Epidemiology and Health最新文献

{"title":"Socioeconomic factors affecting breast and cervical cancer screening compliance in Asian National Cancer Centers Alliance countries: a systematic review.","authors":"Seowoo Bae, Ye Ji Kang, Jeonghoon Ahn, Bo-Hyoung Jang, Kui Son Choi, Hyeon Ji Lee, Mina Suh","doi":"10.4178/epih.e2025050","DOIUrl":"https://doi.org/10.4178/epih.e2025050","url":null,"abstract":"<p><strong>Objectives: </strong>Breast and cervical cancers are the most frequently diagnosed cancers in women. The Asian National Cancer Centers Alliance (ANCCA) has strengthened cancer control efforts in the Asia region; however, only a few countries have achieved sufficient participation rates. This systematic review aimed to synthesize the existing evidence on socioeconomic factors influencing women's compliance with breast and cervical cancer screening in ANCCA countries.</p><p><strong>Methods: </strong>This study was conducted as a systematic review, with studies collected from PubMed, Cochrane Library, Scopus, and Embase. All included studies employed cross-sectional designs to identify socioeconomic factors affecting compliance with breast or cervical cancer screening. Study selection, quality assessment, and data extraction were carried out by 2 independent reviewers with cross-checking.</p><p><strong>Results: </strong>In total, 48 studies were reviewed. Education level and family history were associated with participation in breast cancer screening, while education level, household income, marital status, and medical insurance were linked with cervical cancer screening. When stratified by Human Development Index (HDI) level or by the presence of a National Cancer Screening Program, differences were observed in the factors influencing screening compliance. Nevertheless, higher education consistently correlated with higher screening rates for both cancer types, regardless of HDI level.</p><p><strong>Conclusion: </strong>This systematic review identified multiple socioeconomic factors that shape breast and cervical cancer screening compliance in Asian countries. To reduce disparities in participation, tailored multi-strategy approaches adapted to each country's specific context are required. These findings may provide useful evidence for future research and policy initiatives aimed at addressing health equity issues.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2025050"},"PeriodicalIF":2.2,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decentralized pandemic response and health equity: an analysis of socioeconomic disparities in COVID-19 mortality in Japan.","authors":"Hasan Jamil, Aminu Abubakar Kende, Shuhei Nomura, Fumiya Inoue, Takao Suzuki, Stuart Gilmour","doi":"10.4178/epih.e2025049","DOIUrl":"https://doi.org/10.4178/epih.e2025049","url":null,"abstract":"<p><strong>Objectives: </strong>Global data often link greater socioeconomic deprivation to higher COVID-19 mortality. However, whether decentralized governance can mitigate this disparity by enabling tailored, equitable local responses remains unclear. We assessed whether Japan's decentralized pandemic response moderated the association between area-level socioeconomic deprivation and COVID-19 mortality across municipalities.</p><p><strong>Methods: </strong>We analyzed 20,760 COVID-19 deaths from all Japanese municipalities during 2020-2021. We computed standardized mortality ratios using national age- and sex-specific rates to derive expected counts. We then fit a Bayesian spatial Poisson regression model with the log of expected counts as an offset to estimate smoothed relative risks (RRs). The Area Deprivation Index (ADI) represented the primary predictor; structured and unstructured random effects captured spatial correlation and residual variability.</p><p><strong>Results: </strong>Mapping of smoothed RRs, categorized into quintiles, revealed higher mortality risk in northern, central, and western municipalities, with lower risk in southern and scattered central regions. Contradicting global trends, deprivation and COVID-19 mortality demonstrated an inverse association (ADI coefficient, -0.095; 95% credible interval, -0.173 to -0.018), indicating that more deprived municipalities exhibited lower RRs for COVID-19 mortality (9.1% reduction per 1-unit increase in ADI).</p><p><strong>Conclusion: </strong>The inverse relationship between area deprivation and COVID-19 mortality in Japan contrasts with global patterns. Although Japan's decentralized health system ensured equitable access to COVID-19 treatment, lower mortality in more deprived areas likely reflects additional protective factors, including population density patterns and community-specific adaptations. These findings underscore the complex interplay between socioeconomic conditions and health outcomes during global health emergencies.