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Abstract Background Long-term exposure to PM2.5 has been linked to increased mortality risk. However, limited studies have examined the potential modifying effect of community-level characteristics on this association, particularly in Asian contexts. This study aimed to estimate the effects of long-term exposure to PM2.5 on mortality in South Korea and to examine whether community-level deprivation, medical infrastructure, and greenness modify these associations. Methods We conducted a nationwide cohort study using the National Health Insurance Service-National Sample Cohort. A total of 394,701 participants aged 30 years or older in 2006 were followed until 2019. Based on modelled PM2.5 concentrations, 1 to 3-year and 5-year moving averages of PM2.5 concentrations were assigned to each participant at the district level. Time-varying Cox proportional-hazards models were used to estimate the association between PM2.5 and non-accidental, circulatory, and respiratory mortality. We further conducted stratified analysis by community-level deprivation index, medical index, and normalized difference vegetation index to represent greenness. Results PM2.5 exposure, based on 5-year moving averages, was positively associated with non-accidental (Hazard ratio, HR: 1.10, 95% Confidence Interval, CI: 1.01, 1.20, per 10 µg/m3 increase) and circulatory mortality (HR: 1.22, 95% CI: 1.01, 1.47). The 1-year moving average of PM2.5 was associated with respiratory mortality (HR: 1.33, 95% CI: 1.05, 1.67). We observed higher associations between PM2.5 and mortality in communities with higher deprivation and limited medical infrastructure. Communities with higher greenness showed lower risk for circulatory mortality but higher risk for respiratory mortality in association with PM2.5. Conclusions Our study found mortality effects of long-term PM2.5 exposure and underlined the role of community-level factors in modifying these association. These findings highlight the importance of considering socio-environmental contexts in the design of air quality policies to reduce health disparities and enhance overall public health outcomes.

Abstract Psychological theories on heat-aggression relationship have existed for decades and recent models suggest climate change will increase violence through varying pathways. Although observational studies have examined the impact of temperature on violent crime, the evidence for associations is primarily limited to coarse temporal resolution of weather and crime (e.g., yearly/monthly) and results from a few Western communities, warranting studies based on higher temporal resolution data of modern systemic crime statistics for various regions. This observational study examined short-term temperature impacts on violent crime using national crime data for the warm months (Jun.–Sep.) across South Korea (2016–2020). Distributed lag non-linear models assessed relative risks (RRs) of daily violent crime counts at the 70th, 90th, and 99th summer temperature percentiles compared to the reference temperature (10th percentile), with adjustments for long-term trends, seasonality, weather, and air pollution. Results indicate potentially non-linear relationships between daily summer temperature (lag0–lag10) and violent crime counts. Violent crimes consistently increased from the lowest temperature and showed the highest risk at the 70th temperature (~ 28.0 °C). The RR at the 70th and 90th percentiles of daily mean temperature (lag0–lag10), compared to the reference, was 1.11 (95% CI 1.09, 1.15) and 1.04 (95% CI 1.01, 1.07), indicating significant associations. Stratified analysis showed significant increases in assault and domestic violence for increases in temperature. The lagged effects, the influences of heat on subsequent crime incidence, did not persist 21 days after the exposure, possibly due to the displacement phenomenon. We found curvilinear exposure–response relationships, which provide empirical evidence to support the psychological theories for heat and violence. Lower public safety through increased violent crime may be an additional public health harm of climate change.

There is a growing body of literature on the adverse health effects of ambient air pollution. Children are more adversely affected by air pollution due to their biological susceptibility and exposure patterns. This review summarized the accumulated epidemiologic evidence with emphasis on studies conducted in Korea and heterogeneity in the literature. Based on systematic reviews and meta-analyses, there is consistent evidence on the association between exposure to ambient air pollution and children’s health, especially respiratory health and adverse birth outcomes, and growing evidence on neurodevelopmental outcomes. Despite these existing studies, the mechanism of the adverse health effects of air pollution and the critical window of susceptibility remain unclear. There is also a need to identify causes of heterogeneity between studies in terms of measurement of exposure/outcome, study design, and the differential characteristics of air pollutants and population.

