Occupational exposure to polycyclic aromatic hydrocarbons in Korean adults: evaluation of urinary 1-hydroxypyrene, 2-naphthol, 1-hydroxyphenanthrene, and 2-hydroxyfluorene using Second Korean National Environmental Health Survey data.

Background: Polycyclic aromatic hydrocarbons (PAHs) are occupational and environmental pollutants generated by the incomplete combustion of organic matter. Exposure to PAHs can occur in various occupations. In this study, we compared PAH exposure levels among occupations based on 4 urinary PAH metabolites in a Korean adult population. Methods: The evaluation of occupational exposure to PAHs was conducted using Second Korean National Environmental Health Survey data. The occupational groups were classified based on skill types. Four urinary PAH metabolites were used to evaluate PAH exposure: 1-hydroxypyrene (1-OHP), 2-naphthol (2-NAP), 1-hydroxyphenanthrene (1-OHPHE), and 2-hydroxyfluorene (2-OHFLU). The fraction exceeding the third quartile of urinary concentration for each PAH metabolite was assessed for each occupational group. Adjusted odds ratios (ORs) for exceeding the third quartile of urinary PAH metabolite concentration were calculated for each occupational group compared to the "business, administrative, clerical, financial, and insurance" group using multiple logistic regression analyses. Results: The "guard and security" (OR: 2.949; 95% confidence interval [CI]: 1.300-6.691), "driving and transportation" (OR: 2.487; 95% CI: 1.418-4.364), "construction and mining" (OR: 2.683; 95% CI: 1.547-4.655), and "agriculture, forestry, and fisheries" (OR: 1.973; 95% CI: 1.220-3.191) groups had significantly higher ORs for 1-OHP compared to the reference group. No group showed significantly higher ORs than the reference group for 2-NAP. The groups with significantly higher ORs for 1-OHPHE than the reference group were "cooking and food service" (OR: 2.073; 95% CI: 1.208-3.556), "driving and transportation" (OR: 1.724; 95% CI: 1.059-2.808), and "printing, wood, and craft manufacturing" (OR: 2.255; 95% CI: 1.022-4.974). The OR for 2-OHFLU was significantly higher in the "printing, wood, and craft manufacturing" group (OR: 3.109; 95% CI: 1.335-7.241) than in the reference group. Conclusions: The types and levels of PAH exposure differed among occupational groups in a Korean adult population.

Electroacupuncture for the treatment of frozen shoulder: A systematic review and meta-analysis.

Background: Electroacupuncture (EA) has reportedly been successful in controlling pain, but there have been no systematic reviews examining the impact of EA on patients with frozen shoulder (FS). The purpose of this review is to provide evidence on the safety and efficacy of EA for pain management in patients with FS. Methods: We searched 11 databases from their inception: EMBASE, the Cochrane Library, PubMed, AMED, one Chinese medical database, and six Korean medical databases. Two researchers independently performed the study selection, data extraction, and assessment. Bias-related risk was evaluated using the Cochrane risk-of-bias assessment tool. Results: This review included thirteen studies involving 936 patients. The EA group exhibited improvements in FS pain (MD -1.11, 95% CI -1.61 to -0.61, p < 0.0001, I 2 = 97%), function (SMD 2.02, 95% CI 0.36-3.69, p < 0.00001, I 2 = 97%), and response rates (RR 1.16, 95% CI 1.07-1.25; p = 0.0002; I 2 = 0%) over the manual acupuncture (MA) group. As an adjunct treatment, EA improved FS pain (SMD -1.12, 95% CI -1.52 to -0.71, P < 0.00001, I 2 = 0) compared to the control treatments. No adverse effects were reported. Conclusion: EA is reported to improve FS pain and function compared with control treatments. Additionally, EA can be used as an adjunct therapy for FS pain. EA could emerge as a potent intervention against FS. Systematic review registration: [http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42021247090], identifier [CRD42021247090].

Exposure to polycyclic aromatic hydrocarbons and serum total IgE in the Korean adults: the Third Korean National Environmental Health Survey (2015-2017).