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2025049"},"PeriodicalIF":2.2,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a telemedicine pilot project for hypertension in Korea: a nationwide real-world data study.","authors":"Jeong-Yeon Kim, Yeryeon Jung, Seongwoo Seo, Youseok Kim, Min Jung Ko, Hun-Sung Kim","doi":"10.4178/epih.e2025048","DOIUrl":"https://doi.org/10.4178/epih.e2025048","url":null,"abstract":"<p><strong>Objectives: </strong> A telemedicine pilot project has received temporary authorization in Korea. The clinical effectiveness of telemedicine is well established; however, ongoing research must assess medical utilization, sustainability, prescription continuity, and safety.</p><p><strong>Methods: </strong> This study evaluated medical utilization, sustainability, prescription continuity, and safety before and after the implementation of a telemedicine pilot project between June 2022 and December 2023. Data were obtained from the Korean National Health Insurance Service (NHIS), and participants were divided into those who received non-face-to-face hypertension treatment at least once and those who did not.</p><p><strong>Results: </strong> This study included 124,210 patients diagnosed with hypertension who received telemedicine (the Tele_G group) and 124,210 propensity score-matched control individuals. The difference-in-difference (DID) for medical utilization between the Tele_G and control groups was 0.10 (-0.03 vs. -0.12, p<0.001). The DID for the Modified Modified Continuity Index was -0.005 (-0.003 vs. 0.002, p<0.001), while that for Most Frequent Provider Continuity was -0.006 (-0.004 vs. 0.002, p<0.001). The DID for the prescription day rate was 0.41 (-0.61 vs. -1.02, p<0.001), and that for the appropriate prescription continuation rate was 0.52 (-1.23 vs. -1.75, p<0.005).</p><p><strong>Conclusion: </strong> Telemedicine did not fully achieve the same standard as face-to-face treatment for hypertension management; however, it showed comparable safety, suggesting potential as secondary care. As the first NHIS-based study on this topic in Korea, this research highlights the benefits of telemedicine when appropriately utilized for patients with hypertension. Nevertheless, due to limitations regarding long-term continuity and policy design, cautious interpretation is required, and further prospective studies are warranted.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2025048"},"PeriodicalIF":2.2,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavioral and psychosocial factors associated with sugar-sweetened beverage consumption among Korean adolescents: a path analysis using the 2022 Korea Youth Risk Behavior Survey.","authors":"Hye-Young Park, Soo Rack Ryu, Hoon-Ki Park, Hwan-Sik Hwang, Kye-Yeung Park","doi":"10.4178/epih.e2025047","DOIUrl":"https://doi.org/10.4178/epih.e2025047","url":null,"abstract":"<p><strong>Objectives: </strong>Rising obesity rates among adolescents are a major global health concern and are closely linked to the consumption of sugar-sweetened beverages (SSBs). This study aimed to identify key behavioral and psychosocial factors influencing SSB consumption among adolescents.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from the 2022 Korea Youth Risk Behavior Web-based Survey, which included 49,548 participants aged 12-18 years. Information on SSB consumption frequency, sociodemographic characteristics, eating habits, sedentary behaviors, and other health-related factors was collected through self-administered questionnaires. Path analysis was used to model SSB consumption and estimate the direct and indirect effects of modifiable factors.</p><p><strong>Results: </strong>Male students, current alcohol drinkers, those with higher frequencies of fast-food or late-night snack consumption, and heavy smartphone users were more likely to frequently consume SSBs. Fast-food intake had the strongest direct effect on SSB consumption (B = 0.3884), while nighttime eating showed a substantial direct effect (B = 0.1437) and mediated 21.7% of the relationship between fast-food intake and SSB consumption. Leisure sitting time exerted both direct (B = 0.0741) and indirect effects on SSB intake, mediated through watching mukbang, smartphone use, fast-food consumption, and nighttime eating. Self-perceived health status was negatively associated with SSB consumption (B = -0.0619), with indirect effects mediated by fast-food intake and nighttime eating.</p><p><strong>Conclusion: </strong>Among Korean adolescents, SSB consumption was strongly associated with unhealthy eating patterns and prolonged leisure sitting time. Increased fast-food consumption, nighttime eating, watching mukbang, smartphone use, and negative self-perceived health status not only directly influenced SSB intake, but also acted as mediating factors.