Background of the Korea Children’s Environmental Health (Ko-CHENS) Birth Cohort Study

Environmental factors influencing human health vary across countries due to differences in climate, geography, and living conditions. These variations can give rise to country-specific environmentally related diseases. Furthermore, even under similar environmental exposures, health impacts may differ among populations depending on genetic characteristics, adaptive capacity, and the complex interactions among these factors.

Through a nationally representative cohort study in Korea, scientific data are being accumulated to provide critical information on environmental factors that affect vulnerable populations, such as infants, young children, and women. Ultimately, these findings help guide the development of effective environmental health policies and services that protect public health.

Infants and young children are particularly susceptible to environmental pollutants due to their rapid metabolism and physiological immaturity compared with adults. Globally, growing concern has been raised about increasing environmental risks to children. At the 1998 G8 Environment Ministers’ Meeting, the declaration on Children’s Health and the Environment highlighted the impact of environmental degradation on children and the need for preventive action. In countries such as Denmark and Norway, large-scale epidemiological studies involving approximately 100,000 children were launched in the mid-1990s.

In Korea, participation in the 2009 G8 Environment Ministers’ Meeting in Syracuse, Italy, emphasized the need to establish large-scale birth cohort studies focused on children’s environmental health. Such cohorts make it possible to analyze causal relationships between environmental exposures and disease occurrence and to promote evidence-based environmental health policies.

• * Cohort Study:

  A cohort study recruits a group of individuals with shared characteristics and follows them over time to examine associations between exposure to environmental risk factors and the development of specific diseases.

About Ko-CHENS

Ko-CHENS, conducted by the Ministry of Climate, Energy and Environment, recruited approximately 70,000 pregnant women residing in Korea between 2015 and 2019. The study follows their children from the from the fetal period through adolescence to examine the effects of environmental pollutants on:

- Growth and development - Neurocognitive development (e.g., ADHD) - Atopic dermatitis and allergic diseases - Social and emotional development

Ko-CHENS focuses on environmentally related diseases associated with exposure to harmful substances. The study encompasses five primary domains: pregnancy and birth, allergic diseases, growth and endocrine development, neurocognitive development, and social and emotional development. It tests 39 core hypotheses, and findings from the study will provide a scientific foundation for developing evidence-based environmental health policies for children. In addition, Ko-CHENS aims to establish stage-specific health protection guidelines from pregnancy and infancy through adolescence, define evidence-based exposure standards for environmental pollutants, and ultimately deliver comprehensive environmental health services to the public.

Biospecimens that are not immediately analyzed are preserved in the national biobank, providing essential data for future research on environmental exposures. These specimens represent a valuable national resource for advancing environmental health studies.

Members of the Ko-CHENS Study group

• Pregnancy

  Central Coordinating Center

  Suejin Kim1, Choonghee Park1, Sanghwan Song1, Jueun Lee1, Huibyeol Park1, JungHeum Jo1, A-Ra Jung1, Seung Do Yu1, Hyun Jeong Kim1, Soon-Won Jung1, Sooyeon Hong1, Heung Won Seo2, Namkyoung Hwang2, Tack Shin Kang2, Dong Jin Jeong2, Seungjune Lee2

  1Environmental Health Research Division Department of Environmental Health Research , National Institute of Environmental Research, Ministry of Environment, Incheon, Republic of Korea

  2Environmental Health Policy Division, Office of Environmental Health, Ministry of Environment, Sejong, Republic of Korea

  Supporting Center

  Eunhee Ha1, Yi-Jun Kim1, Surabhi Shah1, Jongmin Oh1, Hwan-Cheol Kim2, Kyoung Sook Jeong3, Byungmi Kim4, Seulbi Lee5, Hyesook Kim6

  1Department of Environmental Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea

  2Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea

  3Department of Occupational and Environmental Medicine, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea

  4Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang, Korea

  5Department of Big Data Strategy, National Health Insurance Service, Wonju, Republic of Korea

  6Department of Food and Nutrition, Wonkwang University, Iksan, Republic of Korea

  Seoul National University Hospital

  Yun-Chul Hong1,2,3, Baek-Yong Choi3, Seung-Woo Ryoo3, Seok-Yoon Son3, Ji-Hyeon Lee3, Dong-Wook Lee3

  1Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea;

  2Seoul metropolitan government Environmental Health Center, Seoul National University College of Medicine, Seoul, Republic of Korea;

  3Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.

