Mobile Phone Use and Time Trend of Brain Cancer Incidence Rate in Korea.

This study evaluated the time trends in mobile phone subscriber number by mobile network generation (G) and brain cancer incidence by type in Korea. We obtained data from the Information Technology Statistics of Korea (1984-2017) and Korea Central Cancer Registry (1999-2017). The average annual percent change was estimated using Joinpoint regression analysis. We evaluated 29,721 brain cancer cases with an age-standardized incidence rate (ASR) of 2.89/100,000 persons. The glioma and glioblastoma annual ASR significantly increased in 2.6% and 3.9% of males and 3.0% and 3.8% of females, respectively. The ASR for frontal lobe involvement was the highest. The ASR of gliomas of unspecified grade annually increased by 7.8%; those for unspecified topology and histology decreased. The incidence of glioma, glioblastoma, frontal, temporal, and high-grade glioma increased among those aged ≥60 years. No association was observed between the mobile phone subscriber number and brain cancer incidence in Korea. Furthermore, long-term research is warranted because of the latency period of brain cancer. © 2021 Bioelectromagnetics Society.

Associations among High Risk for Sleep-disordered Breathing, Related Risk Factors, and Attention Deficit/Hyperactivity Symptoms in Elementary School Children.

OBJECTIVE: : Habitual snoring is a common problem in children. We evaluated the association between a high risk for sleep-disordered breathing and attention deficit/hyperactivity symptoms. METHODS: Parents of 13,560 children aged 6 to 12 years responded to questionnaires including items on habitual snoring and the Korean attention deficit/hyperactivity disorder rating scale. The snoring score comprised the number of "yes" responses to habitual-snoring items, and a high risk for sleep-disordered breathing was defined as a snoring score ≥ 2. RESULTS: The odds ratio (OR) of a high risk for sleep-disordered breathing was significantly higher in boys (OR = 1.47; p < 0.001), overweight children (OR = 2.20; p < 0.001), and children with current secondhand-smoking exposure (OR = 1.38; p < 0.001). The Korean attention deficit/hyperactivity disorder rating scale score increased significantly with the snoring score (0 vs. 1, B = 1.56, p < 0.001; 0 vs. 2, B = 2.44, p < 0.001; 0 vs. 3, B = 2.48, p < 0.001; 0 vs. 4, B = 3.95; p < 0.001). CONCLUSION: Our study confirms several risk factors of sleep-disordered breathing, namely male sex, overweight, and exposure to tobacco smoking, and found a positive association between habitual snoring and attention deficit/hyperactivity symptoms.

Associations between Exposure to Bisphenol A and Behavioral and Cognitive Function in Children with Attention-deficit/Hyperactivity Disorder: A Case-control Study.

OBJECTIVE: Bisphenol A (BPA) is a widely produced synthetic chemical used to manufacture polycarbonate plastics and epoxy resins. We aimed to investigate the association between exposure to BPA and behavioral and cognitive function in children with attention-deficit/hyperactivity disorder (ADHD) and healthy controls. METHODS: The study included 444 children aged from 6 to 10 years. The ADHD and control groups included 195 and 249 children, respectively. BPA levels were assessed via urinalysis, while behavior was assessed using the Korean version of the ADHD Rating Scale (K-ARS) and the Behavior Assessment System for Children (BASC-2). Cognitive function was assessed using the Continuous Performance Test (i.e., ADHD Diagnostic System [ADS]). Participants were categorized into tertile groups based on urinary BPA concentration. RESULTS: Scores on the K-ARS and the hyperactivity, aggression, anxiety, and depression subscales of the BASC-2 were significantly different among tertile groups for urinary BPA levels. Scores on visual omission error, commission error, response time variability, and auditory commission error of the ADS were significantly different among three BPA groups. Subgroup analysis revealed that these differences of behavior and cognition among three BPA groups were observed in only boys and normal controls. CONCLUSION: Exposure to BPA was associated with unfavorable behavioral and cognitive outcomes. Our study extends the findings of previous studies regarding the association between BPA exposure and behavior/cognitive function by including children with ADHD. Further studies are required to determine the mechanisms underlying sex- and group-based differences in these associations.