Abstract Background Time-series analysis with case-only data is a prominent method for the effect of environmental determinants on disease events in environmental epidemiology. In this analysis, adjustment for seasonality and long-term time-trend is crucial to obtain valid findings. When applying this analysis for long-term exposure (e.g., months, years) of which effects are usually studied via survival analysis with individual-level longitudinal data, unlike its application for short-term exposure (e.g., days, weeks), a standard adjustment method for seasonality and long-term time-trend can extremely inflate standard error of coefficient estimates of the effects. Given that individual-level longitudinal data are difficult to construct and often available to limited populations, if this inflation of standard error can be solved, rich case-only data over regions and countries would be very useful to test a variety of research hypotheses considering unique local contexts. Methods We discuss adjustment methods for seasonality and time-trend used in time-series analysis in environmental epidemiology and explain why standard errors can be inflated. We suggest alternative methods to solve this problem. We conduct simulation analyses based on real data for Seoul, South Korea, 2002–2013, and time-series analysis using real data for seven major South Korean cities, 2006–2013 to identify whether the association between long-term exposure and health outcomes can be estimated via time-series analysis with alternative adjustment methods. Results Simulation analyses and real-data analysis confirmed that frequently used adjustment methods such as a spline function of a variable representing time extremely inflate standard errors of estimates for associations between long-term exposure and health outcomes. Instead, alternative methods such as a combination of functions of variables representing time can make sufficient adjustment with efficiency. Conclusions Our findings suggest that time-series analysis with case-only data can be applied for estimating long-term exposure effects. Rich case-only data such as death certificates and hospitalization records combined with repeated measurements of environmental determinants across countries would have high potentials for investigating the effects of long-term exposure on health outcomes allowing for unique contexts of local populations.

Objectives To understand a 20-year trend of gender-specific smoking prevalence among adults in South Korea.Design Age-period-cohort analysis using the intrinsic estimator method was applied to examine the separate contribution of age, period and cohort effect on smoking prevalence. The Driving Force-Pressure-State-Exposure-Effect-Action (DPSEEA) framework was used to explain the observed smoking trends by mapping potential determinants and to address policy implications.Setting General adult population in South Korea.Participants 34 828 men and 43 632 women who aged 19–78 years, were not currently pregnant and were without a prior diagnosis of cardiovascular disease or cancer.Outcome measures Gender-specific current smoking prevalence using the 1998–2017 Korea National Health and Nutrition Examination Survey.Results Our results showed gender-specific age and birth cohort effects. More specifically, the smoking prevalence peaked at their mid-20s (prevalence rate ratio (PRR): 1.54, 95% CI: 1.49 to 1.59) and cohort born in 1959–1963 (PRR: 1.63, 95% CI: 1.57 to 1.70) and then decreased in men. On the other hand, in women, the smoking prevalence consistently increased until their mid-40s (PRR: 1.53, 95% CI: 1.27 to 1.84) and in recent birth cohort groups (PRR in 1994–1998 cohort: 1.55, 95% CI: 1.13 to 2.13). The period effects declined from 1998−2002 to 2003–2007, following increasing fluctuations in both genders. The smoking-DPSEEA framework showed the absence of policy actions to target female smokers and emphasised a proactive approach that tackles the upstream causes for smoking in women.Conclusions Men and women are clearly in different phases of the smoking epidemic in Korean population, and gender-tailored policies should be implemented.

Abstract Background Increasing evidence suggests that sleep duration is associated with risks of various diseases including type 2 diabetes, cardiovascular disease (CVD), and certain types of cancer. However, the relationship with mortality is not clear, particularly in non-European populations. In this study, we investigated the association between sleep duration and mortality in a population-based prospective cohort of Korean adults. Methods This analysis included 34,264 participants (14,704 men and 19,560 women) of the Korea National Health and Nutrition Examination Survey (KNHANES) 2007–2013 who agreed to mortality follow-up through December 31, 2016. Sleep duration was self-reported at baseline and was categorized into four groups: ≤4, 5–6, 7–8, and ≥ 9 h/day. Cox proportional hazards models were performed to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the associations with mortality (all-cause as well as CVD- and cancer-specific), adjusting for potential confounders. Results During up to 9.5 years of follow-up, we identified a total of 1028 deaths. We observed the lowest mortality at 5–6 h/day sleep. Compared with 7–8 h/day of sleep, short (≤4 h/day) and long (≥9 h/day) sleep were associated with a 1.05-fold (95% CI = 0.79–1.39) and 1.47-fold (95% CI = 1.15–1.87) higher all-cause mortality, respectively. After additional adjustment for self-rated health, the positive association with short sleep disappeared (HR = 0.99, 95% CI = 0.75–1.32) and the association with long sleep was slightly attenuated (HR = 1.38, 95% CI = 1.08–1.76). Long sleep was also nonsignificantly positively associated with both cancer-mortality (HR = 1.30, 95% CI = 0.86–1.98) and CVD-mortality (HR = 1.27, 95% CI = 0.73–2.21). There was no statistically significant evidence for nonlinearity in the relationships between sleep duration and mortality (all-cause as well as CVD- and cancer-specific). Effect modification by age, sex, education, and occupation were not statistically significant. Conclusions Our findings suggest that long sleep duration is associated with an increased all-cause mortality in Korean adults.

