Consumer-Product Chemical Mixture and Systemic Inflammation: Survey-Weighted Analysis of Seven Urinary Biomarkers in NHANES 2005–2010
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Background
Endocrine-disrupting chemicals (EDCs) in consumer products are ubiquitously detected in human biospecimens, yet most epidemiological studies examine single chemicals rather than real-world co-exposures. We evaluated associations between a mixture of seven urinary chemical biomarkers and systemic inflammation.
Methods
Survey-weighted log-log regression models adjusted for age, sex, race/ethnicity, poverty-income ratio, and survey cycle were conducted with Benjamini-Hochberg FDR correction (primary analysis, N=4,864). A sensitivity analysis additionally adjusted for body mass index and smoking status (N=4,494).
Results
In the primary analysis, 5 of 7 chemicals showed significant associations after FDR correction: ethylparaben (β = −0.056, FDR P < .001), propylparaben (β = −0.026, FDR P = .007), bisphenol A (β = +0.052, FDR P = .005), monoethyl phthalate (β = +0.043, FDR P = .002), and monocyclohexyl phthalate (β = +0.215, FDR P = .007). The WQS mixture index was significantly associated with CRP (β = +0.056, 95% CI [0.031, 0.081], P < .001), with monocyclohexyl phthalate carrying the largest mixture weight (0.342). In the BMI- and smoking-adjusted sensitivity analysis, associations attenuated to null for all chemicals, though MCP preserved direction (β = +0.129) and the WQS mixture direction was maintained (β = +0.018). Two multiple imputation sensitivity analyses confirmed that monocyclohexyl phthalate was the only chemical to maintain a positive direction across all four analytical specifications (primary complete-case, BMI-adjusted complete-case, primary-aligned imputation, and BMI-adjusted imputation), reaching statistical significance in three of four specifications and providing convergent evidence of a robust MCP-inflammation association.
Conclusions
The chemical mixture showed a significant collective association with systemic inflammation, consistent with a cumulative pro-inflammatory burden from co-exposure to multiple consumer product chemicals. These findings suggest that regulatory approaches should shift from single-chemical to mixture-based risk assessment frameworks for consumer product safety.