Environmental pollutants affecting children's growth and development: Collective results from the MOCEH study, a multi-centric prospective birth cohort in Korea.

BACKGROUND: The Mothers and Children's Environmental Health study (MOCEH) is a multi-centric prospective birth cohort study investigating effects of various environmental pollutants like heavy metals, endocrine disruptors, air pollutants, nutrition and lifestyle on birth outcomes, growth and development, health and disease of children. In this study, we report all the outcomes from the MOCEH study describing the different environmental pollutants affecting children's health and disease. METHODS: In MOCEH study, 1,751 pregnant women in their first trimester were recruited at 3 centers from 2006 to 2010 in South Korea. The children were followed from birth up to 6 years. Information on health outcomes of children including birth parameters, demographic characteristics, medical and child-rearing history, and nutritional status, were repeatedly obtained through the follow-ups by questionnaires administration, clinical evaluation, and biological specimen collection and measurements. Prenatal and postnatal measurement in biospecimen, i.e., lead, mercury, cadmium, manganese, 1-hydroxypyrene, 2-naphthol, malonadialdehyde, hippuric acid, bisphenol A and phthalate metabolites, and measurement in air samples, i.e., particulate matter, nitrogen dioxide, and total volatile organic compounds were performed. RESULTS: The results show the adverse effect of prenatal exposure to heavy metals like mercury, lead and cadmium on children's physical, cognitive and neurobehavioral development. Exposure to endocrine disruptors, air pollution, second hand smoke, and mother's lifestyle during pregnancy affects children's growth and development. We also identified specific window periods of exposure of pollutants significantly related to children's health outcomes. CONCLUSION: The collective results from MOCEH study provide strong scientific evidence that exposures to prenatal and postnatal environmental pollutants have a negative effect on growth and development of children, which will be useful in implementing effective national policy to improve children's environmental health.

Gender difference in the effects of lead exposure at different time windows on neurobehavioral development in 5-year-old children.

BACKGROUND: Although the association between lead exposure and children's neurodevelopment has been studied, gender differences remain to be investigated. We examined the effects of lead exposure on the neurobehavioral development of 5-year-old children to identify the vulnerable time window of exposure and potential gender difference. METHOD: A total of 1751 pregnant women and children participated in the prospective birth cohort study, Mothers and Children's Environmental Health study, since 2006. Lead levels were measured in the maternal blood in early and late pregnancies, in cord blood at birth, and in 2-, 3-, and 5-year-old children's blood. The behavior of 575 children aged 5years were assessed using the Korean Child Behavior Checklist. The association between the blood lead level at each time window and behavior was examined using a generalized linear model adjusted for potential confounders and covariates. RESULTS: Lead levels at late pregnancy were significantly associated with increased risk of behavioral problems in males. Lead levels in 2- and 5-year-old children's blood significantly increased behavioral risks in females: for a 1-µg/dL increase in blood lead levels, the score for total behavioral problems increased by 3.00 (95% confidence interval [CI]: 0.56-5.45) during the late pregnancy in males, whereas it increased by 3.82 (95% CI: 1.25-6.39) at 2years and by 5.72 (95% CI: 0.44-10.99) at 5years in females with a stronger effect in attention and sleep problems. CONCLUSION: Effects of lead toxicity on children's neurobehavioral development showed gender differences. Males were more susceptible to prenatal exposure, while females were more susceptible to postnatal exposure with stronger effects in attention and sleep problems.

Assessment of radiofrequency electromagnetic field exposure from personal measurements considering the body shadowing effect in Korean children and parents.