The prevalence of osteoporotic fracture is increasing globally due to rapid population growth and aging. Current evidence suggests adverse impacts of air pollution on bone mineral density loss and osteoporosis, but population-based evidence for the associations between fine particulate matter (particulate matter no larger than 2.5 μ m in diameter [PM _2.5 ]) and osteoporotic fracture is limited due to the small number of studies. This longitudinal study assessed the associations between long-term exposure to PM _2.5 and osteoporotic fracture incidence in adults aged ⩾40 years, who enrolled in the National Health Insurance Service-National Sample Cohort data in 2002–2019 in South Korea. A time-varying moving window of past exposures of PM _2.5 up to ten past years was estimated for participants’ residential addresses using modeled PM _2.5 . We used Cox proportional hazard models to estimate hazard ratios (HRs) of time-variant moving concentrations of PM _2.5 exposure and osteoporotic fracture. The Cox models calculated HRs for an interquartile range (IQR) increase in PM _2.5 exposure, adjusting for age, sex, body mass index, health behaviors, medications, disease history, income, and urbanicity. We assessed 161 831 participants over 993 104 person-year of follow-up. Results suggested linear and positive exposure-response associations for past PM _2.5 exposure in the prior four years or more. The IQR increase in 5-year moving average PM _2.5 was significantly associated with increased osteoporotic risk (HR = 1.079, 95% CI: 1.001, 1.164). The HRs were significant in women (1.102, 95% CI: 1.011, 1.200) and the subset of women aged 50–74 years (1.105, 95% CI: 1.005, 1.214) but not in men overall or by age groups. The association was not significantly different by income, physical activities, urbanicity, or diet. Overall, long-term PM _2.5 exposure was associated with increased osteoporotic fracture risks in Korean adults, especially women.

Lag is one of the major uncertainties in the heterogeneity of short-term effects of particulate matter with aerodynamic diameter

The Korean Association of Medical Colleges (KAMC) developed graduate outcomes based on “The role of Korean doctor, 2014” to serve as guidelines regarding outcome-based education in Korea. The working group in this study analyzed 65 competencies proposed in “The role of Korean doctor, 2014” according to the developmental principle that certain outcomes should be demonstrated at the point of entry into the graduate medical education. We established 34 competencies as “preliminary graduate outcomes” (PGOs). The advisory committee consisted of 11 professors, who reviewed the validity of PGOs. Ultimately, a total of 19 “revised graduate outcomes” (RGOs) were selected. We modified the RGOs based on opinions from medical schools and a public hearing. In November 2017, the KAMC announced the “graduate outcomes for basic medical education,” which serves as a guide for basic medical education for the 40 medical schools throughout Korea. Medical schools can expand the graduate outcomes according to their educational goals and modify them according to their own context. We believe that graduate outcomes can be a starting point for connecting basic medical education to graduate medical education.

