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August 31, 2020
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High BPA exposure may increase all-cause mortality

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Exposure to the endocrine-disrupting chemical bisphenol A was significantly and positively associated with all-cause mortality in U.S. adults, according to an analysis of National Health and Nutrition Examination Survey data.

Wei Bao

“Bisphenol A exposure is ubiquitous in the general population,” Wei Bao, MD, PhD, assistant professor of epidemiology at the University of Iowa College of Public Health, told Healio. “In line with our findings, previous studies have shown a wide range of potentially toxic effects of BPA in humans. Therefore, it is imperative and important to minimize human exposure to BPA, through ‘2R’ strategies, reducing the use of BPA-containing products and replacing BPA-containing products with other safer products.”

High BPA exposure has been linked to increases in all-cause and cardiovascular disease mortality rates.

Bao and colleagues analyzed data from 3,883 adults who participated in the NHANES 2003-2008 waves and provided urine samples for BPA level measurements (mean age, 44 years; 51.4% women). Urinary BPA levels were quantified using online solid-phase extraction coupled with high-performance liquid chromatography with isotope-dilution tandem mass spectrometry. Participants were stratified by BPA tertile levels, with median levels of 0.7 ng/mL (reference), 2.1 ng/mL and 5.7 ng/mL. Researchers linked participant data all-cause mortality data from survey date through Dec. 31, 2015.

During 36,514 person-years of follow-up (median, 9.6 years), 344 deaths occurred, including 71 deaths from cardiovascular disease and 75 deaths from cancer.

Researchers found that participants with higher urinary BPA levels were at higher risk for death.

HRs comparing the highest vs. lowest tertile of urinary BPA levels were 1.49 (95% CI, 1.01-2.19) for all-cause mortality and 1.46 (95% CI, 0.67-3.15) for CV mortality. There was no association between BPA exposure and cancer mortality. All results persisted after adjustment for age, sex, race, socioeconomic status, dietary and lifestyle factors, BMI, and urinary creatinine levels.

Researchers noted that the observed but statistically nonsignificant association between BPA exposure and CV mortality warrants further investigation.

“Replication of the findings in other populations is needed,” Bao said. “Second, mechanistic studies are warranted to understand the biological pathways.”

For more information:

Wei Bao, MD, PhD, can be reached at the Department of Epidemiology, College of Public Health, University of Iowa, 145 N Riverside Dr, Room S431 CPHB, Iowa City, IA 52242; email: wei-bao@uiowa.edu.