Journal of Preventive Medicine and Public Health

Cohort Profile

Etiome Study Using Molecular Epigenetic Markers and Lung Organoid in Korean School Meal Service Workers (Etiome Study in S-meal Workers): Study Protocol: Sungji Moon, Soseul Sung, Sue K. Park; J Prev Med Public Health. 2025;58(3):231-240. Published online April 10, 2025; DOI: https://doi.org/10.3961/jpmph.25.020

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Abstract Summary PDF Supplementary Material: School meal service workers may face an increased risk of lung cancer due to the nature of their work. This study aims to assess environmental exposure levels during occupational cooking among these workers in Seoul, Korea, and to examine the associations with carcinogen-associated biomarkers. Additionally, the study seeks to verify lung carcinogenesis through experiments using lung organoids treated with carcinogens, such as polycyclic aromatic hydrocarbons (PAHs) and particulate matter. Here, we introduce the study protocol and outline our research strategies. This etiome study employs molecular epidemiological approaches involving at least 200 school meal service workers from 25-30 school cafeterias in Seoul, as well as in vitro lung organoid experiments. The study includes a questionnaire survey to analyze workers’ occupational environments, focusing on exposure to hazardous substances such as cooking oil fumes and assessing the use of personal protective equipment (e.g., masks) and the presence of ventilation systems. We measure molecular epigenomic biomarkers, including PAH adducts and metabolites along with methylation markers, in the exposure and control groups. Additionally, lung organoid experiments are performed to investigate the potential for lung cancer development due to respiratory carcinogen exposure in cooks. This study is expected to contribute to health risk assessments and the establishment of preventive strategies for meal service workers.; Summary

Korean summary
조리업 종사자의 폐암 발생 위험도가 높다고 보고되지만 실제 발암 물질에 어느정도 노출되어 있는지 전 세계적으로 아직까지 밝혀진 바 없습니다. 본 연구는 서울시내 학교 조리업 종사자 모집과 발암물질 노출 마커 측정 대한 방법론적인 논문이며 향후 추적 관찰할 수 있는 코호트 연구에 대한 초석 역할을 합니다.

Key Message
Although previous studies have reported an increased risk of lung cancer among cooking workers, the extent of their exposure to carcinogens has not yet been well characterized globally. This study presents the methodology for recruiting school cooking workers in Seoul and measuring biomarkers of carcinogen exposure. It serves as a foundational step toward establishing a prospective cohort for long-term follow-up.

Original Articles

The Role of CYP2B6*6 Gene Polymorphisms in 3,5,6-Trichloro-2-pyridinol Levels as a Biomarker of Chlorpyrifos Toxicity Among Indonesian Farmers: Jen Fuk Liem, Dwi A. Suryandari, Safarina G. Malik, Muchtaruddin Mansyur, Dewi S. Soemarko, Aria Kekalih, Imam Subekti, Franciscus D. Suyatna, Bertha Pangaribuan; J Prev Med Public Health. 2022;55(3):280-288. Published online May 16, 2022; DOI: https://doi.org/10.3961/jpmph.21.641

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4 Crossref

Objectives
One of the most widely used pesticides today is chlorpyrifos (CPF). Cytochrome P450 (CYP)2B6, the most prominent catalyst in CPF bioactivation, is highly polymorphic. The objective of our study was to evaluate the role of CYP2B6*6, which contains both 516G>T and 785A>G polymorphisms, in CPF toxicity, as represented by the concentration of 3,5,6-trichloro-2-pyridinol (TCPy), among vegetable farmers in Central Java, Indonesia, where CPF has been commonly used.
Methods
A cross-sectional study was conducted among 132 vegetable farmers. Individual socio-demographic and occupational characteristics, as determinants of TCPy levels, were obtained using a structured interviewer-administered questionnaire and subsequently used to estimate the cumulative exposure level (CEL). TCPy levels were detected with liquid chromatography-mass spectrometry. CYP2B6*6 gene polymorphisms were analyzed using a TaqMan® SNP Genotyping Assay and Sanger sequencing. Linear regression analysis was performed to analyze the association between TCPy, as a biomarker of CPF exposure, and its determinants.
Results
The prevalence of CYP2B6*6 polymorphisms was 31% for *1/*1, 51% for *1/*6, and 18% for *6/*6. TCPy concentrations were higher among participants with CYP2B6*1/*1 than among those with *1/*6 or *6/*6 genotypes. CYP2B6*6 gene polymorphisms, smoking, CEL, body mass index, and spraying time were retained in the final linear regression model as determinants of TCPy.
Conclusions
The results suggest that CYP2B6*6 gene polymorphisms may play an important role in influencing susceptibility to CPF exposure. CYP2B6*6 gene polymorphisms together with CEL, smoking habits, body mass index, and spraying time were the determinants of urinary TCPy concentrations, as a biomarker of CPF toxicity.

