European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, United Kingdom.
Environ Int. 2013 Sep;59:328-35. doi: 10.1016/j.envint.2013.06.017. Epub 2013 Jul 24.
Low level chronic exposure to toxicants is associated with a range of adverse health effects. Understanding the various factors that influence the chemical burden of an individual is of critical importance to public health strategies. We investigated the relationships between socioeconomic status (SES) and bio-monitored chemical concentration in five cross-sectional waves of the U.S. National Health and Nutrition Examination Survey (NHANES). We utilised adjusted linear regression models to investigate the association between 179 toxicants and the poverty income ratio (PIR) for five NHANES waves. We then selected a subset of chemicals associated with PIR in 3 or more NHANES waves and investigated potential mediating factors using structural equation modelling. PIR was associated with 18 chemicals in 3 or more NHANES waves. Higher SES individuals had higher burdens of serum and urinary mercury, arsenic, caesium, thallium, perfluorooctanoic acid, perfluorononanoic acid, mono(carboxyoctyl) phthalate and benzophenone-3. Inverse associations were noted between PIR and serum and urinary lead and cadmium, antimony, bisphenol A and three phthalates (mono-benzyl, mono-isobutyl, mono-n-butyl). Key mediators included fish and shellfish consumption for the PIR, mercury, arsenic, thallium and perfluorononanoic acid associations. Sunscreen use was an important mediator in the benzophenone-3/PIR relationship. The association between PIR and cadmium or lead was partially mediated by smoking, occupation and diet. These results provide a comprehensive analysis of exposure patterns as a function of socioeconomic status in US adults, providing important information to guide future public health remediation measures to decrease toxicant and disease burdens within society.
低水平的慢性暴露于有毒物质与一系列不良健康影响有关。了解影响个体化学负荷的各种因素对于公共卫生策略至关重要。我们研究了社会经济地位（SES）与美国国家健康和营养检查调查（NHANES）五个横断面波次中生物监测化学浓度之间的关系。我们利用调整后的线性回归模型研究了 179 种有毒物质与五个 NHANES 波次的贫困收入比（PIR）之间的关系。然后，我们选择了与 3 个或更多 NHANES 波次中的 PIR 相关的一组化学物质，并使用结构方程模型研究了潜在的中介因素。PIR 与 3 个或更多 NHANES 波次中的 18 种化学物质相关。SES 较高的个体血清和尿液中的汞、砷、铯、铊、全氟辛酸、全氟壬酸、单（羧辛基）邻苯二甲酸酯和二苯甲酮-3 的负担更高。相反，PIR 与血清和尿液中的铅和镉、锑、双酚 A 和三种邻苯二甲酸酯（单苄基、单异丁基、单正丁基）呈负相关。关键的中介因素包括 PIR 与汞、砷、铊和全氟壬酸的关系中的鱼类和贝类消费。防晒霜的使用是二苯甲酮-3/PIR 关系中的一个重要中介因素。PIR 与镉或铅的关系部分由吸烟、职业和饮食介导。这些结果全面分析了美国成年人社会经济地位对暴露模式的影响，为指导未来公共卫生修复措施提供了重要信息，以减少社会中的有毒物质和疾病负担。