  Samsung Medical Center

  Sukyung Kim1, Jihyun Kim1, Kangmo Ahn1

  1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

  Korea University ANAM Hospital

  Young Yoo1,2, Dae Jin Song1,2, Jue Seong Lee1,2, Wonsuck Yoon2, Seung-Ah Choe2,3, Seunghyun Kim2, Ji Tae Choung1,2

  1Department of Pediatrics, Korea University Medical College

  2Allergy Immunology Center, Korea University

  3Department of Preventive Medicine, Korea University Medical College

  Ewha Womans University Medical Center

  Mi-Hye Park1

  1Department of Obstetrics and Gynecology, Ewha Womans University College of Medicine, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea.

  Inha University Hospital

  Dae Hyun Lim1, Jeong Hee Kim1

  1Department of Pediatrics, Inha University School of Medicine, Incheon, Republic of Korea

  Kangwon National University Hospital

  Woo Jin Kim1, Sunghun Na2, Myoung-Nam Lim1

  1Department of Internal Medicine and Environmental Health Center, Kangwon National University, Chuncheon, Republic of Korea

  2Department of Obstetrics and Gynecology, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Republic of Korea

  Jeju National University Hospital

  Sung-Chul Hong1,2, Keun Hwa Lee1,3, Su-Young Kim1,2

  1Environmental Health Center, Jeju National University College of Medicine, Jeju, Republic of Korea

  2Department of Preventive Medicine, Jeju National University College of Medicine, Jeju, Republic of Korea

  3Department of Microbiology and Immunology, Hanyang University College of Medicine, Seoul, Republic of Korea

  Dankook University Hospital

  Mina Ha1, Ki-Chung Paik2,4, Ho-Jang Kwon1,4, Myung-Ho Lim3,4, Seung Jin Yoo4, Sanghyuk Bae5

  1Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea

  2Department of Psychiatry, Dankook University College of Medicine, Cheonan, Republic of Korea

  3Department of Psychology, College of Public Services, Dankook University, Cheonan, Republic of Korea

  4Environmental Health Center, Dankook University Medical Center, Cheonan, Republic of Korea

  5Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Republic of Korea

  Taean Environmental Health Center

  Jongil Hur1, Myung-Sook Park3,4,5, Kyung-Hwa Choi1,2, Seung-Hwa Lee1, Yeonhee Chu1, Jung-Ah Kim1

  1Taean Environmental Health Center, Taean, Republic of Korea

  2Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea

  3Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea;

  4Seoul metropolitan government Environmental Health Center, Seoul National University College of Medicine, Seoul, Republic of Korea;

  5Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.

  Chonnam National University

  Hoon Kook1, Hee Jo Baek1, Jai Dong Moon2, Won Ju Park2, Myung-Geun Shin3

  1Environmental Health Center for Childhood Leukemia and Cancer, and Department of Pediatrics, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea

  2Environmental Health Center for Childhood Leukemia and Cancer, and Department of Occupational and Environmental Medicine, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea

  3Environmental Health Center for Childhood Leukemia and Cancer, and Department of Laboratory Medicine, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea

  Ulsan University Hospital

  Yangho Kim1, Jiho Lee1, Chang Sun Sim1, A Ram Kim1, Inbo Oh2

  1Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea

  2Environmental Health Center, University of Ulsan College of Medicine, Ulsan, Republic of Korea

  Dong-A University Hospital

  Young-Seoub Hong1, Yu-Mi Kim2, Hyunjin Son1

  1Department of Preventive Medicine and Busan Environmental Health Center, Dong-A university College of Medicine, Busan, Republic of Korea

  2Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea

  Daegu Catholic University Medical Center

  Jin Kyung Kim1, Jisuk Bae2

  1Department of Pediatrics, Daegu Catholic University School of Medicine, Daegu, Republic of Korea

  2Department of Preventive medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea

  Soonchunhyang University Hospital

  Kuck Hyeun Woo1, Seong Yong Yoon1

  1Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, Gumi, Republic of Korea

• Infancy(~36 Months)

  Central Coordinating Center

  Suejin Kim1, Choonghee Park1, Sanghwan Song1, Jueun Lee1, Huibyeol Park1, JungHeum Jo1, A-Ra Jung1, Woo-Mi Lee1, Sung Yeon Kim1, Heung Won Seo2, Jeeyoung Kim2, Namkyoung Hwang2, Tack Shin Kang2, Hyerin Yoon2, Dong Jin Jeong2, Seungjune Lee2, Hyeonjin Noh2, JIan Kim2, Seyoung Park2

  1Environmental Health Research Division Department of Environmental Health Research , National Institute of Environmental Research, Ministry of Environment, Incheon, Republic of Korea

  2Environmental Health Policy Division, Office of Environmental Health, Ministry of Environment, Sejong, Republic of Korea

