Environmental Public Health Commons^™

Trends In Access To Water Supply And Sanitation In 31 Major Sub-Saharan African Cities: An Analysis Of Dhs Data From 2000 To 2012, Mike R. Hopewell, Jay P. Graham

Environmental and Occupational Health Faculty Publications

Background

By 2050, sub-Saharan Africa’s (SSA) urban population is expected to grow from 414 million to over 1.2 billion. This growth will likely increase challenges to municipalities attempting to provide access to water supply and sanitation (WS&S). This study aims to characterize trends in access to WS&S in SSA cities and identify factors affecting those trends.

Methods

DHS data collected between 2000 and 2012 were used for this analysis of thirty-one cities in SSA. Four categories of household access to WS&S were studied using data from demographic and health surveys – these included: 1) household access to an improved water …

A Case Control Study Of Environmental And Occupational Exposures Associated With Methicillin Resistant Staphylococcus Aureus Nasal Carriage In Patients Admitted To A Rural Tertiary Care Hospital In A High Density Swine Region, Leah Schinasi, Steve Wing, Kerri L. Augustino, Keith M. Ramsey, Delores L. Nobles, David B. Richardson, Lance B. Price, Maliha Aziz, Pia Macdonald, Jill R. Stewart

Environmental and Occupational Health Faculty Publications

Background

Distinct strains of methicillin resistant Staphylococcus aureus (MRSA) have been identified on livestock and livestock workers. Industrial food animal production may be an important environmental reservoir for human carriage of these pathogenic bacteria. The objective of this study was to investigate environmental and occupational exposures associated with nasal carriage of MRSA in patients hospitalized at Vidant Medical Center, a tertiary hospital serving a region with intensive livestock production in eastern North Carolina.

Methods

MRSA nasal carriage was identified via nasal swabs collected within 24 hours of hospital admission. MRSA carriers (cases) were gender and age matched to non-carriers (controls). …

Ending Open Defecation In Rural Tanzania: Which Factors Facilitate Latrine Adoption?, Stephen Sara, Jay P. Graham

Environmental and Occupational Health Faculty Publications

Diarrheal diseases account for 7% of deaths in children under five years of age in Tanzania. Improving sanitation is an essential step towards reducing these deaths. This secondary analysis examined rural Tanzanian households’ sanitation behaviors and attitudes in order to identify barriers and drivers to latrine adoption. The analysis was conducted using results from a cross-sectional study of 1000 households in five rural districts of Tanzania. Motivating factors, perceptions, and constraints surrounding open defecation and latrine adoption were assessed using behavioral change theory. Results showed a significant association between use of improved sanitation and satisfaction with current sanitation facility (OR: …

Internet And Telephonic Ivr Mixed-Mode Survey For Longitudinal Studies: Choice, Retention, And Data Equivalency, Santosh K. Verma, Theodore K. Courtney, David A. Lombardi, Wen-Ruey Chang, Yueng-Hsiang Huang, Melanye J. Brennan, Melissa J. Perry

Environmental and Occupational Health Faculty Publications

Purpose

This study examined data equivalency and loss to follow-up rates from Internet and interactive voice response (IVR) system surveys in a prospective-cohort study.

Methods

475 limited-service restaurant workers participating in the 12-week study were given a choice to report their weekly slipping experience by either IVR or Internet. Demographic differences, loss to follow-up, self-reported rates of slipping, and selection of first and last choices were compared.

Results

Loss to follow-up rates were slightly higher for those choosing the IVR mode. Rates of slipping and selection of first and last choices were not significantly different between survey modes. Propensity to …

The Epidemic Of Extended-Spectrum-Β-Lactamase-Producing Escherichia Coli St131 Is Driven By A Single Highly Pathogenic Subclone, H30-Rx, Lance B. Price, James R. Johnson, Maliha Aziz, Connie Clabots, Brian Johnston, Veronika Tchesnokova, Lora Nordstrom, Maria Billig, Sujay Chattopadhyay, Marc Stegger, Paal S. Andersen, Talima Pearson, Kim Riddell, Peggy Rogers, Delia Scholes, Barbara Kahl, Paul Keim, Evgeni V. Sokurenko

