 8 (aOR, 2.20; 95% CI, 1.30 to 3.72; p=0.003). Poor sleep quality was also a significant predictor (aOR, 1.77; 95% CI, 1.29 to 2.44; p<0.001), as was a history of attempted suicide (aOR, 5.31; 95% CI, 4.00 to 7.06; p<0.001). Physical inactivity was associated with lower odds of co-use (aOR, 0.45; 95% CI, 0.33 to 0.62; p<0.001). Additionally, non-attendance of physical education classes (aOR, 1.48; 95% CI, 1.06 to 2.05; p=0.021), infrequent unapproved parental checks (aOR, 1.37; 95% CI, 1.04 to 1.80; p=0.024), and lower parental awareness of free-time activities (aOR, 0.63; 95% CI, 0.45 to 0.87; p=0.005) were associated with higher odds of co-use. Factors not significantly linked to co-use included age group, being in grade 9, always feeling lonely, having no close friends, being bullied outside school, and whether a parent or guardian understood the adolescent’s worries.
Conclusions
The findings highlight the critical need for comprehensive interventions in the Philippines, addressing not only physical inactivity and parental monitoring but also focusing on sex, academic grade, participation in physical education classes, sleep quality, and suicide attempt history, to effectively reduce alcohol and cannabis co-use among adolescents.

Summary

Key Message
This cross-sectional study examines the prevalence and key predictors of alcohol and cannabis co-use among 9263 Filipino adolescents using data from the 2019 Global School-based Student Health Survey. Significant predictors of co-use include male sex, lower academic grade, poor sleep quality, history of attempted suicide, physical inactivity, non-attendance in physical education classes, infrequent parental checks, and low parental awareness of adolescents' activities, with a weighted co-use prevalence of 4.2%. The study underscores the need for comprehensive interventions addressing these factors to reduce substance co-use among Filipino adolescents.

Citations

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Comparing self-rated health among exclusive e-cigarette users and traditional cigarette smokers: an analysis of the Health Survey for England 2019
Yusuff Adebayo Adebisi, Duaa Abdullah Bafail
Internal and Emergency Medicine.2025; 20(2): 441. CrossRef
Self-rated health differences between exclusive e-cigarette users and exclusive cigarette smokers: evidence from the 2017–2019 Scottish Health Survey
Yusuff Adebayo Adebisi, Don Eliseo Lucero-Prisno, Isaac Olushola Ogunkola
Internal and Emergency Medicine.2025; 20(3): 771. CrossRef
Prevalence, drug education, and other associated factors of current illicit drug use among a nationally representative sample of school-aged adolescents in the Philippines in 2019
Supa Pengpid, Karl Peltzer, Lyndon Esconde Santos, Earl Francis Infante Mallari
Substance Abuse Treatment, Prevention, and Policy.2025;[Epub] CrossRef
Prevalence Rates, Perceptions of Risk, and Motivations for Nonmedical Cannabis Use in Pediatric Pain
Joe Kossowsky, Christine Greco, Bridget A. Nestor, Camila Koike, Nicole Tacugue, Andreas M. Baumer, Elissa R. Weitzman
JAMA Network Open.2025; 8(5): e2512870. CrossRef
Sleep Disturbances Across the Addiction Stages: A Review of Alcohol, Cannabis and their Co-Use
Claudia B. Padula, Ariel Grayson, Sarah Izabel, Lea-Tereza Tenekedjieva, Emma Zhang, Andrea N. Goldstein-Piekarski
Current Addiction Reports.2025;[Epub] CrossRef
Prevalence, demographic, socio-economic, and lifestyle factors associated with cigarette, e-cigarette, and dual use: evidence from the 2017–2021 Scottish Health Survey
Yusuff Adebayo Adebisi, Duaa Abdullah Bafail, Oluwatobi Ebenezer Oni
Internal and Emergency Medicine.2024; 19(8): 2151. CrossRef

