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.

Lifestyle and Psychological Factors Associated With Depression in College Students in Hokkaido, Japan During the COVID-19 Pandemic: A Cross-sectional Study: Atsushi Mizumoto, Reiya Tsuji, Kotomi Echizen, Yuichi Takata; J Prev Med Public Health. 2025;58(6):581-588. Published online July 22, 2025; DOI: https://doi.org/10.3961/jpmph.25.186

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Abstract Summary PDF: Objectives
Although studies have demonstrated a decline in mental health during the early stages of the coronavirus disease 2019 (COVID-19) pandemic, the long-term psychological effects remain insufficiently understood. This study conducted a web-based questionnaire survey to identify factors associated with depression among college students in Hokkaido, Japan, during the COVID-19 pandemic.
Methods
A total of 187 participants who responded to a questionnaire administered in April 2022 were included in this study. The survey evaluated depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CES-D) and included items on exercise habits, sleep duration, food frequency score (FFS), World Health Organization-Five Well-Being Index (WHO-5), Fear of COVID-19 Scale (FCV-19S), daily step count, part-time job participation, and involvement in club activities.
Results
The mean CES-D score was 18.2±9.9, with 95 participants (50.8%) exhibiting symptoms of depression. Compared to those in the depression group, participants in the non-depression group were significantly more likely to engage in regular exercise and part-time jobs, as well as higher FFS, WHO-5, and FCV-19S scores. Logistic regression analysis showed that, even after adjusting for confounding variables, the WHO-5 score, FCV-19S score, and participation in part-time jobs remained significantly associated with depression scores.
Conclusions
Almost half of the participants showed symptoms of depression. These symptoms were associated with poor exercise habits and lack of part-time employment, among other factors. Among college students who had experienced more than 2 years of the pandemic, engaging in part-time work may have reduced social isolation and helped lower the risk of depression.; Summary

Key Message
This study conducted a web-based survey to identify factors associated with depression among college students in Hokkaido during the COVID-19 pandemic. Compared with students in the depression group, those without depression were more likely to engage in regular exercise and part-time jobs and had higher FFS, WHO-5, and FCV-19S scores. Logistic regression showed that WHO-5, FCV-19S, and participation in part-time jobs remained significantly associated with depression after adjustment. Among students who had experienced more than two years of the pandemic, part-time employment may have reduced social isolation and lowered the risk of depression.

Is Job Insecurity Worse for Mental Health Than Having a Part-time Job in Canada?: Il-Ho Kim, Cyu-Chul Choi, Karen Urbanoski, Jungwee Park, Jiman Kim; J Prev Med Public Health. 2021;54(2):110-118. Published online January 11, 2021; DOI: https://doi.org/10.3961/jpmph.20.179

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6 Crossref

Abstract Summary PDF

Objectives
A growing number of people depend on flexible employment, characterized by outsider employment status and perceived job insecurity. This study investigated whether there was a synergistic effect of employment status (full-time vs. part-time) and perceived job insecurity on major depressive disorder.
Methods
Data were derived from the 2012 Canadian Community Health Survey-Mental Health of 12 640 of Canada’s labor force population, aged 20 to 74. By combining employment status with perceived job insecurity, we formed four employment categories: fulltime secure, full-time insecure, part-time secure, and part-time insecure.
Results
Results showed no synergistic health effect between employment status and perceived job insecurity. Regardless of employment status (full-time vs. part-time), insecure employment was significantly associated with a high risk of major depressive disorder. Analysis of the interaction between gender and four flexible employment status showed a gender-contingent effect on this link in only full-time insecure category. Men workers with full-time insecure jobs were more likely to experience major depressive disorders than their women counterparts.
Conclusions
This study’s findings imply that perceived job insecurity may be a critical factor for developing major depressive disorder, in both men and women workers.

Summary

Korean summary
본 연구는 CCHS-MH (2012) 자료를 이용하여 비정규직과 주관적 고용불안정성이 우울장애에 미치는 시너지 효과를 분석하였다. 연구결과 비정규직 여부와 무관하게, 주관적 고용불안정성은 우울장애와의 연관성이 유의하게 높았다. 특히 정규직 여성보다 정규직 남성에서 주관적 고용불안정성과 우울장애의 연관성이 유의하게 높았다. 이 연구결과는 비정규직 여부보다 주관적 고용불안정성이 주요우울장애에 더 큰 영향요인임을 제시하고 있다.

Citations

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The Association Between Oxidative Stress and Depressive Symptom Scores in Elderly Population: A Repeated Panel Study: Changwoo Han, Youn-Hee Lim, Yun-Chul Hong; J Prev Med Public Health. 2016;49(5):260-274. Published online August 23, 2016; DOI: https://doi.org/10.3961/jpmph.16.029

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216 Download
14 Crossref

Abstract PDF Supplementary Material

Objectives
Previous epidemiological studies about oxidative stress and depression are limited by hospital-based case-control design, single-time measurements of oxidative stress biomarkers, and the small number of study participants. Therefore, in this study, we analyzed the association between biomarker of oxidative stress and depressive symptom scores using repeatedly measured panel data from a community-dwelling elderly population.
Methods
From 2008 to 2010, a total of 478 elderly participants residing in Seoul, Korea, were evaluated three times. Participants underwent the Korean version of the Short Form Generic Depression Scale (SGDS-K) test for screening depression, and urinary malondialdehyde (MDA) levels were measured as an oxidative stress biomarker. We used a generalized estimating equation with a compound symmetry covariance structure to estimate the effects of oxidative stress on depressive symptom scores.
Results
A two-fold increase in urinary MDA concentration was significantly associated with a 33.88% (95% confidence interval [CI], 21.59% to 47.42%) increase in total SGDS-K scores. In subgroup analyses by gender, a two-fold increase in urinary MDA concentration was significantly associated with increased SGDS-K scores in both men and women (men: 30.88%; 95% CI, 10.24% to 55.37%; women: 34.77%; 95% CI, 20.09% to 51.25%). In bivariate analysis after an SGDS-K score ≥8 was defined as depression, the third and the fourth urinary MDA quartiles showed a significantly increased odds ratio(OR) of depression compared to the lowest urinary MDA quartile (third quartile OR, 6.51; 95% CI, 1.77 to 24.00; fourth quartile OR, 7.11; 95% CI, 1.99 to 25.42).
Conclusions
Our study suggests a significant association between oxidative stress and depressive symptoms in the elderly population.

Summary

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