Abstract Background Occupational physicians (OPs) have complex relationships with employees, employers, and the general public. OPs may have simultaneous obligations towards third parties, which can lead to variable conflicts of interests. Among the various studies of ethical issues related to OPs, few have focused on the Korean OPs. The aim of the present survey was to investigate the ethical contexts, the practical resolutions, and the ethical principles for the Korean OPs. Methods An email with a self-administered questionnaire was sent to members of the Korean Society of Occupational and Environmental Medicine, comprising 150 specialists and 130 residents. The questionnaire was also distributed to 52 specialists and 46 residents who attended the annual meeting of the Korean Association of Occupational and Environmental Clinics in October 2015, and to 240 specialists by uploading the questionnaire to the online community ‘oem-doctors’ in February 2016. The responses to each question (perception of general ethical conflicts, recognition of various ethical codes for OPs, core professional values in ethics of occupational medicine, and a mock case study) were compared between specialists and residents by the chi-squared test and Fisher’s exact test. Results Responses were received from 80 specialists and 71 residents. Most participants had experienced ethical conflicts at work and felt the need for systematic education and training. OPs suffered the most ethical conflicts in decisions regarding occupational health examination and evaluation for work relatedness. Over 60% of total participants were unaware of the ethical codes of other countries. Participants thought ‘consideration of worker’s health and safety’ (26.0%) and ‘neutrality’ (24.7%) as the prominent ethical values in professionality ofoccupational medicine. In mock cases, participants chose beneficence and justice for fitness for work and confidential information acquired while on duty, and beneficence and respect for autonomy in pre-placement examinations. Conclusions This study evaluated the current perception of and attitude toward ethical issues among the Korean OPs. These findings will facilitate the development of a code of ethics and the ethical decision-making program forthe Korean OPs.

To improve air quality and reduce adverse health effects due to air pollutants, Seoul metropolitan government has introduced emission reduction policies in Seoul metropolitan area since 2007. As a result, air quality in Seoul has improved. However, no study has reported whether emission reduction policies have affected respiratory morbidities in Korea. Thus, we aimed to assess an association between air pollutant emissions and ambient concentrations, and the effect of implemented emission reduction policies on asthma. The population of Daejeon, one of the metropolitan cities in Korea other than Seoul was used as a reference population to adjust for possible long-term background trend.Trends of air pollutant emissions, ambient concentrations, and hospital visit rates in Seoul and Daejeon were evaluated using descriptive statistics. To evaluate the possible beneficial effect of air pollutant emission reduction policies implemented since 2007 on hospital visits for asthma in Seoul, we conducted interrupted time-series analysis.As a result, we found evidence for the association between emission reductions and reduced ambient concentrations. Trends in hospital visit rates for asthma, which were previously increasing in Seoul, have decreased since the implementation of the policies. Prevented hospital visits cases for asthma in the total population and younger population (0–18 years) were estimated as 500,000 (11.3% of hospital visit cases if there was no intervention) cases and 320,000 (15.5% of hospital visit cases if there was no intervention) cases, respectively in Seoul. Our study provides evidence for the possible beneficial effect of emission reduction policies on hospital visits for asthma. Keywords: Air pollution, Air pollutant emission, Environmental policy, Asthma, Accountability, Interrupted time series

Purpose This study aimed to explore students’ cognitive patterns while solving clinical problems in 3 different types of assessments—clinical performance examination (CPX), multimedia case-based assessment (CBA), and modified essay question (MEQ)—and thereby to understand how different types of assessments stimulate different patterns of thinking. Methods A total of 6 test-performance cases from 2 fourth-year medical students were used in this cross-case study. Data were collected through one-on-one interviews using a stimulated recall protocol where students were shown videos of themselves taking each assessment and asked to elaborate on what they were thinking. The unit of analysis was the smallest phrases or sentences in the participants’ narratives that represented a meaningful cognitive occurrence. The narrative data were reorganized chronologically and then analyzed according to the hypothetico-deductive reasoning framework for clinical reasoning. Results Both participants demonstrated similar proportional frequencies of clinical reasoning patterns on the same clinical assessments. The results also revealed that the three different assessment types may stimulate different patterns of clinical reasoning. For example, the CPX strongly promoted the participants’ reasoning related to inquiry strategy, while the MEQ strongly promoted hypothesis generation. Similarly, data analysis and synthesis by the participants were more strongly stimulated by the CBA than by the other assessment types. Conclusion This study found that different assessment designs stimulated different patterns of thinking during problem-solving. This finding can contribute to the search for ways to improve current clinical assessments. Importantly, the research method used in this study can be utilized as an alternative way to examine the validity of clinical assessments.