  Supporting Center

  Eunhee Ha1, Yi-Jun Kim1, Surabhi Shah1, Jongmin Oh1, Hwan-Cheol Kim2, Kyoung Sook Jeong3, Byungmi Kim4, Seulbi Lee5, Hyesook Kim6

  1Department of Environmental Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea

  2Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea

  3Department of Occupational and Environmental Medicine, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea

  4Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang, Korea

  5Department of Big Data Strategy, National Health Insurance Service, Wonju, Republic of Korea

  6Department of Food and Nutrition, Wonkwang University, Iksan, Republic of Korea

  Seoul National University Hospital

  Yun-Chul Hong1,2,3, Myung-Sook Park1,2,3, Baek-Yong Choi3, Seung-Woo Ryoo3, Seok-Yoon Son3, Ji-Hyeon Lee3, Dong-Wook Lee3

  1Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea;

  2Seoul metropolitan government Environmental Health Center, Seoul National University College of Medicine, Seoul, Republic of Korea;

  3Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.

  Samsung Medical Center

  Sukyung Kim1, Jihyun Kim1, Kangmo Ahn1

  1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

  Korea University ANAM Hospital

  Young Yoo1,2, Dae Jin Song1,2, Jue Seong Lee1,2, Wonsuck Yoon2, Seung-Ah Choe2,3, Seunghyun Kim2

  1Department of Pediatrics, Korea University Medical College

  2Allergy Immunology Center, Korea University

  3Department of Preventive Medicine, Korea University Medical College

  Ewha Womans University Medical Center

  Hae Soon Kim1, Eun Sun Yoo1, Ji Hyen Lee1, Young Bae Sohn2, Han Wool Kim3

  1Department of, Pediatrics, Ewha Womans University College of Medicine, Seoul, Republic of Korea

  2Department of Medical Genetics, Ajou University Hospital, Ajou University School of Medicine, Suwon, Republic of Korea.

  3Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine

  Inha University Hospital

  Dae Hyun Lim1, Jeong Hee Kim1

  1Department of Pediatrics, Inha University School of Medicine, Incheon, Republic of Korea

  Kangwon National University Hospital

  Woo Jin Kim1, Sunghun Na2, Myoung-Nam Lim1

  1Department of Internal Medicine and Environmental Health Center, Kangwon National University, Chuncheon, Republic of Korea

  2Department of Obstetrics and Gynecology, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Republic of Korea

  Jeju National University Hospital

  Keun Hwa Lee1, Ju Wan Kang2, Jung-Kook Song3,4, Ki-Soo Kang5, Min-Su Oh5

  1Department of Microbiology and Immunology, Hanyang University College of Medicine, Seoul, Republic of Korea

  2Department of Otorhinolaryngology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea

  3Environmental Health Center, Jeju National University College of Medicine, Jeju, Republic of Korea

  4Department of Preventive Medicine, Jeju National University College of Medicine, Jeju, Republic of Korea

  5Department of Pediatrics, Jeju National University College of Medicine, Jeju, Republic of Korea

  Dankook University Hospital

  Mina Ha1, Ho-Jang Kwon1,3, Myung-Ho Lim2,3

  1Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea

  2Department of Psychology, College of Public Services, Dankook University, Cheonan, Republic of Korea

  3Environmental Health Center, Dankook University Medical Center, Cheonan, Republic of Korea

  Chonnam National University

  Hoon Kook1

  1Environmental Health Center for Childhood Leukemia and Cancer, and Department of Pediatrics, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea

  Eulji Medical Center

  Soo Jin Lee1

  1Department of Pediatrics, Eulji University School of Medicine, Daejeon, Republic of Korea

  Gwangju Mirae Children’s Hospital

  Dong-Kyun Han1

  1Mirae Children’s Hospital, Gwangju, Republic of Korea

  Ulsan University Hospital

  Yangho Kim1, Jiho Lee1, Chang Sun Sim1, A Ram Kim1, Inbo Oh2

  1Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea

  2Environmental Health Center, University of Ulsan College of Medicine, Ulsan, Republic of Korea

  Dong-A University Hospital

  Young-Seoub Hong1, Yu-Mi Kim2, Hyunjin Son1

  1Department of Preventive Medicine and Busan Environmental Health Center, Dong-A university College of Medicine, Busan, Republic of Korea

  2Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea

  Daegu Catholic University Medical Center

  Jin Kyung Kim1, Jisuk Bae2

  1Department of Pediatrics, Daegu Catholic University School of Medicine, Daegu, Republic of Korea

  2Department of Preventive medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea

  Soonchunhyang University Hospital

  Kuck Hyeun Woo1, Seong Yong Yoon1, Seong Su Kim1

  1Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, Gumi, Republic of Korea