Association of Endocrine-Disrupting Chemicals with All-Cause and Cause-Specific Mortality in the U.S.: A Prospective Cohort Study

Abstract

Wide exposure to endocrine-disrupting chemicals (EDCs) poses a great risk on human health. However, few large-scale cohort studies have comprehensively estimated the association between EDCs exposure and mortality risk. This study aimed to investigate the association of urinary EDCs exposure with mortality risk and quantify attributable mortality and economic loss. Multivariable Cox proportional hazards regression models were performed to investigate the association of 38 representative EDCs exposure with mortality risk in the National Health and Nutrition Examination Survey (NHANES). During a median follow-up of 7.7 years, 47,279 individuals were enrolled. All-cause mortality was positively associated with 1-hydroxynaphthalene, 2-hydroxynaphthalene, cadmium, antimony, cobalt, and monobenzyl phthalate. Cancer mortality was positively associated with cadmium. Cardiovascular disease (CVD) mortality was positively associated with 1-hydroxynaphthalene, 2-hydroxynaphthalene, and 2-hydroxyfluorene. Nonlinear U-shaped relationships were found between all-cause mortality and cadmium and cobalt, which was also identified between 2-hydroxyfluorene and CVD mortality. J-shaped association of cadmium exposure with cancer mortality was also determined. EDCs exposure may cause 56.52% of total deaths (1,528,500 deaths) and around 1,897 billion USD in economic costs. Exposure to certain phthalates, polycyclic aromatic hydrocarbons, phytoestrogens, or toxic metals, even at substantially low levels, is significantly associated with mortality and induces high economic costs.

Toxicological Effects of Naturally Occurring Endocrine Disruptors on Various Human Health Targets: A Rapid Review

“…Finally, in this review we identified one paper assessing the relationship between EDCs and N-EDCs, such as PEs, and human mortality in a prospective cohort study. The study found a positive correlation between genistein and all-cause mortality, while enterolactone showed an inverse correlation [ 50 ].…”

The association between polychlorinated dibenzo-p-dioxin exposure and cancer mortality in the general population: a cohort study

“…These findings additionally demonstrate that there exists a distinct chemical specificity between environmental substances and the risk of mortality. Previous research in the field of mortality risk among the overall populace has indicated a strong correlation between the element cadmium and tumor fatality ( 18 , 19 ). It is suggested that PCDD may also have similar risks.…”

Mediating Role of Glucose-Lipid Metabolism in the Association between the Increased Risk of Coronary Heart Disease and Exposure to Organophosphate Esters, Phthalates, and Polycyclic Aromatic Hydrocarbons

“…Metabolites of the investigated EDCs were used as biomarkers of exposure (Table ). The biomarkers were selected based on (1) the response relationship between each parent compound and the biomarker and (2) the detection frequencies among reported populations, which exceeded 50%. − For the detection of OFR metabolites (mOFRs), 100 μL of 200 ng/mL mixed internal standards (IS) (i.e., d 8-BBOEP, d 8-BCEP, d 12-BCIPP, d 10-BDCIPP, d 18-DBP, d 14-DoCP, d 14-DpCP, and d 10-DPHP) and 12 μL of formic acid were added to 2 mL of urine. After cartridge activation with 2 mL of 5% NH 4 OH in methanol and 3 mL of 0.6% formic acid in water, solid-phase extraction was conducted using CNW polysery PWAX cartridges.…”