The Korea National Health and Nutrition Examination Survey (KNHANES) is a national health survey mandated by Article 16 of the National Health Promotion Act to assess the health and nutritional status of the Korean population. Over the past 2 decades, the survey has continuously introduced timely survey components while strengthening its survey methodology and operational systems to enhance both the policy relevance and scientific utility of its findings. The 10th Korea National Health and Nutrition Examination Survey (10th KNHANES, 2025-2027) preserves the statistical representativeness of its sampling design while expanding the use of web-based self-administered questionnaires to improve participant convenience. In response to Korea's transition into a super-aged society, the 10th KNHANES incorporates enhanced older-adult health surveys, including osteoporosis assessment and older adults' life functioning, and newly introduces items addressing social support as part of the social determinants of health. In addition, a longitudinal follow-up survey system has been established to monitor long-term changes in population health. Collectively, these changes are expected to improve understanding of aging-related health issues, support evidence-based national health policy development, and expand the applicability of KNHANES data for academic research.

Adverse pregnancy outcomes (APOs) and low socioeconomic status (SES) are both associated with an increased long-term risk of atherosclerotic cardiovascular disease (ASCVD). In this analysis, we evaluated whether the association between a history of APO and ASCVD risk varies across different SES groups. We conducted this analysis using data from the UK Biobank, a large prospective cohort including participants aged 40 years to 69 years recruited between 2006 and 2010, with ongoing follow-up. APOs included hypertensive disorders of pregnancy, gestational diabetes mellitus, low birth weight (<2.5 kg), and stillbirth. At enrollment, SES was assessed using the following indicators: household income, education, employment, and Townsend Deprivation Score. The hazard ratio (HR) for new-onset ASCVD was analyzed according to history of APO and SES categories. Among 146,064 women, those with a history of APO had a higher risk of new-onset ASCVD and overall lower SES-including lower income, less education, higher unemployment, and greater deprivation-compared with those without APO (p<0.001). The increased ASCVD risk associated with APO history was significant only in the low SES group (adjusted HR, 1.26; 95% confidence interval [CI], 1.16 to 1.36), but not in the high SES group (adjusted HR, 1.07; 95% CI, 0.74 to 1.55, p=not significant). We found that women with low SES were more vulnerable to the adverse effects of APO history, resulting in a greater increase in ASCVD risk. This study highlights the need for SES-tailored preventive policies to reduce long-term cardiovascular disease in women with a history of APO.

Muscle strength is a key indicator of overall health, and its decline has been linked to increased morbidity and mortality. Socioeconomic factors may contribute to disparities in this decline. Therefore, this study aimed to examine trends in muscle strength and to identify groups with lower muscle strength according to socioeconomic variables. We analyzed data from the cross-sectional Korea National Health and Nutrition Examination Survey (KNHANES), including 34,080 adults. Multivariable linear regression analyses were conducted, adjusting for socioeconomic and health-related covariates, and KNHANES survey weights were applied to obtain nationally representative estimates that accounted for the complex sampling design. Overall, mean grip strength significantly decreased from 2014 to 2022 in both males (from 43.45±0.24 to 41.59± 0.29 kg) and females (from 26.48±0.15 to 24.94±0.13 kg). This trend was consistently observed across all covariate strata, except for individuals aged over 70 years and those in the green-collar occupational group. In 2022, grip strength was lower among individuals with the lowest education level (26.45±0.34 vs. 34.75±0.32 kg in the undergraduate group) and the lowest household income level (29.59±0.45 vs. 34.53±0.35 kg in the highest income group), as well as among unemployed individuals (29.36± 0.30 vs. 37.00±0.47 kg in the blue-collar group), compared with their higher socioeconomic counterparts. These findings provide descriptive evidence of grip strength trends and socioeconomic disparities in Korea. They may serve as baseline information to guide future longitudinal studies and inform public health strategies.