We aimed to assess the personal radiofrequency electromagnetic field (RF-EMF) exposure levels of children and adults through their activities, with consideration to the body shadowing effect. We recruited 50 child-adult pairs, living in Seoul, Cheonan, and Ulsan, South Korea. RF-EMF measurements were performed between September and December 2016, using a portable exposure meter tailored to capture 14 Korean radiofrequency (RF) bands ranging from 87.5 to 5875MHz. The participants carried the device for 48h and kept a time-activity diary using a smartphone application in flight mode. To enhance accuracy of the exposure assessment, the body shadowing effect was compensated during the statistical analysis with the measured RF-EMF exposure. The compensation was conducted using the hybrid model that represents the decrease of the exposure level due to the body shadowing effect. A generalized linear mixed model was used to compare the RF-EMF exposure levels by subjects and activities. The arithmetic (geometric) means of the total power density were 174.9 (36.6) µW/m2 for all participants, 226.9 (44.6) for fathers, 245.4 (44.8) for mothers, and 116.2 (30.1) for children. By compensating for the body shadowing effect, the total RF-EMF exposure increased marginally, approximately 1.4 times. Each frequency band contribution to total RF-EMF exposure consisted of 76.7%, 2.4%, 9.9%, 5.0%, 3.3%, and 2.6% for downlink, uplink, WiFi, FM Radio, TV, and WiBro bands, respectively. Among the three regions, total RF-EMF exposure was highest in Seoul, and among the activities, it was highest in the metro, followed by foot/bicycle, bus/car, and outside. The contribution of base-station exposure to total RF-EMF exposure was the highest both in parents and children. Total and base-station RF-EMF exposure levels in Korea were higher than those reported in European countries.

Secondhand Smoke Exposure and Low Blood Lead Levels in Association With Attention-Deficit Hyperactivity Disorder and Its Symptom Domain in Children: A Community-Based Case-Control Study.

AIM: Secondhand smoke (SHS) is a major indoor pollutant. We examined the possible association between exposure to both SHS and low levels of lead and attention-deficit-hyperactivity disorder (ADHD) and its symptom domain in children. METHODS: This case-control study was based on the results of a community survey using the ADHD rating scale conducted in 49 elementary schools. Both cases and control subjects were confirmed by a child psychiatrist. Each case was matched with one control subject according to gender, school, and grade in school. Using a multivariate conditional logistic regression model, we analyzed 214 case-control pairs of children who ranged in age from 6 to 10 years. Urine and blood levels of cotinine and of lead were determined, and information pertaining to SHS exposure was obtained by means of a questionnaire. RESULTS: Exposure to low levels of lead (geometric mean = 1.65 µg/dL) was related to ADHD, particularly inattention (odds ratio [OR] = 1.67, 95% confidence interval [CI] = 1.07-2.59), whereas SHS exposure was associated mainly with hyperactivity/impulsivity (OR = 3.85, 95% CI = 1.55-9.56). In the pathway from blood lead to hyperactivity/impulsivity, children's SHS exposure mediated and indirectly accounted for about 73% of this relationship. The combined exposure to lead and SHS synergistically increased the risk of ADHD, evident as both inattention and hyperactivity/impulsivity. CONCLUSION: SHS, which is associated with hyperactivity/impulsivity in particular, combined with exposure to low blood levels of lead synergistically increased the risk of ADHD. Therefore, the exposure of children to both SHS and lead needs to be reduced. IMPLICATIONS: Although exposure to low levels of lead has been shown to be associated with ADHD, there is little evidence of symptom domain specificity. In our study, low blood lead levels were related to inattention. In addition, prenatal or postnatal exposure to SHS increased the risk of ADHD, particularly hyperactivity/impulsivity. Combined exposure to lead and SHS synergistically increased the risk for both these ADHD symptom domains. To protect children from environmental risk factors related to ADHD, it is necessary to further reduce children's exposure to SHS and lead, even in those with low blood lead levels.