Background: Polycyclic aromatic hydrocarbons (PAHs) have become common pollutants with industrial development. Although the effect of exposure to PAHs on allergic disease in humans has been evaluated, evidence of an association is sparse. The association between PAH exposure and serum total immunoglobulin E (IgE) levels was evaluated in Korean adults. Methods: In total, this study included 3,269 participants in the Third Korean National Environmental Health Survey (2015-2017). Four urinary PAH metabolites were used to assessed exposure to PAHs: 1-hydroxypyrene, 1-hydroxyphenanthrene, 2-naphthol, and 2-hydroxyfluorene. The analyses were performed on 3 cutoff levels (100 IU/mL, 114 IU/mL, and 150 IU/mL) set as the total IgE elevation. Prevalence of total IgE elevation by PAH exposure group and general characteristics (age, sex, BMI, smoking, alcohol drinking, and occupation) were analyzed using the Rao-Scott χ2 test. Multiple logistic regression analyses were conducted to calculate adjusted odds ratios (ORs) for total IgE elevation by PAH exposure groups. Results: Total IgE elevation differed significantly by age, sex, smoking status, alcohol drinking status, and occupation. For 2-hydroxyfluorene, the fourth quartile showed a significant association with IgE elevation compared to the first quartile in the analyses of cutoff-level 100 IU/mL (OR: 1.372, 95% confidence interval [CI]: 1.007-1.869) and 114 IU/mL (OR: 1.643, 95% CI: 1.167-2.312). In the analysis of cutoff-level 150 IU/mL, the adjusted ORs of the third and fourth quartile of 2-hydroxyfluorene were significantly higher than the first quartile (3rd quartile: OR: 1.478, 95% CI: 1.034-2.113; 4th quartile: OR: 1.715, 95% CI: 1.161-2.534). However, there were no significant positive associations for the other metabolites. Conclusions: This study implied that PAHs exposure is associated with total IgE elevation in Korean adults. More research is needed to confirm the effect of exposure to PAHs on serum IgE and allergic diseases.

Electroacupuncture for the treatment of frozen shoulder: A protocol for systematic review and meta-analysis.

BACKGROUND: Electroacupuncture has been reported to successfully control pain. Currently, no systematic reviews of the effects of electroacupuncture on frozen shoulder patients have been performed. This review aims to provide current evidence on the efficacy of electroacupuncture for the management of pain in frozen shoulder. METHODS AND ANALYSES: Eleven databases will be searched from their inception: PubMed, AMED, EMBASE, the Cochrane Library, 6 Korean medical databases, and 1 Chinese medical database. Study selection, data extraction, and assessment will be performed independently by 2 researchers. Risk of bias will be assessed using the Cochrane risk of bias assessment tool. ETHICS AND DISSEMINATION: Ethical approvals and patient consent are not required because the meta-analysis will be based on published research. This systematic review will be published in a peer-reviewed journal and disseminated both electronically and in print. The review will be updated to inform and guide health care practice and policy. TRIAL REGISTRATION NUMBER: PROSPERO 2021 CRD42021247090.

The Anti-Inflammatory and the Antinociceptive Effects of Mixed Agrimonia pilosa Ledeb. and Salvia miltiorrhiza Bunge Extract.

Arthritis is a common condition that causes pain and inflammation in a joint. Previously, we reported that the mixture extract (ME) from Agrimonia pilosa Ledeb. (AP) and Salvia miltiorrhiza Bunge (SM) could ameliorate gout arthritis. In the present study, we aimed to investigate the potential anti-inflammatory and antinociceptive effects of ME and characterize the mechanism. We compared the anti-inflammatory and antinociceptive effects of a positive control, Perna canaliculus powder (PC). The results showed that one-off and one-week treatment of ME reduced the pain threshold in a dose-dependent manner (from 10 to 100 mg/kg) in the mono-iodoacetate (MIA)-induced osteoarthritis (OA) model. ME also reduced the plasma TNF-α, IL-6, and CRP levels. In LPS-stimulated RAW 264.7 cells, ME inhibited the release of NO, PGE2, LTB4, and IL-6, increased the phosphorylation of PPAR-γ protein, and downregulated TNF-α and MAPKs proteins expression in a concentration-dependent (from 1 to 100 µg/mL) manner. Furthermore, ME ameliorated the progression of ear edema in mice. In most of the experiments, ME-induced effects were almost equal to, or were higher than, PC-induced effects. Conclusions: The data presented here suggest that ME shows anti-inflammatory and antinociceptive activities, indicating ME may be a potential therapeutic for arthritis treatment.