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2025047"},"PeriodicalIF":2.2,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for Q fever incidence in South Korea: a comparative analysis using frequentist and Bayesian methods.","authors":"Ji-Hyun Son, Sung-Dae Park","doi":"10.4178/epih.e2025046","DOIUrl":"https://doi.org/10.4178/epih.e2025046","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigated the principal determinants of human Q fever incidence and explored regional variation between metropolitan cities and provinces in South Korea.</p><p><strong>Methods: </strong>Panel data on human Q fever incidence, livestock populations, and facility metrics were collected across 17 metropolitan cities and provinces from 2017 to 2024. Analytical approaches included frequentist models (ordinary least squares [OLS], random effects, fixed effects) and Bayesian models.</p><p><strong>Results: </strong>Frequentist panel analysis indicated that slaughterhouse count was positively associated with Q fever incidence in both pooled OLS (β=1.20, p<0.001) and random effects models (β=1.03, p<0.001), but not in the fixed effects model (β=0.14, p=0.65). After correcting for serial correlation using Driscoll-Kraay standard errors, livestock population (β=0.55, p<0.01), livestock market count (β=-2.01, p<0.05), and livestock Q fever cases (β=-0.11, p<0.01) were significantly associated with human incidence. A Bayesian fixed effects model confirmed a significant relationship between slaughterhouses and human Q fever incidence (posterior mean: 0.87, 95% credible interval [CrI], 0.21-1.42), providing more stable inference with limited samples and allowing probabilistic uncertainty estimation. A Bayesian hierarchical model revealed a stronger association in metropolitan cities (posterior mean, 1.46; 95% CrI, 0.34-2.57) than in provinces (1.22), while livestock population remained significant in provinces (0.94, 95% CrI, 0.15-1.74).</p><p><strong>Conclusion: </strong>In South Korea, slaughterhouse density was the main determinant of Q fever in metropolitan areas and livestock density was the primary risk factor in provinces. These findings underscore the need for region-specific preventive strategies and reinforce the value of a One Health approach.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2025046"},"PeriodicalIF":2.2,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in sustainable dietary patterns in United States adults, 2007-2018.","authors":"Sukyoung Jung, Heather Young, Barbara Braffett, Samuel Simmens, Eunice Hong Lim Lee, Cynthia Ogden","doi":"10.4178/epih.e2025045","DOIUrl":"https://doi.org/10.4178/epih.e2025045","url":null,"abstract":"<p><strong>Objectives: </strong>Adopting sustainable diets is essential for improving both human and planetary health, and such diets should be evaluated from a multidimensional perspective. We characterized trends in sustainable dietary patterns, quantified by the Sustainable Diet Index for US adults (SDI-US), along with trends in diet quality, diet-related environmental impacts, food affordability, and food practices.</p><p><strong>Methods: </strong>This study analyzed data from the National Health and Nutrition Examination Survey (2007-2018) for adults aged ≥20 years (n = 25,543). The SDI-US (range: 4-20 points), with higher scores indicating more sustainable diets, was calculated using 24-hour dietary recall data and responses to consumer and dietary behavior questionnaires. Mean total SDI-US scores, sub-indices, and 12 individual indicators were estimated for each survey cycle. Trends were assessed using orthogonal polynomial contrasts in regression models.</p><p><strong>Results: </strong>From 2007 to 2018, total SDI-US scores showed no significant overall trend (overall mean = 13.1). Nutritional and sociocultural indicators remained relatively stable, whereas the economic indicator (food expenditures) worsened from 21.4% to 26.4% (p<0.05, linear trend) between 2007-2008 and 2017-2018. Environmental impacts initially worsened between 2007-2008 and 2013-2014 but improved through 2017-2018 (all p<0.05, quadratic trend). When stratified by age (p for interaction <0.0001), a slight decline in SDI-US was observed among adults aged ≥60 years (14.1 to 13.9, p<0.0001).</p><p><strong>Conclusion: </strong>From 2007 to 2018, total SDI-US scores largely remained unchanged, although declines occurred among adults ≥60 years and scores remained lower among adults aged 20-39 years. Ongoing monitoring and coordinated improvements across all dimensions are needed to advance sustainable diets in all age groups.