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Association of Exposure to Persistent Organic Pollutants With Mortality Risk: An Analysis of Data From the Prospective Investigation of Vasculature in Uppsala Seniors (PIVUS) Study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.ORCID iD: 0000-0002-8949-3555
Orebro Univ, Sch Med Sci, Inflammatory Response & Infect Susceptibil Ctr, Orebro, Sweden;Orebro Univ, Sch Sci & Technol, Man Technol Environm MTM Res Ctr, Orebro, Sweden.
Orebro Univ, Sch Sci & Technol, Man Technol Environm MTM Res Ctr, Orebro, Sweden;Wellington Labs Inc, Guelph, ON, Canada.
Orebro Univ, Sch Sci & Technol, Man Technol Environm MTM Res Ctr, Orebro, Sweden.
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2019 (English)In: JAMA NETWORK OPEN, ISSN 2574-3805, Vol. 2, no 4, article id e193070Article in journal (Refereed) Published
Abstract [en]

IMPORTANCE It has been suggested that persistent organic pollutants (POPs) are harmful to human health.

OBJECTIVE To investigate if POP levels in plasma are associated with future mortality.

DESIGN, SETTING, AND PARTICIPANTS Cohort study using data from the population-based Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study, collected between May 2001 and June 2004 when participants reached age 70 years. Participants were followed up for 5 years after the first examination. Mortality was tracked from age 70 to 80 years. Data analysis was conducted in January and February 2018.

EXPOSURES Eighteen POPs identified by the Stockholm Convention, including polychlorinated biphenyls (PCBs), organochlorine pesticides, and a brominated flame retardant, were measured in plasma levels by gas chromatography-mass spectrometry.

MAIN OUTCOMES AND MEASURES All-cause mortality.

RESULTS The study sample initially included 992 individuals (497 [50.1%] men) aged 70 years, who were examined between 2001 and 2004. At the second examination 5 years later, 814 individuals (82.1%; 412 [50.7%] women) completed follow-up. During a follow-up period of 10.0 years, 158 deaths occurred. When updated information on POP levels at ages 70 and 75 years was associated with all-cause mortality using Cox proportional hazard analyses, a significant association was found between hexa-chloro-through octa-chloro-substituted (highly chlorinated) PCBs and all-cause mortality (except PCB 194). The most significant association was observed for PCB 206 (hazard ratio [HR] for 1-SD higher natural log-transformed circulating PCB 206 levels, 1.55; 95% CI, 1.26-1.91; P < .001). Following adjustment for hypertension, diabetes, smoking, body mass index, and cardiovascular disease at baseline, most associations were no longer statistically significant, but PCBs 206, 189, 170, and 209 were still significantly associated with all-cause mortality (PCB 206: adjusted HR, 1.47; 95% CI, 1.19-1.81; PCB 189: adjusted HR, 1.29; 95% CI, 1.08-1.55; PCB 170: adjusted HR, 1.24; 95% CI, 1.02-1.52; PCB 209: adjusted HR, 1.29; 95% CI, 1.04-1.60). In a secondary analysis, these associations were mainly because of death from cardiovascular diseases rather than noncardiovascular diseases. Three organochlorine pesticides, including dichlorodiphenyldichloroethylene, and the brominated flame retardant diphenyl ether 47 were also evaluated but did not show any significant associations with all-cause mortality.

CONCLUSIONS AND RELEVANCE Higher levels of highly chlorinated PCBs were associated with an increased mortality risk, especially from cardiovascular diseases. These results suggest that public health actions should be undertaken to minimize exposure to highly chlorinated PCBs.

Place, publisher, year, edition, pages
AMER MEDICAL ASSOC , 2019. Vol. 2, no 4, article id e193070
National Category
Occupational Health and Environmental Health
Identifiers
URN: urn:nbn:se:uu:diva-392891DOI: 10.1001/jamanetworkopen.2019.3070ISI: 000476798700069PubMedID: 31026035OAI: oai:DiVA.org:uu-392891DiVA, id: diva2:1353737
Funder
Swedish Research Council Formas, 2004-2007Available from: 2019-09-24 Created: 2019-09-24 Last updated: 2019-09-24Bibliographically approved

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