Summary

Citations

Citations to this article as recorded by

Aplicaciones de la xenometabolómica para la identificación de biomarcadores de toxicidad: una revisión del tema
Juan Pablo Betancourt Arango, Alejandro Patiño Ospina, Gonzalo Taborda Ocampo, Jhon Alexander Fiscal Ladino
Biosalud.2025; 19(1): 7. CrossRef
Pesticide metabolite 3, 5, 6-trichloro-2-pyridinol causes massive damage to the cochlea resulting in hearing loss in adult mice
Mao Huang, Shuangshuang Mao, Yunfei Pan, Ziying Zhang, Fei Gui, Xiaohua Tan, Yu Hong, Rong Chen
Environmental Pollution.2024; 360: 124691. CrossRef
Human CYP2C19 Substrate and Inhibitor Characterization of Organophosphate Pesticides
Patricia A. Vignaux, Pratik Shriwas, Andre Revnew, Garima Agarwal, Thomas R. Lane, Craig A. McElroy, Sean Ekins
Chemical Research in Toxicology.2023; 36(9): 1451. CrossRef
The determinants of thyroid function among vegetable farmers with primary exposure to chlorpyrifos: A cross-sectional study in Central Java, Indonesia
Jen Fuk Liem, Imam Subekti, Muchtaruddin Mansyur, Dewi S. Soemarko, Aria Kekalih, Franciscus D. Suyatna, Dwi A. Suryandari, Safarina G. Malik, Bertha Pangaribuan
Heliyon.2023; 9(6): e16435. CrossRef

Reconstruction of Radiation Dose Received by Diagnostic Radiologic Technologists in Korea: Yeongchull Choi, Jaeyoung Kim, Jung Jeung Lee, Jae Kwan Jun, Won Jin Lee; J Prev Med Public Health. 2016;49(5):288-300. Published online August 23, 2016; DOI: https://doi.org/10.3961/jpmph.16.064

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Abstract PDF Supplementary Material

Objectives
Diagnostic medical radiation workers in Korea have been officially monitored for their occupational radiation doses since 1996. The purpose of this study was to design models for reconstructing unknown individual radiation doses to which diagnostic radiation technologists were exposed before 1996.
Methods
Radiation dose reconstruction models were developed by using cross-sectional survey data and the personal badge doses of 8167 radiologic technologists. The models included calendar year and age as predictors, and the participants were grouped into six categories according to their sex and facility type. The annual doses between 1971 and 1995 for those who were employed before 1996 were estimated using these models.
Results
The calendar year and age were inversely related to the estimated radiation doses in the models of all six groups. The annual median estimated doses decreased from 9.45 mSv in 1971 to 1.26 mSv in 1995, and the associated dose variation also decreased with time. The estimated median badge doses from 1996 (1.22 mSv) to 2011 (0.30 mSv) were similar to the measured doses (1.68 mSv to 0.21 mSv) for the same years. Similar results were observed for all six groups.
Conclusions
The reconstruction models developed in this study may be useful for estimating historical occupational radiation doses received by medical radiologic technologists in Korea.