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2025045"},"PeriodicalIF":2.2,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between psychosocial safety climate and depression risk among Korean workers.","authors":"Soo Kyung Cho, Seong-Sik Cho, Maureen F Dollard, May Young Loh, Mo-Yeol Kang","doi":"10.4178/epih.e2025044","DOIUrl":"https://doi.org/10.4178/epih.e2025044","url":null,"abstract":"<p><strong>Objectives: </strong>Psychosocial safety climate (PSC) reflects an organization's commitment to safeguarding workers' psychological health and safety. While international evidence links low PSC to poor mental health outcomes, its association with depression has not been well established in Korea. This study aimed to examine the relationship between PSC and depression among Korean workers, utilizing a large-scale, population-based survey.</p><p><strong>Methods: </strong>We analyzed data from 5,337 wage employees who participated in the fifth wave of the Korean Work, Sleep, and Health Study. Depression was measured using the 9-item Patient Health Questionnaire, and PSC was assessed with a validated 4-item scale (PSC-4). Participants were classified into low-, intermediate-, and high-risk groups based on their PSC scores. Multivariable logistic regression was conducted to estimate the association between PSC and depression, with stratified analyses performed according to gender, age, and occupational characteristics.</p><p><strong>Results: </strong>The prevalence of depression increased as PSC scores decreased. Compared to the low-risk group, the intermediate- and high-risk PSC groups exhibited 1.19 and 2.69 times higher risks of depression, respectively, suggesting a clear exposure-response relationship. Stratified analyses indicated that associations were stronger among individuals without union representation or access to occupational health and safety resources.</p><p><strong>Conclusion: </strong>These findings underscore the critical role of PSC in workplace mental health. Promoting a high PSC may help reduce depression risk and support mental well-being among workers. Interventions considering vulnerable subgroups are warranted to create psychologically safer work environments in Korea.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2025044"},"PeriodicalIF":2.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individual- and neighborhood-level factors influencing diet quality: a multilevel analysis using Korea National Health and Nutrition Examination Survey data, 2010-2019.","authors":"Dahyun Park, Min-Jeong Shin, S V Subramanian, Clara Yongjoo Park, Rockli Kim","doi":"10.4178/epih.e2025043","DOIUrl":"https://doi.org/10.4178/epih.e2025043","url":null,"abstract":"<p><strong>Objectives: </strong>Although environmental factors influence lifestyle choices, few studies have examined how individual- and neighborhood-level sociodemographic factors interact to affect diet quality in Korea. We investigated the associations between multilevel factors and diet quality among Korean adults and explored potential interactions by gender and age.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of 42,035 adults from 1,671 towns using data from the Korea National Health and Nutrition Examination Survey (2010-2019) and the Population and Housing Census of Korea (2010-2019). Individual-level variables included gender, age, education, income, number of household members, smoking, drinking, physical activity, and subjective health status. Neighborhood-level variables included residential area, housing type, number of restaurants per capita, population size, and the proportion of low-income households and older adults. Associations with the Korean Healthy Eating Index (KHEI) were assessed using 2-level hierarchical models.</p><p><strong>Results: </strong>Of the total variance in KHEI, 5.2% was attributable to neighborhood-level differences. Individual-level factors explained 48.1% of variance at the neighborhood level, while neighborhood-level factors accounted for an additional 12.4%. Individuals living in rural areas, non-apartment housing, neighborhoods with higher proportions of low-income households and older adults, or in areas with smaller populations, had lower KHEI scores than their counterparts. In random slope models with cross-level interaction terms, diet quality among adults aged 70 years and older varied significantly according to neighborhood-level characteristics.</p><p><strong>Conclusion: </strong>Both individual- and neighborhood-level factors influence diet quality in Korea, with older adults being especially vulnerable to neighborhood characteristics. Multilevel approaches are needed to identify at-risk populations and improve dietary outcomes.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2025043"},"PeriodicalIF":2.