Association Between the Frequency of Eating Non-home-prepared Meals and Women Infertility in the United States: Sohyae Lee, Jin-young Min, Hye-Jin Kim, Kyoung-bok Min; J Prev Med Public Health. 2020;53(2):73-81. Published online February 10, 2020; DOI: https://doi.org/10.3961/jpmph.19.218

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Abstract Summary PDF

Objectives
The purpose of this study was to determine whether eating non-home-prepared meals (NHPM), including fast food, ready-to-eat foods, and frozen foods, was associated with self-reported infertility in the United States women. Methods: Data on diet and infertility from women aged 20-49 years who participated in the 2013-2014 and 2015-2016 National Health and Nutrition Examination Surveys were analyzed (n=2143). Dietary information, including the number and types of NHPM consumed, was obtained from a self-reported questionnaire, and infertility status was analyzed using the following question, “Have you ever attempted to become pregnant over a period of at least a year without becoming pregnant?” Results: The frequency of NHPM consumption was positively associated with self-reported infertility after adjusting for confounding effects (odds ratio [OR], 2.82; 95% confidence interval [CI], 1.48 to 5.38 of >1 vs. 0 NHPM/d). The odds of infertility were 2-3 times higher in women who consumed fast food than in those who did not consume fast food (OR, 2.73; 95% CI, 1.15 to 6.48 of >1 vs. 0 times/d). Conclusions: The frequency and types of NHPM may be a factor contributing to infertility. Although our findings require confirmation, they suggest that eating out may be deleterious to women fecundity.

Summary

Korean summary
본 연구에서는 미국 국민건강영양조사 자료를 사용하여 패스트푸드, 냉동식품, 그리고 포장하여 판매하는 음식과 같이 집에서 조리하지 않은 음식 섭취와 불임의 연관성을 분석하였다. 잠재적인 교란변수들을 통제하여 분석한 결과 집에서 조리하지 않은 음식 섭취 횟수는 불임과 연관이 있는 것으로 나타났다 (OR 2.82, 95% CI 1.48 to 5.38 of >1 vs. 0 NHPM/d).

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Current trends in take-out food consumption and its influencing factors among first-trimester pregnant women in Changsha
Sheng Teng, Yi Yang, Leshi Lin, Wenjuan Li, Li Li, Fang Peng, Xiao Gao, Dongmei Peng
BMC Public Health.2025;[Epub] CrossRef
Junk Food Infertility: A Silent Threat to Reproductive Health in Pakistani Youth
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Diet and female fertility: a population-based study re-evaluating the need for prescriptive dietary patterns
Simon Alesi, Jessica A. Grieger, Helena Teede, James R. Hébert, R. Kendal Moss, Sherry Price, Allison Hodge, Lisa Moran, Aya Mousa
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Maryam Khalid Rizvi, Roshina Rabail, Seemal Munir, Muhammad Waleed Rizvi, Gholamreza Abdi, Rana Muhammad Aadil
Food Science & Nutrition.2024; 12(9): 6226. CrossRef
Assessing the influence of preconception diet on female fertility: a systematic scoping review of observational studies
Simon Alesi, Nahal Habibi, Thais Rasia Silva, Nicole Cheung, Sophia Torkel, Chau Thien Tay, Alejandra Quinteros, Hugo Winter, Helena Teede, Aya Mousa, Jessica A Grieger, Lisa J Moran
Human Reproduction Update.2023; 29(6): 811. CrossRef
Environmental factors in declining human fertility
Niels E. Skakkebæk, Rune Lindahl-Jacobsen, Hagai Levine, Anna-Maria Andersson, Niels Jørgensen, Katharina M. Main, Øjvind Lidegaard, Lærke Priskorn, Stine A. Holmboe, Elvira V. Bräuner, Kristian Almstrup, Luiz R. Franca, Ariana Znaor, Andreas Kortenkamp,
Nature Reviews Endocrinology.2022; 18(3): 139. CrossRef
Impact of Ready-Meal Consumption during Pregnancy on Birth Outcomes: The Japan Environment and Children’s Study
Hazuki Tamada, Takeshi Ebara, Taro Matsuki, Sayaka Kato, Hirotaka Sato, Yuki Ito, Shinji Saitoh, Michihiro Kamijima, Mayumi Sugiura-Ogasawara
Nutrients.2022; 14(4): 895. CrossRef

