From a public health perspective, there is growing concern about dietary mercury intake as the most important source of mercury exposure. This study was performed to estimate dietary mercury exposure and to analyze the association between mercury intake and blood mercury levels in Koreans. The study subjects were 553 adults, comprising a 10% representative subsample of the Korean National Environmental Health Survey (KoNEHS) 2012–2014, who completed a health examination, a face-to-face interview, and a three-day food record. Dietary mercury and methylmercury intakes were assessed from the three-day food record, and blood mercury concentration was measured using a mercury analyzer. The association between dietary mercury intake and blood mercury levels was analyzed by comparing the odds ratios for the blood mercury levels above the Human BioMonitoring (HBM) I value (5 μg/L) among the three groups with different mercury intakes. The average total mercury intake was 4.74 and 3.07 μg/day in males and females, respectively. The food group that contributed most to mercury intake was fish and shellfish, accounting for 77.8% of total intake. The geometric mean of the blood mercury concentration significantly and linearly increased with the mercury and methylmercury intakes (p < 0.001). The odds ratios for blood mercury levels above the HBM I value in the highest mercury and methyl mercury intake group were 3.27 (95% Confidence Interval (CI) 1.79–5.95) and 3.20 (95% CI 1.77–5.79) times higher than that of the lowest intake group, respectively. Our results provide compelling evidence that blood mercury level has a strong positive association with dietary intake, and that fish and shellfish contribute most to the dietary mercury exposure.
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