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can resident registration expiration statistics due to death be used for near-real-time mortality tracking? A validation study using 2023 data from South Korea.","authors":"Jin-Hwan Kim","doi":"10.4178/epih.e2025042","DOIUrl":"https://doi.org/10.4178/epih.e2025042","url":null,"abstract":"<p><strong>Objectives: </strong>Real-time mortality tracking is essential for public health surveillance, especially during emergencies such as the COVID-19 pandemic. In South Korea, delayed availability of Vital Statistics (VS) data has hindered timely mortality monitoring. This study evaluates whether National Administrative Data (NAD) on resident registration expiration due to death, provided by the Ministry of Interior and Safety (MOIS), could serve as a reliable alternative for near real-time mortality surveillance.</p><p><strong>Methods: </strong>We compared mortality counts between VS and NAD for 2023 at multiple geographic levels (county, province, and nation) and across demographic strata (sex and age groups). The analysis was conducted in 3 stages: comparing overall mortality counts, analyzing county-level distributions, and assessing equivalence through correlation analyses, scatter plots, and density plots.</p><p><strong>Results: </strong>NAD showed strong agreement with VS at the national level, reporting only 0.4% more deaths overall (0.2% for men, 0.6% for women). Notable differences were observed in early childhood mortality, with NAD showing 16.8% fewer deaths for neonates (age 0) and 14.8% more for ages 1-4, as well as in monthly variations (5¬-9%). Correlation analyses indicated extremely high consistency between the 2 data sources across all geographic levels (correlation coefficients ≥0.999), especially at the national and provincial levels.</p><p><strong>Conclusion: </strong>NAD provides a reliable alternative to VS for real-time mortality surveillance in South Korea, providing comparable accuracy with much-improved timeliness. Although some variations are present in specific age groups and monthly trends, these can be addressed through appropriate analytical strategies. The recent availability of sex- and age-specific data in NAD since 2023 establishes it as a valuable infrastructure for mortality surveillance.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2025042"},"PeriodicalIF":2.2,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between secondhand smoke exposure and incidence of metabolic syndrome: analyses of Korean Genome and Epidemiology Study (KoGES) data.","authors":"Seungmi Choi, Sanghyuk Bea","doi":"10.4178/epih.e2025041","DOIUrl":"https://doi.org/10.4178/epih.e2025041","url":null,"abstract":"<p><strong>Objectives: </strong>Secondhand smoke exposure remains a major public health concern and is linked to various chronic diseases, including metabolic syndrome (MetS). Although smoking rates have declined, exposure to secondhand smoke remains common and poses significant health risks to non-smokers. This study investigated the association between secondhand smoke exposure and the incidence of MetS using longitudinal data from a community-based cohort in South Korea.</p><p><strong>Methods: </strong>We utilized data from the Korean Genome and Epidemiology Study, collected biennially between 2001 and 2020. Of 10,030 adults aged 40-69 years, a total of 3,042 never-smokers without pre-existing MetS were included. Secondhand smoke exposure was assessed through self-reported questionnaires. Cox proportional hazards models were employed to estimate hazard ratios (HRs) and 95% confidence intervals, adjusting for potential confounders.</p><p><strong>Results: </strong>During follow-up, 638 participants in the secondhand smoke exposure group developed MetS. Those exposed to secondhand smoke had a significantly higher risk of developing MetS compared to the non-exposed group (HR, 1.15; 95% CI, 1.02-1.27). Among MetS components, secondhand smoke exposure was significantly associated with increased risks of hypertension (HR, 1.13; 95% CI, 1.00-1.28) and hyperglycemia (HR, 1.19; 95% CI, 1.03-1.37). Although home exposure was not significantly associated with MetS risk, workplace exposure to secondhand smoke demonstrated a dose-response relationship according to exposure frequency and duration.</p><p><strong>Conclusion: </strong>Our findings suggest that secondhand smoke exposure may increase the risk of developing MetS. These results underscore the importance of strengthening regulations on secondhand smoke in public places and raising social awareness of its detrimental effects on non-smokers.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2025041"},"PeriodicalIF":2.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}