Polyhexamethylene guanidine phosphate (PHMG-P) is a guanidine-based disinfectant previously used in household humidifiers in Korea. This study evaluated whether PHMG-P exposure is causally linked to pneumonitis by integrating epidemiological, toxicological, and mechanistic evidence. We prespecified an evidence-integration framework aligned with the Office of Health Assessment and Translation/Grading of Recommendations Assessment, Development and Evaluation approaches, and applied the Organisation for Economic Cooperation and Development adverse outcome pathway (AOP) guidance to organize mechanistic evidence. We systematically identified studies and synthesized findings across 3 domains: epidemiology (age-period-cohort [APC], difference-in-differences [DID], and interrupted time-series [ITS] analyses), toxicology (animal and in vitro studies), and mechanism (mapping key events to an AOP). We assessed internal and external validity, coherence, and strength of evidence within and across domains. Epidemiological analyses showed that pneumonitis incidence rose during humidifier disinfectant use and declined after the 2011-2012 withdrawal, with higher risks in children and reproductive-age females. APC, DID, and ITS, including PHMG-P-specific time-series analysis, indicated increased pneumonitis incidence and mortality during exposure periods. Toxicological studies demonstrated that PHMG-P exposure resulted in epithelial injury, inflammation, fibrosis, and impaired lung function consistent with chemical pneumonitis. Mechanistic evidence linked PHMG-P exposure to epithelial damage, oxidative stress, macrophage polarization, and fibrotic changes. Multiple lines of evidence support a causal link between PHMG-P exposure and pneumonitis, underscoring the value of integrating epidemiology and toxicology to strengthen risk assessment and inform policy.

In 2024, Korea experienced a nationwide pertussis epidemic, with Gyeonggi Province accounting for nearly one-third of reported cases. This study investigated the epidemiological characteristics of the outbreak and explored the association between vaccination history and healthcare utilization. We analyzed 14,275 pertussis cases reported in Gyeonggi Province in 2024 using de-identified national surveillance data. Comparisons were performed by age group (<20 vs. ≥20 years) and vaccination status (<20 years). The chi-square and Mann-Whitney U tests were used, and effect sizes were assessed using Cramér's V. Of all cases, 89.8% occurred in individuals <20 years, particularly those aged 10-14 years. Children and adolescents were more often involved in clusters and had more identified contacts than adults, whereas adults had higher rates of hospitalization (13.2 vs. 5.9%) and emergency visits (4.4 vs. 0.9%; p<0.001). Among individuals <20 years, hospitalization was more common in the unvaccinated or unknown group (11.7%) than in the fully (5.9%) or partially vaccinated (5.5%) groups (p=0.045). The epidemic was concentrated in school-aged populations, particularly adolescents. While vaccination status showed a limited association with healthcare utilization, individuals who were unvaccinated or had an undocumented vaccination history experienced delayed diagnosis and higher care needs. These findings highlight the importance of strengthening adolescent-focused vaccination strategies and preparedness for future pertussis outbreaks.

Despite a steady decline in incidence, tuberculosis (TB) remains a substantial public health burden in Korea, particularly among older adults. Existing national TB surveillance systems lack sufficiently comprehensive data to assess long-term outcomes and health disparities. The K-TB-N cohort integrates data from 3 national sources: the Korean Tuberculosis Surveillance System (2011-2022), the National Health Insurance Database (2010-2022), and mortality data from Statistics Korea (2010-2022). After data cleaning and linkage, the final cohort included 373,812 patients (375,440 episodes) with either drug-susceptible TB or drug- resistant TB. TB notifications declined by approximately 60% over the study period, while the median patient age continued to rise. Treatment success improved over time, accompanied by reductions in lost to follow-up. However, mortality during treatment increased, with more than half of deaths attributed to non-TB causes such as pneumonia, cancer, and cardiovascular disease. Post-treatment mortality also remained high, particularly among patients with drug-resistant TB. The K-TB-N cohort provides a comprehensive, linked dataset for advancing research on TB epidemiology, treatment outcomes, comorbidities, and health disparities. It enables evaluations of public health interventions, long-term prognosis, and strategies for post-TB care. This cohort will remain a valuable resource for shaping data-driven TB control policies in aging and high-burden settings.

This study aimed to trace the origin and propagation of the common but incorrect belief that the World Health Organization (WHO) declared Republic of Korea (ROK) malaria-free in 1979. We conducted a source-based historical review of WHO Weekly Epidemiological Record (WER), regional reports from WHO's Western Pacific Regional Office (WPRO), United States Department of Defense (DoD) health reports, and scholarly and web-based citations. WHO WER 1981 identified the Democratic People's Republic of Korea (DPRK) as one of the countries that had eliminated malaria by 1979. WHO/WPRO, to which ROK belongs, reported that malaria had not been eliminated in ROK as of 1980. Misinterpretations within United States. DoD documents incorrectly attributed this certification to ROK, resulting in widespread citation errors across academic literature and online sources. The misattribution of DPRK's elimination status to ROK derives from a misreading of WHO records and has persisted for decades through repeated, unverified citations. Strengthening source accuracy and citation practices is essential for ensuring reliability in global health reporting.

