Self-reported HDLI cases were identified by exposure assessment of HD. Exposure assessment of HD is a nationwide ongoing exposure assessment series designed to evaluate HD-related exposures and their health effects, which were conducted by the KCDC of the Korea Ministry of Health and Welfare between July 2013 and March 2014 and subsequently conducted by the Korea Environmental Industry and Technology Institute of Korea Ministry of Environment between July 2014 and the present [3]. Exposure assessment was performed for all registered participants who experienced clinical signs suggestive of HDLI that aimed to cover the entire exposed population in Korea and was carried out through extensive household interviews using structured HD-specific questionnaires regarding demographic characteristics, environmental exposure, and HD-related information [19]. The present study used the data of 6059 subjects enrolled in the four cycles of exposure assessment from July 2013 to May 2019 (360 subjects in cycle I, 168 subjects in cycle II, 669 subjects in cycle III, and 4862 subjects in cycle IV). In particular, cycle IV of the HD exposure assessment included four units, that is, IV-1, IV-2, IV-3, and IV-4. Because the last unit is still ongoing, we used all of the currently available data, and a total of 6059 subjects enrolled between cycles I and IV-3. The enrolled subjects who experienced clinical signs suggestive of HDLI were categorized as either current survivors or non-survivors (hereinafter referred to as HDLI-survivors or HDLI-deaths). HDLI-survivors were asked the question, “Which year was it when HDLI happened?”, while HDLI-deaths were asked, “Which year was it when the subjects died?”.

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