The way we produce and use energy is transforming. Policy in this area intersects decisions that affect climate change, air quality, and the economy. The exponential increase in use of fossil fuel and nuclear energy has now essentially replaced human and animal energy (McKinney 2019 Curr. Pollut. Rep. 5 394–406; Solomon and Krishna 2011 Energy Policy 39 7422–31). These transitions have contributed to notable gains, such as improvements in mortality rates attributable to improved heating, water quality and transportation (Rayner 2012 Ecological Public Health : Reshaping the Conditions for Good health/Geof Rayner and Tim Lang (Abingdon, Oxon: Earthscan); Rosen 2015 A History of Public Health (Jhu Press); Pain 2017 Nature 551 S134–7; Cutler and Miller 2005 Demography 42 1–22). However, such transitions have also been accompanied by health detriments. Improvements in transportation and occupational efficiencies have promoted lifestyle transitions that have contributed to the chronic disease epidemic (Heath 2009 Am. J. Lifestyle Med. 3 27S–31S). Certain energy-related accidents and waste products have been long-established as carcinogenic (Guizard et al 2001 J. Epidemiol. Community Health 55 469; Cardis and Hatch 2011 Clin. Oncol. 23 251–60) and potential precursors to genetic mutations (Beir 1990 Health Effects of Exposure to Low Levels of Ionizing Radiation (Washington, DC: National Academy of Sciences); Desouky et al 2015 J. Radiat. Res. Appl. Sci. 8 247–54). Moreover, air pollution emissions are increasingly becoming recognised as a major contributor the global burden of disease, particularly cardiovascular and respiratory mortality (Cohen et al 2017 Lancet 389 1907–18). Although renewable energies can be perceived as ‘clean’, the shift to renewables has been relatively more recent and consequently, less is known about associated health impacts. The life course of renewable energy begins with the process of manufacturing renewable technologies, includes the means of transportation for the distribution and collection of these technologies as well as the disposal of their waste products and subsequent contamination. All of these stages have potential to involve direct chemical exposures through the groundwater, soil or air; and have potential to affect health through indirect pathways. A relatively understudied area, and the topic of this Focus Issue on Energy Transitions, Air Quality and Health , is the relevance of energy transitions and their associated environmental factors in a contemporary setting, how such factors affect health now, and will affect health in future.

Access to urban greenspace has many benefits such as improved health and social cohesion. If access differs by population, these benefits make access to greenspace an environmental justice issue, but little is known regarding accessibility of parks among different sub-groups in Seoul, South Korea. We explored potential socioeconomic inequities for access to parks in Seoul measuring two park provision metrics: total park area per capita (TPPC), and park accessibility index determined by size and proximity of parks. We assessed correlations between a deprivation index for the 25 Gus (administrative unit equivalent to the US borough) and each park provision metric. Regression analyses were applied for the associations between eight socioeconomic indicators of the 424 Dongs (equivalent to the US neighborhood) and each park provision metric. An interquartile range (IQR) increase in percent elderly (⩾65 years) (3.2%) was significantly associated with larger TPPC (1.6 m ^2 /person, 95% CI: 0.8, 2.4). Park accessibility index was associated with more socioeconomic variables than was TPPC. An IQR increase in percent elderly and divorce rates (1.2/1000 population) was associated with increased park accessibility by 3571 km (95% CI: 1103, 6040) and decreased park accessibility by 1387 (95% CI: −2706, −67), respectively. An IQR increase in percentage of the population receiving social low-income support aid (2.2%) was associated with increased park accessibility (reflecting park size and proximity of parks) of residential parks near residential areas by 1568 (95% CI: 15, 3120). Results suggest higher park access for socioeconomically disadvantaged regions. Findings indicate that measures of detailed park access considering spatial proximity and park size may more accurately measure park inequity compared to more basic metrics (e.g. TPPC), which may bias estimation of park inequity by capturing only one characteristic of parks. Detailed park measures should be considered in urban planning and health studies of greenspace.

Purpose: The quality of problem representation is critical for developing students’ problem-solving abilities in problem-based learning (PBL). This study investigates preclinical students’ experience with standardized patients (SPs) as a problem representation method compared to using video cases in PBL. Methods: A cohort of 99 second-year preclinical students from Inje University College of Medicine (IUCM) responded to a Likert scale questionnaire on their learning experiences after they had experienced both video cases and SPs in PBL. The questionnaire consisted of 14 items with eight subcategories: problem identification, hypothesis generation, motivation, collaborative learning, reflective thinking, authenticity, patient-doctor communication, and attitude toward patients. Results: The results reveal that using SPs led to the preclinical students having significantly positive experiences in boosting patient-doctor communication skills; the perceived authenticity of their clinical situations; development of proper attitudes toward patients; and motivation, reflective thinking, and collaborative learning when compared to using video cases. The SPs also provided more challenges than the video cases during problem identification and hypotheses generation. Conclusion: SPs are more effective than video cases in delivering higher levels of authenticity in clinical problems for PBL. The interaction with SPs engages preclinical students in deeper thinking and discussion; growth of communication skills; development of proper attitudes toward patients; and motivation. Considering the higher cost of SPs compared with video cases, SPs could be used most advantageously during the preclinical period in the IUCM curriculum.