Environmental and Occupational Health Faculty Publications

The Escherichia coli sequence type 131 (ST131) clone is notorious for extraintestinal infections, fluoroquinolone resistance, and extended-spectrum beta-lactamase (ESBL) production, attributable to a CTX-M-15-encoding mobile element. Here, we applied pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing to reconstruct the evolutionary history of the ST131 clone. PFGE-based cluster analyses suggested that both fluoroquinolone resistance and ESBL production had been acquired by multiple ST131 sublineages through independent genetic events. In contrast, the more robust whole-genome-sequence-based phylogenomic analysis revealed that fluoroquinolone resistance was confined almost entirely to a single, rapidly expanding ST131 subclone, designated H30-R. Strikingly, 91% of the CTX-M-15-producing isolates also …

Molecular Epidemiology Of Escherichia Coli Sequence Type 131 And Its H30 And H30-Rx Subclones Among Extended-Spectrum-Β-Lactamase-Positive And -Negative E. Coli Clinical Isolates From The Chicago Region, 2007 To 2010, Ritu Banerjee, Ari Robicsek, Michael A. Kusikowski, Stephen Porter, Brian D. Johnston, Evgeni Sokurenko, Veronika Tchesnokova, Lance B. Price, James R. Johnson

Environmental and Occupational Health Faculty Publications

We assessed Escherichia coli ST131 and its H30 and H30-Rx subclones for virulence genes, antimicrobial resistance, and extended-spectrum beta-lactamase (ESBL) type. Although both subclones were associated with ESBL production, H30-Rx isolates had higher resistance scores and were associated specifically with CTX-M-15. Three virulence genes (iha, sat, and iutA) were more prevalent among H30 than non-H30 ST131 isolates. Thus, the H30 and H30-Rx subclones are more antimicrobial resistant and have virulence profiles that are distinct from those of non-H30 ST131 isolates.

Rapid Differentiation Between Livestock-Associated And Livestock-Independent Staphylococcus Aureus Cc398 Clades, Marc Stegger, Cindy M. Liu, Jesper Larsen, Katerina Soldanova, Maliha Aziz, Tania Contente-Cuomo, Andreas Petersen, Stien Vandendriessche, Judy N. Jiménez, Caterina Mammina, Alex Van Belkum, Saara Salmenlinna, Frederic Laurent, Robert L. Skov, Anders R. Larsen, Paal S. Andersen, Lance B. Price

Environmental and Occupational Health Faculty Publications

Staphylococcus aureus clonal complex 398 (CC398) isolates cluster into two distinct phylogenetic clades based on single-nucleotide polymorphisms (SNPs) revealing a basal human clade and a more derived livestock clade. The scn and tet(M) genes are strongly associated with the human and the livestock clade, respectively, due to loss and acquisition of mobile genetic elements. We present canonical single-nucleotide polymorphism (canSNP) assays that differentiate the two major host-associated S. aureus CC398 clades and a duplex PCR assay for detection of scn and tet(M). The canSNP assays correctly placed 88 S. aureusCC398 isolates from a reference collection into …

Epidemiology Of Esophageal Cancer, Yuwei Zhang

Environmental and Occupational Health Faculty Publications

Esophageal cancer (EsC) is one of the least studied and deadliest cancers worldwide because of its extremely aggressive nature and poor survival rate. It ranks sixth among all cancers in mortality. In retrospective studies of EsC, smoking, hot tea drinking, red meat consumption, poor oral health, low intake of fresh fruit and vegetables, and low socioeconomic status have been associated with a higher risk of esophageal squamous cell carcinoma. Barrett’s esophagus is clearly recognized as a risk factor for EsC, and dysplasia remains the only factor useful for identifying patients at increased risk, for the development of esophageal adenocarcinoma in …

Allostatic Load Amplifies The Effect Of Blood Lead Levels On Elevated Blood Pressure Among Middle-Aged U.S. Adults: A Cross-Sectional Study, Ami R. Zota, Edmond R. Shenassa, Rachel Morello-Frosch

Environmental and Occupational Health Faculty Publications

Background

Scientists and regulators have sought to understand whether and how physiologic dysregulation due to chronic stress exposure may enhance vulnerability to the adverse health effects of toxicant exposures. We conducted a cross-sectional study to determine whether allostatic load (AL), a composite measure of physiologic response to chronic exposure to stress, amplifies the effect of lead exposure on blood pressure among middle-aged adults.

