Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
JAMA Netw Open. 2024 Sep 3;7(9):e2435484. doi: 10.1001/jamanetworkopen.2024.35484.
Organophosphate flame retardants (OPFRs) are an important group of pollutants associated with endocrine disorders, cancer, and nephrotoxicity. However, temporal trends in OPFR metabolite concentrations remain understudied.
To examine changes in urinary concentrations of OPFR metabolites among US children, youths, and adults from 2011 to 2020, and to evaluate whether sociodemographic factors were associated with variations in temporal trends.
DESIGN, SETTING, AND PARTICIPANTS: This population-based cross-sectional study used data from 4 US National Health and Nutrition Examination Survey (NHANES) cycles (2011-2012, 2013-2014, 2015-2016, and 2017-2020 [to March 2020 before the COVID-19 pandemic]). The study included children and youths (aged 6-19 years) and adults (aged ≥20 years) with valid urinary concentrations of the following OPFR metabolites: bis(2-chloroethyl) phosphate (BCEtP), bis(1-chloro-2-propyl) phosphate (BCPP), diphenyl phosphate (DPhP), and dibutyl phosphate (DBuP). Data analysis was performed between February and May 2024.
Calendar year and key sociodemographic subgroups (age, race and ethnicity, sex, educational attainment, and poverty-to-income ratio).
The main outcome was urinary concentrations of OPFR metabolites among children, youths, and adults. Survey-weighted linear regression models were applied to estimate trends.
The study population of 10 549 NHANES participants included 3154 children and youths (mean [SE] age, 12.5 [0.1] years; 51.2% were male) and 7395 adults (mean [SE] age, 47.8 [0.4] years; 52.0% were women). Among children and youths, mean (95% CI) BCEtP concentrations decreased from 0.68 (0.60-0.77) μg/L in 2011-2012 to 0.41 (0.37-0.45) μg/L in 2017-2020 (P for trend < .001). Among adults, mean (95% CI) BCEtP concentrations decreased from 0.43 (0.37-0.50) μg/L in 2011-2012 to 0.29 (0.27-0.33) μg/L in 2017-2020 (P for trend < .001), and mean BCPP concentrations decreased from 0.15 (0.14-0.17) μg/L to 0.13 (0.12-0.14) μg/L (P for trend = .002). Parent level of educational attainment was associated with concentrations of BCPP and BCEtP among children and youths; however, no significant differences among adults were observed.
This study identified variations in temporal trends in urinary concentrations of OPFR metabolites among the US population from 2011 to 2020. In addition, substantial disparities in exposure levels persisted among children with different levels of parent educational attainment. These findings suggest that policy makers should consider socioeconomic factors to further reduce OPFR exposure and promote equity, ensuring a safe living environment for all individuals.
有机磷酸酯阻燃剂 (OPFRs) 是与内分泌紊乱、癌症和肾毒性相关的一类重要污染物。然而，OPFR 代谢物浓度的时间趋势仍研究不足。
研究美国儿童、青少年和成年人尿液中 OPFR 代谢物浓度的变化，评估社会人口因素是否与时间趋势的变化有关。
设计、地点和参与者：这是一项基于人群的横断面研究，使用了美国国家健康和营养调查 (NHANES) 四个周期的数据（2011-2012 年、2013-2014 年、2015-2016 年和 2017-2020 年[2020 年 3 月之前在 COVID-19 大流行之前]）。该研究包括有有效尿液 OPFR 代谢物浓度的儿童和青少年（6-19 岁）和成年人（≥20 岁）：双（2-氯乙基）磷酸酯 (BCEtP)、双（1-氯-2-丙基）磷酸酯 (BCPP)、磷酸二苯酯 (DPhP) 和磷酸二丁酯 (DBuP)。数据分析于 2024 年 2 月至 5 月之间进行。
日历年度和关键社会人口统计学亚组（年龄、种族和民族、性别、教育程度和贫困收入比）。
主要结果是儿童、青少年和成年人尿液中 OPFR 代谢物的浓度。采用加权线性回归模型估计趋势。
这项研究的 10549 名 NHANES 参与者包括 3154 名儿童和青少年（平均[SE]年龄 12.5[0.1]岁；51.2%为男性）和 7395 名成年人（平均[SE]年龄 47.8[0.4]岁；52.0%为女性）。在儿童和青少年中，BCEtP 的平均浓度（95%CI）从 2011-2012 年的 0.68（0.60-0.77）μg/L 降至 2017-2020 年的 0.41（0.37-0.45）μg/L（趋势 P<0.001）。在成年人中，BCEtP 的平均浓度（95%CI）从 2011-2012 年的 0.43（0.37-0.50）μg/L 降至 2017-2020 年的 0.29（0.27-0.33）μg/L（趋势 P<0.001），BCPP 的平均浓度从 0.15（0.14-0.17）μg/L 降至 0.13（0.12-0.14）μg/L（趋势 P=0.002）。父母的教育程度与儿童和青少年的 BCPP 和 BCEtP 浓度有关；然而，在成年人中没有观察到显著差异。
本研究确定了 2011 年至 2020 年美国人群尿液中 OPFR 代谢物浓度的时间趋势变化。此外，在父母教育程度不同的儿童中，暴露水平仍然存在显著差异。这些发现表明，政策制定者应考虑社会经济因素，以进一步减少 OPFR 暴露，促进公平，确保所有个人都有一个安全的生活环境。
