Associations of brominated flame retardants exposure with chronic obstructive pulmonary disease: A US population-based cross-sectional analysis

BACKGROUNDS: Whether there existed an association between brominated flame retardants (BFRs) and chronic obstructive pulmonary disease (COPD) prevalence in humans is still a mystery. OBJECTIVE: To investigate the association between serum single or mixture BFRs and COPD prevalence. METHODS: Data of 7,591 participants from NHANES 2007–2016 was utilized. Serum BFRs, including PBDE-28, PBDE-47, PBDE-85, PBDE-99, PBDE-100, PBDE-154, PBDE-183, PBDE-209, and PBB-153 were enrolled. The survey-weighted generalized logistic regression model, restricted cubic splines (RCS), weighted quantile sum (WQS) regression, and quantile-based g-computation (QGC) analysis were performed. RESULTS: After adjustment for all confounding factors, log-transformed continuous serum PBDE-28 (OR: 1.43; 95% CI: 1.10–1.85; P = 0.01), PBDE-47 (OR: 1.39; 95% CI: 1.11–1.75; P = 0.005), PBDE-85 (OR: 1.31; 95% CI: 1.09–1.57; P = 0.005), PBDE-99 (OR: 1.27; 95% CI: 1.05–1.54; P = 0.02), PBDE-100 (OR: 1.33; 95% CI: 1.08–1.66; P = 0.01), PBDE-154 (OR: 1.29; 95% CI: 1.07–1.55; P = 0.01), PBDE-183 (OR: 1.31; 95% CI: 1.04–1.66; P = 0.02), and PBB-153 (OR: 1.25; 95% CI: 1.03–1.53; P = 0.03) were positively correlated with the prevalence of COPD. Restricted cubic splines curves displayed that PBDE-209 was significantly associated with CPOD in an inverted U-shape (P = 0.03). A significant interaction between being male and a high prevalence of COPD was observed for PBDE-28 (P for interaction <0.05), PBDE-47 (P for interaction <0.05), PBDE-85 (P for interaction <0.05), PBDE-99 (P for interaction <0.05), PBDE-100 (P for interaction <0.05), and PBB-153 (P for interaction < 0.05). Mixture BFRs exposure was positively associated with COPD prevalence in WQS regression (OR: 1.40; 95% CI: 1.14–1.72, P = 0.002) and in QGC analysis (OR: 1.49; 95% CI: 1.27–1.74, P < 0.001). CONCLUSIONS: Our study confirms that individual and mixture BFRs had positive associations with COPD, and further studies are required in larger-scale populations.