Methods

We analyzed associations between blood lead levels and blood pressure in a nationally representative sample of 8,194 U.S. adults (aged 40-65 years) participating in the National Health and Nutritional Examination Survey, 1999--2008. Outcomes were elevated systolic …

Livestock-Associated Methicillin And Multidrug Resistant Staphylococcus Aureus Is Present Among Industrial, Not Antibiotic-Free Livestock Operation Workers In North Carolina, Jessica L. Rinsky, Maya Nadimpalli, Steve Wing, Devon Hall, Dothula Baron, Lance B. Price, Jesper Larsen, Marc Stegger, Jill Stewart, Christopher D. Heaney

Environmental and Occupational Health Faculty Publications

Objectives

Administration of antibiotics to food animals may select for drug-resistant pathogens of clinical significance, such as methicillin-resistant Staphylococcus aureus (MRSA). In the United States, studies have examined prevalence of MRSA carriage among individuals exposed to livestock, but prevalence of multidrug-resistant S. aureus (MDRSA) carriage and the association with livestock raised with versus without antibiotic selective pressure remains unclear. We aimed to examine prevalence, antibiotic susceptibility, and molecular characteristics of S. aureus among industrial livestock operation (ILO) and antibiotic-free livestock operation (AFLO) workers and household members in North Carolina.

Methods

Participants in this cross-sectional study were interviewed and provided a …

Exploring Changes In Open Defecation Prevalence In Sub-Saharan Africa Based On National Level Indices, Deise I. Galan, Seung-Sup Kim, Jay P. Graham

Environmental and Occupational Health Faculty Publications

Background

In sub-Saharan Africa, it is estimated that 215 million people continue to engage in open defecation. This practice facilitates the transmission of diarrheal diseases – one of the leading causes of mortality in children under 5 in sub-Saharan Africa. The main purpose of this study is to: estimate changes in open defecation prevalence between 2005 and 2010 across countries in sub-Saharan Africa; examine the association between national level indices and changes in open defecation prevalence; and assess how many countries can achieve ‘open defecation free status’ by 2015.

Methods

After applying selection criteria, this study analyzed country-level data for …

Genome Analysis Of Staphylococcus Aureus St291, A Double Locus Variant Of St398, Reveals A Distinct Genetic Lineage, Marc Stegger, Maliha Aziz, Tomsz Chroboczek, Lance B. Price, Troels Ronco, Kristoffer Kiil, Robert L. Skov, Frederic Laurent, Paal S. Andersen

Environmental and Occupational Health Faculty Publications

Staphylococcus aureus ST291 has been reported as a homologue recombinant double locus variant of the livestock associated S. aureus ST398. However, whole genome sequencing show that ST291 is a unique genetic lineage with highly variable content within its accessory genome compared to both human and livestock associated genome sequenced CC398s.

Male Circumcision Significantly Reduces Prevalence And Load Of Genital Anaerobic Bacteria, Cindy M. Liu, Bruce A. Hungate, Aaron A.R. Tobian, David Serwadda, Jacques Ravel, Richard Lester, Godfrey Kigozi, Maliha Aziz, Ronald M. Galiwango, Fred Nalugoda, Tania L. Contente-Cuomo, Maria J. Wawer, Paul Keim, Ronald H. Gray, Lance B. Price

Environmental and Occupational Health Faculty Publications

Male circumcision reduces female-to-male HIV transmission. Hypothesized mechanisms for this protective effect include decreased HIV target cell recruitment and activation due to changes in the penis microbiome. We compared the coronal sulcus microbiota of men from a group of uncircumcised controls (n= 77) and from a circumcised intervention group (n = 79) at enrollment and year 1 follow-up in a randomized circumcision trial in Rakai, Uganda. We characterized microbiota using16S rRNA gene-based quantitative PCR (qPCR) and pyrosequencing, log response ratio (LRR), Bayesian classification, nonmetric multidimensional scaling (nMDS), and permutational multivariate analysis of variance (PerMANOVA). At baseline, men …

Access To Chemical Data Used In Regulatory Decision Making, Lynn R. Goldman, Ellen K. Silbergeld, Randall Lutter, Craig Barrow, Christopher J. Borgert, James W. Conrad Jr., Debra Edwards, Allan Felsot

Environmental and Occupational Health Faculty Publications

No abstract provided.