Despite enormous investment in air-quality regulations, there are only a few studies about the health effects of the air-quality regulations. By applying synthetic control methods to controlled-interrupted time-series analysis, this study aimed to test whether air-quality regulations implemented in Seoul metropolitan area since 2005 had reduced cardiovascular mortality rate in Seoul and Incheon. Each synthetic control for Seoul and Incheon was constructed to predict the counterfactual cardiovascular mortality rate through synthetic control methods. By using a synthetic control as a control group in controlled-interrupted time-series analysis, we tested whether the air-quality regulations had changed the trend of cardiovascular mortality rate in Seoul and Incheon after the intervention. The results showed a significant slope change in cardiovascular mortality rate in Seoul (coefficient: −0.001, 95% confidence interval (CI): −0.0015, −0.0004) and Incheon (coefficient: −0.0006, 95% CI: −0.0012, 0). This study suggests additional evidence that air-quality regulations implemented in the Seoul metropolitan areas since 2005 had beneficial effects on cardiovascular mortality rate in Seoul and Incheon.

Children are particularly vulnerable to adverse health effects associated with heavy metal exposure. The goal of this study was to investigate the relationship between proximity to an industry complex and blood lead and urinary cadmium levels for children aged 7-13 who lived in Ulsan where a big petrochemical complex is located. We conducted a questionnaire survey to collect data including sociodemographics, daily habits, residential environment, etc. We also analyzed blood lead and urinary cadmium levels using Atomic Absorption Spectrometry (AAS). Data were analyzed using regression analysis. All statistical analyses were conducted with SAS software version 9.2. We calculated distance by using a Geographic Information System (ArcGIS version 10.0). The geometric mean blood lead level was 1.55 μg/dL (boys: 1.59 μg/dL, girls: 1.51 μg/dL), and the geometric mean urinary cadmium level was 0.51 μg/g creatinine (boys: 0.45 μg/g creatinine, girls: 0.58 μg/g creatinine). In the results of regression analyses, we found that urinary cadmium levels significantly decreased as distance between residence and industrial complex increased after adjusting for age, gender, income, passive smoking and the length of residence. This result was opposite to that for lead levels. Our observations support the hypothesis that urinary cadmium levels in children are related to their proximity to an industrial complex.

The land-use regression (LUR) approach to estimate the levels of ambient air pollutants is becoming popular due to its high validity in predicting small-area variations. However, only a few studies have been conducted in Asian countries, and much less research has been conducted on comparing the performances and applied estimates of different exposure assessments including LUR. The main objectives of the current study were to conduct nitrogen dioxide (NO _2 ) exposure assessment with four methods including LUR in the Republic of Korea, to compare the model performances, and to estimate the empirical NO _2 exposures of a cohort. The study population was defined as the year 2010 participants of a government-supported cohort established for bio-monitoring in Ulsan, Republic of Korea. The annual ambient NO _2 exposures of the 969 study participants were estimated with LUR, nearest station, inverse distance weighting, and ordinary kriging. Modeling was based on the annual NO _2 average, traffic-related data, land-use data, and altitude of the 13 regularly monitored stations. The final LUR model indicated that area of transportation, distance to residential area, and area of wetland were important predictors of NO _2 . The LUR model explained 85.8% of the variation observed in the 13 monitoring stations of the year 2009. The LUR model outperformed the others based on leave-one out cross-validation comparing the correlations and root-mean square error. All NO _2 estimates ranged from 11.3–18.0 ppb, with that of LUR having the widest range. The NO _2 exposure levels of the residents differed by demographics. However, the average was below the national annual guidelines of the Republic of Korea (30 ppb). The LUR models showed high performances in an industrial city in the Republic of Korea, despite the small sample size and limited data. Our findings suggest that the LUR method may be useful in similar settings in Asian countries where the target region is small and availability of data is low.