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    2 Comments for this article
    What is cause; what is effect?
    Duncan Turnbull, DPhil | Retired
    Study results say: "Participants with higher urinary BPA levels were at higher risk of death during the follow-up."
    Results also say: "Participants with higher urinary BPA levels were more likely to be younger, male, and non-Hispanic Black and have lower educational level, lower family income, lower physical activity, higher total energy intake, poorer dietary quality, and higher BMI."
    Quite a few of those latter characteristics well known to be associated with higher risk of death?
    What is the cause and what is the effect? Take your pick.
    Deep Rooted Evil.
    Arvind Joshi, MBBS, MD; FCGP FAMS FICP. | Founder Convener and President Our Own Discussion Group, Mumbai; Consultant Physician at Ruchi Diagnostic Center and Ruchi Clinical Laboratory Kharghar, Maharashtra State, India
    Bisphenol A is used so widely and for so long, it has already contaminated the environment, on the land as well as water bodies including oceans.
    The task at hand is two-fold: to reduce or preferably eliminate use of Bisphenol A; to decontaminate the environment.
    Reduce and eliminate use of Bisphenol A may seem difficult, but is possible. Of course care must be taken that whatever material is used to replace Bisphenol A does not turn out to be as much or more troublesome as Bisphenol A itself.
    Eliminating Bisphenol A from environment may be daunting or even impossible task.
    One of the ways may be to find out microbes which may be able to degrade environmental Bisphenol A to harmless or even useful or beneficial substances. Very easy to say, much difficult to find even in theory, far more difficult to execute on the stupendous magnitude!
    Arvind Joshi;
    Founder Convener and President: Our Own Discussion Group;
    Consaltant Physician at Ruchi Diagnostic Center and Ruchi Clinical Laboratory Sunshine CHS 
    Maharashtra State, India
    Views 15,264
    Citations 0
    Original Investigation
    Environmental Health
    August 17, 2020

    Association Between Bisphenol A Exposure and Risk of All-Cause and Cause-Specific Mortality in US Adults

    Author Affiliations
    • 1Department of Epidemiology, College of Public Health, University of Iowa, Iowa City
    • 2Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology Wuhan, Hubei, China
    • 3State Hygienic Laboratory, University of Iowa, Iowa City
    • 4Department of Pediatrics, New York University School of Medicine, New York
    • 5Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City
    JAMA Netw Open. 2020;3(8):e2011620. doi:10.1001/jamanetworkopen.2020.11620
    Key Points español 中文 (chinese)

    Question  Is exposure to bisphenol A, a ubiquitous chemical of concern, associated with long-term risk of mortality?

    Findings  In a cohort study of 3883 adults in the United States, participants with higher urinary bisphenol A levels were at higher risk for death during approximately 10 years of observation. The adjusted hazard ratio comparing the highest vs lowest tertile of urinary bisphenol A levels was 49% higher for all-cause mortality and was 46% higher, albeit not statistically significant, for cardiovascular disease mortality.

    Meaning  The findings in this study suggest that a higher level of bisphenol A exposure is associated with an increased risk of long-term all-cause mortality.


    Importance  Bisphenol A (BPA) is a major public health concern because of its high-volume industrial production, ubiquitous exposure to humans, and potential toxic effects on multiple organs and systems in humans. However, prospective studies regarding the association of BPA exposure with long-term health outcomes are sparse.

    Objective  To examine the association of BPA exposure with all-cause mortality and cause-specific mortality among adults in the United States.

    Design, Setting, and Participants  This nationally representative cohort study included 3883 adults aged 20 years or older who participated in the US National Health and Nutrition Examination Survey 2003-2008 and provided urine samples for BPA level measurements. Participants were linked to mortality data from survey date through December 31, 2015. Data analyses were conducted in July 2019.

    Exposures  Urinary BPA levels were quantified using online solid-phase extraction coupled to high-performance liquid chromatography–isotope dilution tandem mass spectrometry.

    Main Outcomes and Measures  Mortality from all causes, cardiovascular disease, and cancer.

    Results  This cohort study included 3883 adults aged 20 years or older (weighted mean [SE] age, 43.6 [0.3] years; 2032 women [weighted, 51.4%]). During 36 514 person-years of follow-up (median, 9.6 years; maximum, 13.1 years), 344 deaths occurred, including 71 deaths from cardiovascular disease and 75 deaths from cancer. Participants with higher urinary BPA levels were at higher risk for death. After adjustment for age, sex, race/ethnicity, socioeconomic status, dietary and lifestyle factors, body mass index, and urinary creatinine levels, the hazard ratio comparing the highest vs lowest tertile of urinary BPA levels was 1.49 (95% CI, 1.01-2.19) for all-cause mortality, 1.46 (95% CI, 0.67-3.15) for cardiovascular disease mortality, and 0.98 (95% CI, 0.40-2.39) for cancer mortality.

    Conclusions and Relevance  In this nationally representative cohort of US adults, higher BPA exposure was significantly associated with an increased risk of all-cause mortality. Further studies are needed to replicate these findings in other populations and determine the underlying mechanisms.