Pit Latrines And Their Impacts On Groundwater Quality: A Systematic Review, Jay P. Graham, Matthew L. Polizzotto

Environmental and Occupational Health Faculty Publications

Background: Pit latrines are one of the most common human excreta disposal systems in low-income countries, and their use is on the rise as countries aim to meet the sanitation-related target of the Millennium Development Goals. There is concern, however, that discharges of chemical and microbial contaminants from pit latrines to groundwater may negatively affect human health.

Objectives: Our goals were to a) calculate global pit latrine coverage, b) systematically review empirical studies of the impacts of pit latrines on groundwater quality, c) evaluate latrine siting standards, and d) identify knowledge gaps regarding the potential for …

Open-Source Collaboration For Global Health: Science And Practice, Ariel Pablos-Méndez, Michael Klag, Lynn R. Goldman

Environmental and Occupational Health Faculty Publications

No abstract provided.

The Work Environment Disability-Adjusted Life Year For Use With Life Cycle Assessment: A Methodological Approach, Kelly A. Scanlon, George M. Gray, Royce A. Francis, Shannon M. Lloyd, Peter Lapuma

Environmental and Occupational Health Faculty Publications

Background

Life cycle assessment (LCA) is a systems-based method used to determine potential impacts to the environment associated with a product throughout its life cycle. Conclusions from LCA studies can be applied to support decisions regarding product design or public policy, therefore, all relevant inputs (e.g., raw materials, energy) and outputs (e.g., emissions, waste) to the product system should be evaluated to estimate impacts. Currently, work-related impacts are not routinely considered in LCA. The objectives of this paper are: 1) introduce the work environment disability-adjusted life year (WE-DALY), one portion of a characterization factor used to express the magnitude of …

Foodborne Urinary Tract Infections: A New Paradigm For Antimicrobial-Resistant Foodborne Illness, Lora Nordstrom, Cindy M. Liu, Lance B. Price

Environmental and Occupational Health Faculty Publications

Urinary tract infections (UTIs) are among the most common bacterial infections worldwide. Disproportionately affecting women, UTIs exact a substantial public burden each year in terms of direct medical expenses, decreased quality of life, and lost productivity. Increasing antimicrobial resistance among strains of extraintestinal pathogenic Escherichia colichallenges successful treatment of UTIs. Community-acquired UTIs were long considered sporadic infections, typically caused by the patients’ native gastrointestinal microbiota; however, the recent recognition of UTI outbreaks with probable foodborne origins has shifted our understanding of UTI epidemiology. Along with this paradigm shift come new opportunities to disrupt the infection process and possibly quell …

Assuring Access To Data For Chemical Evaluations, Lynn R. Goldman, Ellen K. Silbergeld

Environmental and Occupational Health Faculty Publications

Background: A database for studies used for U.S. Environmental Protection Agency (EPA) pesticide and chemical reviews would be an excellent resource for increasing transparency and improving systematic assessments of pesticides and chemicals. There is increased demand for disclosure of raw data from studies used by the U.S. EPA in these reviews.

Objectives: Because the Information Quality Act (IQA) of 2001 provides an avenue for request of raw data, we reviewed all IQA requests to the U.S. EPA in 2002–2012 and the U.S. EPA’s responses. We identified other mechanisms to access such data: public access databases, the Freedom of Information Act …

Prevalence Of Antibiotic-Resistant E. Coli In Retail Chicken: Comparing Conventional, Organic, Kosher, And Raised Without Antibiotics, Jack M. Millman, Kara Waits, Heidi Grande, Ann R. Marks, Jane C. Marks, Lance B. Price, Bruce A. Hungate

Environmental and Occupational Health Faculty Publications

Retail poultry products are known sources of antibiotic-resistant Escherichia coli, a major human health concern. Consumers have a range of choices for poultry, including conventional, organic, kosher, and raised without antibiotics (RWA) – designations that are perceived to indicate differences in quality and safety. However, whether these categories vary in the frequency of contamination with antibiotic-resistant E. coli is unknown. We examined the occurrence of antibiotic-resistant E. coli on raw chicken marketed as conventional, organic, kosher and RWA. From April – June 2012, we purchased 213 samples of raw chicken from 15 locations in the New York City metropolitan …

Perception Of Slipperiness And Prospective Risk Of Slipping At Work, Theodore K. Courtney, Santosh K. Verma, Wen-Ruey Chang, Yueng-Hsiang Huang, David A. Lombardi, Melanye J. Brennan, Melissa J. Perry

Environmental and Occupational Health Faculty Publications

Objectives: Falls are a leading cause of injury at work, and slipping is the predominant cause of falling. Prior research has suggested a modest correlation between objective measures (such as coefficient of friction, COF) and subjective measures of slipperiness (such as worker perceptions) in the workplace. However, the degree of association between subjective measures and the actual risk of slipping at the workplace is unknown. This study examined the association between perception of slipperiness and the risk of slipping.