Obesity is a major risk factor for metabolic diseases; however, body mass index (BMI), the most widely used anthropometric indicator, inadequately reflects fat distribution. The body roundness index (BRI) has been proposed as a more precise measure of abdominal obesity. Data from the 2007-2022 Korea National Health and Nutrition Examination Survey (KNHANES) were used. Discrimination for diabetes, hypertension, hypercholesterolemia, and metabolic syndrome was assessed by calculating the area under the receiver operating characteristic curve (AUROC) and estimating odds ratios (ORs). AUROC values ranged from 0.739 to 0.844 for BMI and 0.745 to 0.851 for BRI, with both indices demonstrating their highest performance for metabolic syndrome. BRI outperformed BMI for 3 metabolic diseases except hypertension, with the largest AUROC difference observed for diabetes (0.01). Quintile-based ORs showed stronger associations for BRI, indicating approximately 2-fold higher risks for diabetes and metabolic syndrome compared with BMI. Subgroup analyses identified the most pronounced differences for diabetes in female aged 45 years or older and for metabolic syndrome in male aged 45 years or older. For both indices, the risk associated with increasing quintiles was greater in the younger age group, especially among female under 45 years, in whom the risk of metabolic syndrome was markedly higher in the highest BRI quintile compared with the lowest quintile. BRI showed superior discriminatory power and stronger associations with metabolic diseases compared with BMI, suggesting that it may complement BMI as a useful screening indicator in clinical and public health settings.

Q fever is a bacterial zoonosis that occurs worldwide. Although several studies have reported associations between goat populations and human Q fever outbreaks in Korea, spatial correlation analyses remain limited. Therefore, this study examined the geographic correlation between human Q fever outbreaks and the distributions of goats and cattle in Korea. This study covered a 10-year period (2015-2024), using each of the 250 districts in Korea as the unit of analysis. Data were divided into 2 time periods: 2015-2019 and 2020-2024. Hotspots for the standardized incidence ratio (SIR) were identified using Getis-Ord Gi*. Spatial correlations between SIR and goat and cattle populations were evaluated using a multivariable spatial error model, and the associations between hotspot variables and livestock abundance were assessed using a multivariable Leroux conditional autoregressive model. SIRs for human Q fever showed significant positive spatial associations with goat populations in 2016 (coefficient=46.52, p<0.01) and 2021 (coefficient=70.97, p<0.01). The associations between goat populations (2016 and 2021) and hotspot classifications were consistent across both periods, with the odds ratio increasing from 1.87 (95% credible interval [CrI], 1.23 to 2.85) in 2015-2019 to 2.33 (95% CrI, 1.55 to 3.64) in 2020-2024. No significant associations were observed between human Q fever and cattle populations. Goat populations are becoming more strongly spatially correlated with human Q fever incidence. These findings underscore the need for enhanced preventive management of goat farms to mitigate future outbreaks.

Excessive sodium and insufficient potassium consumption are major dietary contributors to hypertension (HTN) and cardiovascular diseases. The sodium-to-potassium ratio is a known predictor of blood pressure (BP) and HTN. This study evaluated 16-year-trends in dietary sodium, potassium, and the sodium-to-potassium ratio, and their associations with BP and HTN in Korea. Data from 76,484 participants aged 19-79 years were obtained from the Korea National Health and Nutrition Examination Survey conducted in 2007-2022. Sodium and potassium intake were assessed using 24-hour recalls, and the sodium- to-potassium ratio was calculated. All values were energy-adjusted using the residual method. Age-period-cohort (APC) models were used to analyze temporal trends. Associations with BP and HTN were examined using multivariate linear and logistic regression models, adjusting for confounders. Energy-adjusted sodium intake decreased across all age groups, and potassium slightly increased in the recent 5 years, though both remained suboptimal relative to recommendations. APC analyses showed increasing potassium intake with age and a reversed U-shape cohort pattern. The sodium-to-potassium ratio decreased with age and calendar year but increased in recent cohorts. A higher sodium-to-potassium ratio was strongly associated with elevated systolic (β=0.028, p<0.001) and diastolic BP (β=0.036, p<0.001), and increased odds of HTN (odds ratio, 1.19; 95% confidence interval, 1.07 to 1.33). A linear association appeared when the sodium-to-potassium ratio exceeded 1.00 in the spline model. Despite improvements, sodium intake remains excessive, and potassium insufficient, particularly in younger adults and recent cohorts. Public health interventions should prioritize reducing sodium and promoting potassium-rich foods to reduce cardiovascular risk.