HEALTH NEWS

Study Title:

Exposure to Polybrominated Diphenyl Ethers and Risk of All-Cause and Cause-Speci

Study Abstract

Key Points

Question  Is environmental exposure to polybrominated diphenyl ether (PBDE) flame retardants associated with risk of all-cause and cause-specific mortality?

Findings  In this cohort study of 16 162 adults in the general US population, higher serum PBDE exposure levels were associated with increased risk of death from cancer during the follow-up.

Meaning  These results suggest evidence for the long-term adverse health effects of PBDEs in humans.

Abstract

Importance  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.

Objective  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.

Exposures  PBDE analytes in serum samples were measured using solid phase extraction and isotope dilution gas chromatography high-resolution mass spectrometry.

Main Outcomes and Measures  All-cause mortality, cancer mortality, and cardiovascular mortality.

Results  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.

Conclusions and Relevance  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.

Study Information

JAMA Netw Open. 2024;7(4):e243127. doi:10.1001/jamanetworkopen.2024.3127 

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