Urinary polycyclic aromatic hydrocarbon metabolites and mortality in the United States: A prospective analysis.

<h4>Background</h4>Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous organic compounds associated with chronic disease in epidemiologic studies, though the contribution of PAH exposure on fatal outcomes in the U.S. is largely unknown.<h4>Objectives</h4>We investigated ur...

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Autores principales:	Achal P Patel, Suril S Mehta, Alexandra J White, Nicole M Niehoff, Whitney D Arroyave, Amy Wang, Ruth M Lunn
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/fafca47b755f45a58bf9add5ec0e4aa0
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spelling	oai:doaj.org-article:fafca47b755f45a58bf9add5ec0e4aa02021-12-02T20:07:17ZUrinary polycyclic aromatic hydrocarbon metabolites and mortality in the United States: A prospective analysis.1932-620310.1371/journal.pone.0252719https://doaj.org/article/fafca47b755f45a58bf9add5ec0e4aa02021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0252719https://doaj.org/toc/1932-6203<h4>Background</h4>Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous organic compounds associated with chronic disease in epidemiologic studies, though the contribution of PAH exposure on fatal outcomes in the U.S. is largely unknown.<h4>Objectives</h4>We investigated urinary hydroxylated PAH metabolites (OH-PAHs) with all-cause and cause-specific mortality in a representative sample of the U.S. population.<h4>Methods</h4>Study participants were ≥20 years old from the National Health and Nutrition Examination Survey 2001-2014. Concentrations (nmol/L) of eight OH-PAHs from four parent PAHs (naphthalene, fluorene, phenanthrene, pyrene) were measured in spot urine samples at examination. We identified all-cause, cancer-specific, and cardiovascular-specific deaths through 2015 using the National Death Index. We used Cox proportional hazards regression to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between ΣOH-PAHs and mortality endpoints. We assessed potential heterogeneity by age, gender, smoking status, poverty, and race/ethnicity. Additionally, we examined the overall mixture effect using quantile g-computation.<h4>Results</h4>In 9,739 eligible participants, there were 934 all-cause deaths, 159 cancer-specific deaths, and 108 cardiovascular-specific deaths (median 6.75 years follow-up). A log10 increase in ΣOH-PAHs was associated with higher all-cause mortality (HRadj = 1.39 [95%CI: 1.21, 1.61]), and possibly cancer-specific mortality (HRadj = 1.15 [95%CI: 0.79, 1.69]), and cardiovascular-specific mortality (HRadj = 1.49 [95%CI: 0.94, 2.33]). We observed substantial effect modification by age, smoking status, gender, and race/ethnicity across mortality endpoints. Risk of cardiovascular mortality was higher for non-Hispanic blacks and those in poverty, indicating potential disparities. Quantile g-computation joint associations for a simultaneous quartile increase in OH-PAHs were HRadj = 1.15 [95%CI: 1.02, 1.31], HRadj = 1.41 [95%CI: 1.05, 1.90], and HRadj = 0.98 [95%CI: 0.66, 1.47] for all-cause, cancer-specific, and cardiovascular-specific mortalities, respectively.<h4>Discussion</h4>Our results support a role for total PAH exposure in all-cause and cause-specific mortality in the U.S. population.Achal P PatelSuril S MehtaAlexandra J WhiteNicole M NiehoffWhitney D ArroyaveAmy WangRuth M LunnPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0252719 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Achal P Patel Suril S Mehta Alexandra J White Nicole M Niehoff Whitney D Arroyave Amy Wang Ruth M Lunn Urinary polycyclic aromatic hydrocarbon metabolites and mortality in the United States: A prospective analysis.
description	<h4>Background</h4>Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous organic compounds associated with chronic disease in epidemiologic studies, though the contribution of PAH exposure on fatal outcomes in the U.S. is largely unknown.<h4>Objectives</h4>We investigated urinary hydroxylated PAH metabolites (OH-PAHs) with all-cause and cause-specific mortality in a representative sample of the U.S. population.<h4>Methods</h4>Study participants were ≥20 years old from the National Health and Nutrition Examination Survey 2001-2014. Concentrations (nmol/L) of eight OH-PAHs from four parent PAHs (naphthalene, fluorene, phenanthrene, pyrene) were measured in spot urine samples at examination. We identified all-cause, cancer-specific, and cardiovascular-specific deaths through 2015 using the National Death Index. We used Cox proportional hazards regression to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between ΣOH-PAHs and mortality endpoints. We assessed potential heterogeneity by age, gender, smoking status, poverty, and race/ethnicity. Additionally, we examined the overall mixture effect using quantile g-computation.<h4>Results</h4>In 9,739 eligible participants, there were 934 all-cause deaths, 159 cancer-specific deaths, and 108 cardiovascular-specific deaths (median 6.75 years follow-up). A log10 increase in ΣOH-PAHs was associated with higher all-cause mortality (HRadj = 1.39 [95%CI: 1.21, 1.61]), and possibly cancer-specific mortality (HRadj = 1.15 [95%CI: 0.79, 1.69]), and cardiovascular-specific mortality (HRadj = 1.49 [95%CI: 0.94, 2.33]). We observed substantial effect modification by age, smoking status, gender, and race/ethnicity across mortality endpoints. Risk of cardiovascular mortality was higher for non-Hispanic blacks and those in poverty, indicating potential disparities. Quantile g-computation joint associations for a simultaneous quartile increase in OH-PAHs were HRadj = 1.15 [95%CI: 1.02, 1.31], HRadj = 1.41 [95%CI: 1.05, 1.90], and HRadj = 0.98 [95%CI: 0.66, 1.47] for all-cause, cancer-specific, and cardiovascular-specific mortalities, respectively.<h4>Discussion</h4>Our results support a role for total PAH exposure in all-cause and cause-specific mortality in the U.S. population.
format	article
author	Achal P Patel Suril S Mehta Alexandra J White Nicole M Niehoff Whitney D Arroyave Amy Wang Ruth M Lunn
author_facet	Achal P Patel Suril S Mehta Alexandra J White Nicole M Niehoff Whitney D Arroyave Amy Wang Ruth M Lunn
author_sort	Achal P Patel
title	Urinary polycyclic aromatic hydrocarbon metabolites and mortality in the United States: A prospective analysis.
title_short	Urinary polycyclic aromatic hydrocarbon metabolites and mortality in the United States: A prospective analysis.
title_full	Urinary polycyclic aromatic hydrocarbon metabolites and mortality in the United States: A prospective analysis.
title_fullStr	Urinary polycyclic aromatic hydrocarbon metabolites and mortality in the United States: A prospective analysis.
title_full_unstemmed	Urinary polycyclic aromatic hydrocarbon metabolites and mortality in the United States: A prospective analysis.
title_sort	urinary polycyclic aromatic hydrocarbon metabolites and mortality in the united states: a prospective analysis.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/fafca47b755f45a58bf9add5ec0e4aa0
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Urinary polycyclic aromatic hydrocarbon metabolites and mortality in the United States: A prospective analysis.

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