Methods: 475 workers from 36 limited-service restaurants participated in a 12-week prospective cohort study. At baseline, demographic information was collected, participants …

Association Between Childhood Adversities And Adulthood Depressive Symptoms In South Korea: Results From A Nationally Representative Longitudinal Study, Seung-Sup Kim, Hyobum Jang, Hyoung Yoon Chang, Young Su Park, Dong Woo Lee

Environmental and Occupational Health Faculty Publications

Objective To examine how childhood adversity (ie, parental death, parental divorce, suspension of school education due to financial strain or being raised in a relative's house due to financial strain) is associated with prevalence and incidence of adulthood depressive symptoms and whether this association differs by gender and by age in South Korea.

Design Prospective cohort design.

Setting Nationally representative longitudinal survey in South Korea.

Participants 11 526 participants in South Korea.

Outcome measure Prevalence and incidence of adulthood depressive symptoms were assessed as a dichotomous variable using the Centers for Epidemiologic Studies Depression (CES-D) Scale in 2006 and 2007. …

Complete Genome Sequence Of The Epidemic And Highly Virulent Ctx-M-15-Producing H30-Rx Subclone Of Escherichia Coli St131, Paal S. Andersen, Marc Stegger, Maliha Aziz, Tania L. Contente-Cuomo, Henry S. Gibbons, Paul Keim, Evgeni V. Sokurenko, James R. Johnson, Lance B. Price

Environmental and Occupational Health Faculty Publications

We report the complete genome sequence, including five complete plasmid sequences, of Escherichia coli ST131 isolate JJ1886. The isolate was obtained in 2007 in the United States from a patient with fatal urosepsis and belongs to the virulent, CTX-M-15-producing H30-Rx sublineage.

Characterization Of Microflora In Latin-Style Cheeses By Next-Generation Sequencing Technology, Tina S. Lusk, Andrea R. Ottesen, James R. White, Marc W. Allard, Eric W. Brown, Julie A. Kase

Environmental and Occupational Health Faculty Publications

Background

Cheese contamination can occur at numerous stages in the manufacturing process including the use of improperly pasteurized or raw milk. Of concern is the potential contamination by Listeria monocytogenes and other pathogenic bacteria that find the high moisture levels and moderate pH of popular Latin-style cheeses like queso fresco a hospitable environment. In the investigation of a foodborne outbreak, samples typically undergo enrichment in broth for 24 hours followed by selective agar plating to isolate bacterial colonies for confirmatory testing. The broth enrichment step may also enable background microflora to proliferate, which can confound subsequent analysis if not inhibited …

Using Physiologically-Based Pharmacokinetic Models To Incorporate Chemical And Non-Chemical Stressors Into Cumulative Risk Assessment: A Case Study Of Pesticide Exposures, Susan C. Wason, Thomas J. Smith, Melissa J. Perry, Jonathan I. Levy

Environmental and Occupational Health Faculty Publications

Cumulative risk assessment has been proposed as an approach to evaluate the health risks associated with simultaneous exposure to multiple chemical and non-chemical stressors. Physiologically based pharmacokinetic/pharmacodynamic (PBPK/PD) models can allow for the inclusion and evaluation of multiple stressors, including non-chemical stressors, but studies have not leveraged PBPK/PD models to jointly consider these disparate exposures in a cumulative risk context. In this study, we focused on exposures to organophosphate (OP) pesticides for children in urban low-income environments, where these children would be simultaneously exposed to other pesticides (including pyrethroids) and non-chemical stressors that may modify the effects of these exposures …

Prioritization Of Biomarker Targets In Human Umbilical Cord Blood: Identification Of Proteins In Infant Blood Serving As Validated Biomarkers In Adults, Nicole Hansmeier, Tzu-Chiao Chao, Lynn R. Goldman, Frank R. Witter, Rolf U. Halden

Environmental and Occupational Health Faculty Publications

Background: Early diagnosis represents one of the best lines of defense in the fight against a wide array of human diseases. Umbilical cord blood (UCB) is one of the first easily available diagnostic biofluids and can inform about the health status of newborns. However, compared with adult blood, its diagnostic potential remains largely untapped.

