Department of Nursing, The First Affiliated Hospital of USTC, Institute of Public Health Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City.
JAMA Netw Open. 2024 Apr 1;7(4):e243127. doi: 10.1001/jamanetworkopen.2024.3127.
Polybrominated diphenyl ethers (PBDEs) are an important group of persistent organic pollutants with endocrine-disrupting properties. However, prospective cohort studies regarding the association of PBDE exposure with long-term health outcomes, particularly mortality, are lacking.
To examine the association of environmental exposure to PBDEs with risk of all-cause and cause-specific mortality.
DESIGN, SETTING, AND PARTICIPANTS: This nationally representative cohort study used data from the National Health and Nutrition Examination Survey 2003 to 2004 and linked mortality information through December 31, 2019. Adults aged 20 years or older with available data on PBDE measurements and mortality were included. Statistical analysis was performed from February 2022 to April 2023.
PBDE analytes in serum samples were measured using solid phase extraction and isotope dilution gas chromatography high-resolution mass spectrometry.
All-cause mortality, cancer mortality, and cardiovascular mortality.
This study included 1100 participants (mean [SE] age, 42.9 [0.6] years; proportion [SE] female, 51.8% [1.6%]; proportion [SE] Hispanic, 12.9% [2.7%]; proportion [SE] non-Hispanic Black, 10.5% [1.6%]; proportion [SE] non-Hispanic White, 70.8% [3.7%]; proportion [SE] other race and ethnicity, 5.8% [1.1%]). During 16 162 person-years of follow-up (median [IQR] follow-up, 15.8 [15.2-16.3] years; maximum follow-up, 17 years), 199 deaths occurred. Participants with higher serum PBDE levels were at higher risk for death. After adjustment for age, sex, and race and ethnicity, lifestyle and socioeconomic factors, and body mass index, participants with the highest tertile of serum PBDE levels had an approximately 300% increased risk of cancer mortality (HR, 4.09 [95% CI, 1.71-9.79]) compared with those with the lowest tertile of serum PBDE levels. No significant association of PBDE exposure with all-cause mortality (HR, 1.43 [95% CI, 0.98-2.07]) or cardiovascular mortality (HR, 0.92 [95% CI, 0.41-2.08]) was observed.
In this nationally representative cohort study, PBDE exposure was significantly associated with an increased risk of cancer mortality. Further studies are needed to replicate the findings and determine the underlying mechanisms.
多溴二苯醚 (PBDEs) 是一组具有内分泌干扰特性的重要持久性有机污染物。然而，关于 PBDE 暴露与长期健康结果（尤其是死亡率）之间关联的前瞻性队列研究仍很缺乏。
研究环境中 PBDE 暴露与全因和特定原因死亡率风险之间的关联。
设计、设置和参与者：这项全国代表性队列研究使用了 2003 年至 2004 年全国健康和营养调查的数据，并通过截至 2019 年 12 月 31 日的死亡信息进行了关联。纳入了有 PBDE 测量值和死亡率数据的 20 岁或以上的成年人。统计分析于 2022 年 2 月至 2023 年 4 月进行。
使用固相萃取和同位素稀释气相色谱高分辨率质谱法测量血清样本中的 PBDE 分析物。
全因死亡率、癌症死亡率和心血管死亡率。
这项研究纳入了 1100 名参与者（平均[标准差]年龄，42.9[0.6]岁；比例[标准差]女性，51.8%[1.6%]；比例[标准差]西班牙裔，12.9%[2.7%]；比例[标准差]非西班牙裔黑人，10.5%[1.6%]；比例[标准差]非西班牙裔白人，70.8%[3.7%]；比例[标准差]其他种族和民族，5.8%[1.1%]）。在 16162 人年的随访期（中位数[IQR]随访期，15.8[15.2-16.3]年；最长随访期，17 年）期间，有 199 人死亡。血清 PBDE 水平较高的参与者死亡风险更高。在调整年龄、性别和种族与民族、生活方式和社会经济因素以及体重指数后，与血清 PBDE 水平最低三分位组相比，血清 PBDE 水平最高三分位组的癌症死亡率风险增加了约 300%（HR，4.09[95%CI，1.71-9.79]）。未观察到 PBDE 暴露与全因死亡率（HR，1.43[95%CI，0.98-2.07]）或心血管死亡率（HR，0.92[95%CI，0.41-2.08]）之间存在显著关联。
在这项全国代表性队列研究中，PBDE 暴露与癌症死亡率风险增加显著相关。需要进一步的研究来复制这些发现并确定潜在的机制。
