Association between ethylene oxide exposure and prevalence of COPD: Evidence from NHANES 2013-2016

Qiong Huang; Siqi Li; Jinfa Wan; Wenbin Nan; Baimei He

doi:10.1016/j.scitotenv.2023.163871

Association between ethylene oxide exposure and prevalence of COPD: Evidence from NHANES 2013-2016

Sci Total Environ. 2023 Aug 10:885:163871. doi: 10.1016/j.scitotenv.2023.163871. Epub 2023 May 4.

Authors

Qiong Huang¹, Siqi Li¹, Jinfa Wan², Wenbin Nan², Baimei He³

Affiliations

¹ Department of Geriatric Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha 410008, China; Department of Geriatric Medicine, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China.
² Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha 410011, China.
³ Department of Geriatric Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha 410008, China; Department of Geriatric Medicine, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China. Electronic address: hebaimei@126.com.

PMID: 37149189
DOI: 10.1016/j.scitotenv.2023.163871

Abstract

Background: Environmental exposures are major risk factors for chronic obstructive pulmonary disease (COPD). Ethylene oxide (EO) is a ubiquitous organic compound and adversely affects human health. However, it remains unknown whether EO exposure increases the risk of COPD. This study aimed to explore the association between EO exposure and the prevalence of COPD.

Methods: In this cross-sectional study, 2243 participants were analyzed from the National Health and Nutrition Examination Survey (NHANES) between 2013 and 2016. Participants were classified into four groups according to quartiles of log10-transformed hemoglobin adducts of EO (HbEO) levels. HbEO levels were measured using the modified Edman reaction and high-performance liquid chromatography coupled with tandem mass spectrometry (HPLC-MS/MS). Logistic regression, restricted cubic spline regression model, and subgroup analysis were used to assess whether EO exposure was associated with the risk of COPD. A multivariate linear regression model was used to investigate the correlation between HbEO levels and inflammatory factors. A mediating analysis was conducted to estimate whether inflammatory factors were involved in the effects of HbEO on the prevalence of COPD.

Results: Participants with COPD had higher HbEO levels than those without COPD. Log10-transformed HbEO levels were associated with an increased risk of COPD after adjusting for all covariates. [Q4 vs. Q1 in model II: OR = 2.15, 95 % CI: 1.20-3.85, P = 0.010, P for trend = 0.009]. Moreover, a nonlinear J-shaped relationship was observed between HbEO levels and the risk of COPD. Furthermore, HbEO levels were positively correlated with inflammatory cells. In addition, white blood cells and neutrophils mediated the relationship between HbEO and the prevalence of COPD with mediated proportions of 10.37 % and 7.55 %, respectively.

Conclusion: These findings indicate that EO exposure has a J-shaped association with the risk of COPD. Inflammation is a key mediator involved in the effects of EO exposure on COPD.

Keywords: COPD; Epidemiology; Ethylene oxide; Inflammation; NHANES.

MeSH terms

Cross-Sectional Studies
Ethylene Oxide*
Humans
Nutrition Surveys
Prevalence
Pulmonary Disease, Chronic Obstructive* / epidemiology
Tandem Mass Spectrometry

Substances

Ethylene Oxide