Non-linear Relationship Between Body Mass Index and Lower Urinary Tract Symptoms in Korean Males: Chang Kyun Choi, Sun A Kim, Ji-An Jeong, Sun-Seog Kweon, Min-Ho Shin; J Prev Med Public Health. 2019;52(3):147-153. Published online March 29, 2019; DOI: https://doi.org/10.3961/jpmph.18.259

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Abstract Summary PDF

Objectives
The purpose of this study was to evaluate the association between body mass index (BMI) and severe lower urinary tract symptoms (LUTS) in Korean males.
Methods
This study was conducted on males aged ≥50 years who participated in the 2011 Korean Community Health Survey. LUTS severity was assessed using the Korean version of the International Prostate Symptom Score (IPSS) questionnaire, and was dichotomized as severe (IPSS >19) and non-severe (IPSS ≤19). BMI was divided into 6 categories: <18.5, 18.5-22.9, 23.0-24.9, 25.0-27.4, 27.5-29.9, and ≥30.0 kg/m2. To evaluate the relationship between BMI and LUTS, a survey-weighted multivariate Poisson regression analysis was performed to estimate prevalence rate ratios (PRRs). Age, smoking status, alcohol intake, physical activity, educational level, household income, and comorbidities were adjusted for in the multivariate model.
Results
A U-shaped relationship was detected between BMI and severe LUTS. Compared with a BMI of 23.0-24.9 kg/m2, the PRR for a BMI <18.5 kg/m2 was 1.65 (95% confidence interval [CI], 1.35 to 2.02), that for a BMI of 18.5-22.9 kg/m2 was 1.25 (95% CI, 1.09 to 1.44), that for a BMI of 25.0-27.4 kg/m2 was 1.20 (95% CI, 1.00 to 1.45), that for a BMI of 27.5-29.9 kg/m2 was 1.11 (95% CI, 0.83 to 1.47), and that for a BMI ≥30.0 kg/m2 was 1.85 (95% CI, 1.18 to 2.88).
Conclusions
This study showed that both high and low BMI were associated with severe LUTS.

Summary

Korean summary
이 연구는 2011 지역사회건강조사를 기반으로 하였다. 한국인 남성에서 체질량지수와 하부요로증상 간에는 U자형 관련성이 있었으며, 저체중과 비만 모두 높은 하부요로증상 유병률을 보였다. 따라서 전립선 질환의 건강서비스 제공에 있어서 비만 뿐만 아니라 저체중 또한 위험인자로 함께 고려할 필요가 있다.

Citations

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Metabolic syndrome and male lower urinary tract symptoms
Gallus B. INEICHEN, Fiona C. BURKHARD
Panminerva Medica.2022;[Epub] CrossRef

Urinary Mercury Levels Among Workers in E-waste Shops in Nakhon Si Thammarat Province, Thailand: Somsiri Decharat; J Prev Med Public Health. 2018;51(4):196-204. Published online June 19, 2018; DOI: https://doi.org/10.3961/jpmph.18.049

