Association between ethylene oxide exposure and osteoporosis: a cross-sectional nationwide study of the US population

Background Ethylene oxide is widely used in a number of specific industrial and medical applications due to its powerful sterilization and disinfection capabilities and as a raw material for chemical products. However, ethylene oxide is a toxic substance, and prolonged exposure or exposure at high concentrations may be hazardous to human health. Animal studies have demonstrated an association between health hazards and ethylene oxide exposure. Currently, the relationship between ethylene oxide long-term exposure and osteoporosis is unclear. Our aim was to investigate the correlation between blood ethylene oxide (EtO) concentrations and osteoporosis among the general population of the United States. Methods We gathered data on blood EtO levels and BMD from 2208 participants from the 2017–2020 and 2013–2014 National Health and Nutrition Examination Surveys (NHANES). The relationship between ETO and BMD was assessed using multivariable linear regression. To handle the nonlinearity, we fitted smooth curves. To better explain the nonlinearity, we employed a two-piecewise linear regression model. Threshold effects were determined through a two-part linear regression model. Results We found a negative linear connection between HbEO and BMD at all three testing locations. This negative correlation persisted even after quartile variables for HbEO were established. Those in the highest percentile of HbEO had decreases in total femur BMD of 0.03 g/cm2 and femoral neck BMD of 0.02 g/cm2, respectively, compared to those in the lowest quartile. However, there were differences in this unfavourable connection across a few categories. Conclusions The findings of our investigation indicate an inverse correlation between HbEO and BMD (bone mineral density) within the adult demographic of the United States. Additional inquiry is warranted to elucidate the exact physiological process by which exposure to HbEO leads to the development of osteoporosis.