Summary

Citations

Citations to this article as recorded by

Trends in Occupational Radiation Doses for U.S. Radiologic Technologists Performing General Radiologic and Nuclear Medicine Procedures, 1980–2015
Daphnée Villoing, David Borrego, Dale L. Preston, Bruce H. Alexander, André Rose, Mark Salasky, Martha S. Linet, Choonsik Lee, Cari M. Kitahara
Radiology.2021; 300(3): 605. CrossRef
Estimation of the historical radiation dose of Korean radiation workers, 1961–1983
Dalnim Lee, Won Jin Lee, Young Woo Jin, Jiyeong Kim, Soojin Park, Sunhoo Park, Songwon Seo
Journal of Radiological Protection.2021; 41(4): 1005. CrossRef
OCCUPATIONAL EXPOSURE CHARACTERISTICS AND FACTORS ASSOCIATED WITH RADIATION DOSES AMONG KOREAN RADIATION WORKERS
Jiyeong Kim, Songwon Seo, Dal Nim Lee, Soojin Park, Ki-Jung Im, Sunhoo Park, Young Woo Jin
Radiation Protection Dosimetry.2020; 189(1): 106. CrossRef
Thyroid cancer risks among medical radiation workers in South Korea, 1996–2015
Won Jin Lee, Dale L. Preston, Eun Shil Cha, Seulki Ko, Hyeyeun Lim
Environmental Health.2019;[Epub] CrossRef
ESTIMATION OF ORGAN DOSES AMONG DIAGNOSTIC MEDICAL RADIATION WORKERS IN SOUTH KOREA
Yeongchull Choi, Eun Shil Cha, Ye Jin Bang, Seulki Ko, Mina Ha, Choonsik Lee, Won Jin Lee
Radiation Protection Dosimetry.2018; 179(2): 142. CrossRef
Projected lifetime cancer risks from occupational radiation exposure among diagnostic medical radiation workers in South Korea
Won Jin Lee, Yeongchull Choi, Seulki Ko, Eun Shil Cha, Jaeyoung Kim, Young Min Kim, Kyoung Ae Kong, Songwon Seo, Ye Jin Bang, Yae Won Ha
BMC Cancer.2018;[Epub] CrossRef
Assessing the health effects associated with occupational radiation exposure in Korean radiation workers: protocol for a prospective cohort study
Songwon Seo, Wan Young Lim, Dal Nim Lee, Jung Un Kim, Eun Shil Cha, Ye Jin Bang, Won Jin Lee, Sunhoo Park, Young Woo Jin
BMJ Open.2018; 8(3): e017359. CrossRef
Occupational radiation exposure and its health effects on interventional medical workers: study protocol for a prospective cohort study
Seulki Ko, Hwan Hoon Chung, Sung Bum Cho, Young Woo Jin, Kwang Pyo Kim, Mina Ha, Ye Jin Bang, Yae Won Ha, Won Jin Lee
BMJ Open.2017; 7(12): e018333. CrossRef

English Abstract

Reliability of Self-Reported Information by Farmers on Pesticide Use.: Yo Han Lee, Eun Shil Cha, Eun Kyeong Moon, Kyoung Ae Kong, Sang Baek Koh, Yun Keun Lee, Won Jin Lee; J Prev Med Public Health. 2010;43(6):535-542.; DOI: https://doi.org/10.3961/jpmph.2010.43.6.535

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Abstract PDF

OBJECTIVES
Exposure assessment is a major challenge faced by studies that evaluate the association between pesticide exposure and adverse health outcomes. The objective of this study was to investigate the reliability of information that farmers self-report regarding their pesticide use. METHODS: Twenty five items based upon existing questionnaires were designed to focus on pesticide exposure. In 2009 a self-administrated survey was conducted on two occasions four weeks apart among 205 farmers residing in Gyeonggi and Gangwon provinces. For a reliability measure, we calculated the percentage agreement, the kappa statistics and the intraclass correlation coefficient (ICC) between the two reports according to the characteristics of the subjects. RESULTS: Agreement for ever-never use of any pesticide was 96.4% (kappa 0.61). For both 'years used' and 'age at the first use' of overall pesticides, high agreement was obtained (ICC: 0.88 and, 0.78, respectively), whereas those of 'days used' and 'hours used' were relatively low (ICC: 0.42 and, 0.66, respectively). The kappa value for the use of personal protective equipment ranged from 0.46 to 0.59, and hygiene activities came out at 0.19 to 0.37. The agreement for individual pesticide use ranged widely and there was relatively low agreement due to the low response rates. The reliability scores did not significantly vary according to gender, age, the education level, the types of crop or the years of farming. CONCLUSIONS: Our results support that carefully designed, self-reported information on ever-never pesticide use among farmers is reliable. However, the reliability of data on individual pesticide exposure may be unstable due to low response rates and needs to be refined.