Objectives: Our goal was to accelerate biomarker research on UCB by exploring its detectable protein content and providing a priority list of potential biomarkers based on known proteins involved in disease pathways.

Methods: We explored cord blood serum proteins by profiling a UCB pool of 12 …

Environmental Exposure To Polychlorinated Biphenyls And P,P'-Dde And Sperm Sex-Chromosome Disomy, Megan E. Mcauliffe, Paige L. Williams, Susan A. Korrick, Larisa M. Altshul, Melissa J. Perry

Environmental and Occupational Health Faculty Publications

Background: Chromosomal abnormalities contribute substantially to reproductive problems, but the role of environmental risk factors has received little attention.

Objectives: We evaluated the association of polychlorinated biphenyl (PCB) and dichlorodiphenyldichloroethylene (p,p´-DDE) exposures with sperm sex-chromosome disomy.

Methods: We conducted a cross-sectional study of 192 men from subfertile couples. We used multiprobe fluorescence in situ hybridization (FISH) for chromosomes X, Y, and 18 to determine XX, YY, XY, and total sex-chromosome disomy in sperm nuclei. Serum was analyzed for concentrations of 57 PCB congeners and p,p´-DDE. Poisson regression models were used to calculate incidence rate ratios (IRRs) for …

Association Of Hexachlorobenzene (Hcb), Dichlorodiphenyltrichloroethane (Ddt), And Dichlorodiphenyldichloroethylene (Dde) With In Vitro Fertilization (Ivf) Outcomes., Shruthi Mahalingaiah, Stacey A. Missmer, Arnab Maity, Paige L. Williams, John D. Meeker, Katharine Berry, Shelley Ehrlich,, Melissa J. Perry, Daniel W. Cramer, Russ Hauser

Environmental and Occupational Health Faculty Publications

Background: Hexachlorobenzene (HCB), dichlorodiphenyltrichloroethane (DDT), and dichlorodiphenyldichloroethylene (DDE) are persistent chlorinated pesticides with endocrine activity that may adversely affect the early stages of human reproduction.

Objective: Our goal was to determine the association of serum levels of HCB, DDT, and DDE with implantation failure, chemical pregnancy, and spontaneous abortion in women undergoing in vitro fertilization (IVF) from 1994 to 2003.

Methods: Levels of HCB and congeners of DDT and DDE were measured in serum collected during the follicular phase. Multivariable-adjusted statistical models accommodating multiple outcomes and multiple cycles per woman were used to estimate the relation between serum pesticide levels …

Association Between Interpersonal Trust, Reciprocity, And Depression In South Korea: A Prospective Analysis, Seung-Sup Kim, Yeonseung Chung, Melissa J. Perry, Ichiro Kawachi, V. S. Subramanian

Environmental and Occupational Health Faculty Publications

Background

A growing body of empirical evidence indicates that low-level social capital is related to poor mental health outcomes. However, the prospective association between social capital and depression remains unclear, and no published studies have investigated the association with longitudinal data in East-Asian countries.

Methods

We analyzed data from the ongoing Korean Welfare Panel Study to prospectively investigate association between social capital and depression. Social capital was measured at the individual level by two items specific to interpersonal trust and reciprocity. Depression was annually assessed as a dichotomous variable using the Center for Epidemiologic Studies Depression Scale. After excluding participants …

Perceived Discrimination And Self-Rated Health In South Korea: A Nationally Representative Survey, Seung-Sup Kim, David R. Williams

Environmental and Occupational Health Faculty Publications

Background

There is mounting evidence that discriminatory experiences can harm health. However, previous research has mainly focused on the health effects of racial discrimination in U.S. or European countries although there is pervasive discrimination by gender, age, education and other factors in Asian countries.

Methods

We analyzed the data from the 7th wave of Korean Labor and Income Panel Study to investigate the association between perceived discriminatory experience and poor self-rated health in South Korea. Perceived discriminatory experiences were measured in eight situations through a modified Experience of Discrimination questionnaire. In each of eight situations, the lifetime prevalence of perceived …