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Abstract PDF

Objectives
To determine urinary mercury levels in e-waste workers in Southern Thailand and the airborne mercury levels in the e-waste shops where they worked, to describe the associations between urinary and airborne mercury levels, and to evaluate the prevalence of mercury exposure-related health effects among e-waste workers.
Methods
A cross-sectional study was conducted by interviewing 79 workers in 25 e-waste shops who lived in Nakhon Si Thammarat Province, Thailand. Information on general and occupational characteristics, personal protective equipment use, and personal hygiene was collected by questionnaire. Urine samples were collected to determine mercury levels using a cold-vapor atomic absorption spectrometer mercury analyzer.
Results
The e-waste workers’ urinary mercury levels were 11.60±5.23 μg/g creatinine (range, 2.00 to 26.00 μg/g creatinine) and the mean airborne mercury levels were 17.00±0.50 μg/m3 (range, 3.00 to 29.00 μg/m3). The urinary and airborne mercury levels were significantly correlated (r=0.552, p<0.001). The prevalence of self-reported symptoms was 46.8% for insomnia, 36.7% for muscle atrophy, 24.1% for weakness, and 20.3% for headaches.
Conclusions
Personal hygiene was found to be an important protective factor, and should therefore be stressed in educational programs. Employers should implement engineering measures to reduce urinary mercury levels and the prevalence of associated health symptoms among e-waste workers.

Summary

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English Abstract

Health-related Quality of Life Assessment by the EuroQol-5D in Some Rural Adults.: Mi Ah Han, So Yeon Ryu, Jong Park, Myung Geun Kang, Jong Ku Park, Ki Soon Kim; J Prev Med Public Health. 2008;41(3):173-180.; DOI: https://doi.org/10.3961/jpmph.2008.41.3.173

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Abstract PDF

OBJECTIVES
The purposes of this study were to examine the health-related quality of life(HRQoL) and to identify its related factors for a group of rural adults. METHODS: The study subjects were 1,901 adults who were aged 40-70 years and who were living in Naju City, Jeollanamdo. The sociodemographic characteristics, health-related behavior, health status and global self-rated health were collected for statistical analysis. The healthrelated quality of life was measured by the Euroqol EQ-5D instrument. The differences on the EQ-5D index between the groups were assessed with t-test, ANOVA and hierarchical multiple regression analysis. RESULTS: Overall, the mean value of the EQ-5D index was 0.884+/-0.140 and this score was significantly different according to the socioeconomic characteristics, the healthrelated behavior, the health status and the global self-rated health. According to the results from the hierarchical multiple regression analysis, the HRQoL was significantly reduced for females, older subjects, and other subjects with no spouse and the subjects with osteoporosis, obesity, mental distress or poorer global self-rated health. CONCLUSIONS: The HRQoL for rural adults was related to the socioeconomic characteristics, the health status and the global self-rated health. A better understanding of the factors related to the HRQoL would help to improve the rural adults' quality of life.

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Original Article

Community Based Cross-sectional Study on the Risk Factors of Dementia among the Elderly in a City.: Ihn Sook Jeong, Jung Soon Kim, Byung Chul Chun, Eu Soo Cho; Korean J Prev Med. 2002;35(4):313-321.

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Abstract PDF: OBJECTIVES
To identify the risk factors of dementia among the elderly in a large city. METHODS: A cross-sectional study was conducted in July 2001, with potential participants selected by stratified two stage cluster sampling of the elderly population of Keumgog dong, Busan. A total of 452 elderly people aged 65 years and over, underwent a two phase diagnostic procedure. Mini-mental State Examination-Korean (MMSE-K) and Samsung Dementia Questionnaire were used for the 1st stage, and the Clinical Dementia Rating Scale (CDR), the Bartel ADL, and IADL Index, the Korean Geriatric Depression Scale (KGDS), the Modified Hatchinski Ischemic Scale (MHIS), and other laboratory tests were used for the 2nd stage. RESUJLTS: Of the 446 participants finally chosen, 45 were confirmed with dementia, and 363 as normal, with the rests not confirmed with dementia or as normal, were excluded from the analysis. According to the logistic regression analysis, the risk of dementia was significantly higher in; people aged 80 and above (OR=4.36, 95% CI=1.97-9.62), illiterate (OR=3.58, 95% CI=1.71-7.46), who had a history of strokes (OR=6.35, 95% CI=2.71-14.87), or who had a history of hyperlipidemia (OR=4.74, 95% CI=1.65-13.61), compared to their counterparts. CONCLUSIONS: These results suggest that efforts to prevent strokes and hyperlipidemia can significantly decrease the risk of dementia.; Summary

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