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Citations

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Evaluation of two-year recall of self-reported pesticide exposure among Ugandan smallholder farmers
William Mueller, Aggrey Atuhaire, Ruth Mubeezi, Iris van den Brenk, Hans Kromhout, Ioannis Basinas, Kate Jones, Andrew Povey, Martie van Tongeren, Anne-Helen Harding, Karen S. Galea, Samuel Fuhrimann
International Journal of Hygiene and Environmental Health.2022; 240: 113911. CrossRef
Recall of exposure in UK farmers and pesticide applicators: trends with follow-up time
William Mueller, Kate Jones, Hani Mohamed, Neil Bennett, Anne-Helen Harding, Gillian Frost, Andrew Povey, Ioannis Basinas, Hans Kromhout, Martie van Tongeren, Samuel Fuhrimann, Karen S Galea
Annals of Work Exposures and Health.2022; 66(6): 754. CrossRef
Increased risk of atherosclerosis associated with pesticide exposure in rural areas in Korea
Sungjin Park, Jung Ran Choi, Sung-Kyung Kim, Solam Lee, Kyungsuk Lee, Jang-Young Kim, Sung-Soo Oh, Sang-Baek Koh, Paula Boaventura
PLOS ONE.2020; 15(5): e0232531. CrossRef
Exposure to pesticides and the prevalence of diabetes in a rural population in Korea
Sungjin Park, Sung-Kyung Kim, Jae-Yeop Kim, Kyungsuk Lee, Jung Ran Choi, Sei-Jin Chang, Choon Hee Chung, Kyu-Sang Park, Sung-Soo Oh, Sang-Baek Koh
NeuroToxicology.2019; 70: 12. CrossRef
Reliability of self‐reported questionnaire on occupational radiation practices among diagnostic radiologic technologists
Moon Jung Kim, Eun Shil Cha, Yousun Ko, Byung Chul Chun, Won Jin Lee
American Journal of Industrial Medicine.2017; 60(4): 377. CrossRef
Comparison of Questionnaire Items Used to Evaluate the Level of Occupational and Environmental Exposure in Questionnaires for Epidemiological Studies
Jiyeon Lim, Hyung-Suk Yoon, Mansuk Park, Young Seoub Hong, Jong-Koo Lee, Se-Eun Oh, Daehee Kang, Kyoung-Mu Lee
Korean Journal of Environmental Health Sciences.2016; 42(2): 71. CrossRef
Symptom Prevalence and Work-related Risk Factors of Acute Pesticide Poisoning among Korean Farmers in Gyeong-gi Province
Hyang Seok Lee, Ji Hoon Lee, Soo Yong Roh, Ho Gil Kim, Kyung Jun Lee, Sun Ju Nam-gung, Soon Chan Kwon, Soo Jin Lee
Journal of agricultural medicine and community health.2015; 40(4): 228. CrossRef
A Pilot Study for Pesticide Poisoning Symptoms and Information on Pesticide Use among Farmers
Hyun-Joong Kim, Eun-Shil Cha, Eun-Kyeong Moon, You-Sun Ko, Jae-Young Kim, Mi-Hye Jeong, Won-Jin Lee
Korean Journal of Environmental Health Sciences.2011; 37(1): 22. CrossRef
Pesticide Exposure and Health
Won-Jin Lee
Korean Journal of Environmental Health Sciences.2011; 37(2): 81. CrossRef

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