Exposure to phenols, chlorophenol pesticides, phthalate and PAHs and mortality risk: A prospective study based on 6 rounds of NHANES

Dongsheng Di; Ruyi Zhang; Haolong Zhou; Muhong Wei; Yuan Cui; Jianli Zhang; Tingting Yuan; Qian Liu; Tingting Zhou; Junan Liu; Qi Wang

doi:10.1016/j.chemosphere.2023.138650

Exposure to phenols, chlorophenol pesticides, phthalate and PAHs and mortality risk: A prospective study based on 6 rounds of NHANES

Chemosphere. 2023 Jul:329:138650. doi: 10.1016/j.chemosphere.2023.138650. Epub 2023 Apr 8.

Authors

Affiliations

¹ MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
² Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
³ MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. Electronic address: wangqi_tj@hust.edu.cn.

PMID: 37037349
DOI: 10.1016/j.chemosphere.2023.138650

Abstract

Objectives: Human exposure to various endocrine disrupting chemicals (EDCs) is widespread and long-lasting. The primary objective of this study was to prospectively evaluate the association of combined exposure of phenols, chlorophenol pesticides, phthalate and polycyclic aromatic hydrocarbons (PAHs) and mortality risk in a representative US population.

Methods: The data on urinary levels of phenols, chlorophenol pesticides, phthalates, and PAH metabolites, were collected from participants aged ≥20 years in six rounds of the National Health and Nutrition Examination Survey (NHANES) (2003-2014). NHANES-linked death records up to December 31, 2015 were used to ascertain mortality status and cause of death. Cox proportional hazards and competing risk models were mainly used for chemical and mortality risk association analysis. The weighted quantile sum (WQS) regression and the least absolute shrinkage and selection operator regression were employed to estimate the association between EDC co-exposure and mortality risk.

Results: High levels of mono-n-butyl phthalate, monobenzyl phthalate, and 1-napthol were significantly associated with increased risk of all cause, cardiovascular disease (CVD) and cancer mortality among all participants. WQS index was associated with the risks of all-cause (hazard ratio [HR] = 1.389, 95%CI: 1.155-1.669) and CVD mortality (HR = 1.925, 95%CI: 1.152-3.216). High co-exposure scores were associated with elevated all-cause (HR = 2.842, 95% CI: 1.2.094-3.858), CVD (HR = 1.855, 95% CI: 1.525-2.255), and cancer mortality risks (HR = 2.961, 95% CI: 1.468-5.972). The results of subgroup analysis, competing risk model, and sensitivity analysis were generally consistent with the findings from the main analyses, indicating the robustness of our findings.

Conclusions: This study provided the first epidemiological evidence that co-exposure to EDC at fairly low levels contributed to elevated mortality risk among US adults. The underlying mechanisms for the effects of EDC co-exposure on human health are worthy of future exploration.

Keywords: Chlorophenol pesticides; Mortality risks; Phenols; Phthalate; Polycyclic aromatic hydrocarbons.

MeSH terms

Adult
Cardiovascular Diseases*
Chlorophenols*
Environmental Pollutants* / urine
Humans
Neoplasms*
Nutrition Surveys
Pesticides*
Phenols / toxicity
Phenols / urine
Polycyclic Aromatic Hydrocarbons*
Prospective Studies

Substances

Phenols
Chlorophenols
phthalic acid
Environmental Pollutants
Pesticides
Polycyclic Aromatic Hydrocarbons