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Exposure to bisphenols and asthma morbidity among low-income urban children with asthma - 04/02/21

Doi : 10.1016/j.jaci.2020.05.031 
Lesliam Quirós-Alcalá, PhD, MSc a, b, , Nadia N. Hansel, MD, MPH c, Meredith McCormack, MD, MHS c, Antonia M. Calafat, PhD d, Xiaoyun Ye, MSc d, Roger D. Peng, PhD e, Elizabeth C. Matsui, MD, MHS c, f
a Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Md 
b Maryland Institute of Applied Environmental Health, School of Public Health, University of Maryland, College Park, Md 
c School of Medicine, Johns Hopkins University, Baltimore, Md 
d National Center for Environmental Health, US Centers for Disease Control and Prevention, Atlanta, Ga 
e Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Md 
f Dell Medical School, University of Texas, Austin, Tex 

Corresponding author: Lesliam Quirós-Alcalá, PhD, MSc, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205.Department of Environmental Health and EngineeringJohns Hopkins Bloomberg School of Public Health615 N Wolfe StBaltimoreMD21205

Abstract

Background

Bisphenol A (BPA) has been linked with pediatric asthma development and allergic airway inflammation in animal models. Whether exposure to BPA or its structural analogs bisphenol S (BPS) and bisphenol F (BPF) is associated with asthma morbidity remains unknown.

Objective

We examined associations between bisphenols and morbidity due to pediatric asthma.

Methods

We quantified concentrations of BPA, BPS, and BPF in 660 urine samples from 148 predominantly low-income, African American children (aged 5-17 years) with established asthma. We used biobanked biospecimens and data on symptoms, health care utilization, and pulmonary function and inflammation that were collected every 3 months over the course of a year. We used generalized estimating equations to examine associations between concentrations or detection of urinary bisphenols and morbidity outcomes and assessed heterogeneity of associations by sex.

Results

We observed consistent positive associations between BPA exposure and measures of asthma morbidity. For example, we observed increased odds of general symptom days (adjusted odds ratio [aOR] = 1.40 [95% C = 1.02-1.92]), maximal symptom days (aOR = 1.36 [95% CI = 1.00-1.83]), and emergency department visits (aOR = 2.12 [95% CI =1.28-3.51]) per 10-fold increase in BPA concentration. We also observed evidence of sexually dimorphic effects; BPA concentrations were associated with increased odds of symptom days and health care utilization only among boys. Findings regarding BPS and BPF did not consistently point to associations with asthma symptoms or health care utilization.

Conclusion

We found evidence to suggest that BPA exposure in a predominantly low-income, minority pediatric cohort is associated with asthma morbidity and that associations may differ by sex. Our findings support additional studies, given the high pediatric asthma burden and widespread exposure to BPA in the United States.

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Graphical abstract




Il testo completo di questo articolo è disponibile in PDF.

Key words : Asthma, asthma morbidity, childhood asthma, African American, BPA, BPS, BPF, inner-city asthma

Abbreviations used : aOR, BPA, BPF, BPS, BMI, ED, EDC, Feno, GM, ICC, LOD, MAACS, NHANES


Mappa


 L.Q.A. was supported by a National Heart, Lung, and Blood Institute Career Development Award (K01HL138124). N.N.H. was supported by the National Institute of Environmental Health Sciences (NIEHS) (grants ES018176, R01 ES022607, and R01ES023500), the National Institute on Minority Health and Health Disparities (grant P50MD010431), and the US Environmental Protection Agency (EPA) (agreements 83615201, 83451001, and 83615001). M.C.McC. was supported by the NIEHS (grants P50 ES018176 and R21 ES025840,) the National Institute on Minority Health and Health Disparities (grant P50MD010431), and the EPA (agreement 83615201). R.D.P. was supported by the NIEHS (grants P50 ES018176, mnvbR01ES023447, and R01ES026170). E.C.M. was supported by the National Institute of Allergy and Infectious Diseases (grant K24AI114769) and the NIEHS (grants R01ES023447 and R01ES026170). The findings and conclusions in this article are those of the authors and do not necessarily represent the official position or views of the National Institutes of Health, US Centers for Disease Control and Prevention, or EPA. Use of trade names is for identification only and does not imply endorsement by the US Centers for Disease Control and Prevention, the Public Health Service, or the US Department of Health and Human Services.
 Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest.


© 2020  American Academy of Allergy, Asthma & Immunology. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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