Associations Between Indoor Air Pollution and Urinary Volatile Organic Compound Biomarkers in Korean Adults

Volatile organic compounds (VOCs) are common indoor air pollutants known to pose significant health risks, yet little is known about how internal exposure varies across populations and environments. This study investigated the associations between indoor air pollutants and urinary VOC biomarkers in a nationally representative sample. We analyzed data from 1880 adults in the eighth Korea National Health and Nutrition Examination Survey (2020-2021) who completed an indoor air quality (IAQ) survey and provided urine samples, assessing the influence of sociodemographic, behavioral, and environmental factors. Indoor concentrations of PM_2.5, CO₂, formaldehyde, total VOCs, benzene, ethylbenzene, toluene, xylene, and styrene were measured, alongside the urinary concentrations of nine VOC biomarkers. Associations between pollutants, sociodemographic variables, and biomarkers were evaluated using univariate and multivariable linear regression with Bonferroni correction. Older age, female, lower socioeconomic status (SES), and smoking were associated with higher urinary VOC biomarker concentrations, with smoking showing the strongest associations. Indoor ethylbenzene, styrene, benzene, and CO₂ were also associated with multiple metabolites. These findings indicated significant associations between household air pollutants and urinary VOC metabolites, with disparities by age, sex, SES, and smoking status, underscoring the importance of targeted IAQ interventions for vulnerable populations.