Association of same-day urinary phenol levels and cardiac electrical alterations: analysis of the Fernald Community Cohort

Abstract

Background: Exposure to phenols has been linked in animal models and human populations to cardiac function alterations and cardiovascular diseases, although their effects on cardiac electrical properties in humans remains to be established. This study aimed to identify changes in electrocardiographic (ECG) parameters associated with environmental phenol exposure in adults of a midwestern large cohort known as the Fernald Community Cohort (FCC).

Methods: During the day of the first comprehensive medical examination, urine samples were obtained, and electrocardiograms were recorded. Cross-sectional linear regression analyses were performed.

Results: Bisphenol A (BPA) and bisphenol F (BPF) were both associated with a longer PR interval, an indication of delayed atrial-to-ventricle conduction, in females (p < 0.05) but not males. BPA combined with BPF was associated with an increase QRS duration, an indication of delayed ventricular activation, in females (P < 0.05) but not males. Higher triclocarban (TCC) level was associated with longer QTc interval, an indication of delayed ventricular repolarization, in males (P < 0.01) but not females. Body mass index (BMI) was associated with a significant increase in PR and QTc intervals and ventricular rate in females and in ventricular rate in males. In females, the combined effect of being in the top tertile for both BPA urinary concentration and BMI was an estimate of a 10% increase in PR interval. No associations were found with the other phenols.

Conclusion: Higher exposure to some phenols was associated with alterations of cardiac electrical properties in a sex specific manner in the Fernald cohort. Our population-based findings correlate directly with clinically relevant parameters that are associated with known pathophysiologic cardiac conditions in humans.

Keywords: bisphenol; environmental chemicals; heart electrical properties; human population; phenol.

Figure 1

Graphic summary of the effect of phenol exposure on ECG parameters in the Fernald Cohort. Effect size represents the change in the value of ECG parameters with a change in one unit of log transformed urinary phenol concentration. Red bars illustrate effects that have statistical significance. *: P < 0.05; **: P < 0.01.

Figure 2

Top: Relationship between PR interval, urinary BPA concentration, and BMI, with both urinary BPA and BMI divided into tertiles. BPA categories: 1, < 1.65; 2, 1.65 – 2.96; 3, > 2.96 (ng/mL); BMI categories: 1, < 24.2; 2, 24.2 – 28.4; 3, > 28.4. Bottom: Relationship between QTc, urinary BPA concentration, and age, with both urinary BPA and age divided into tertiles. BPA categories: 1, < 1.65; 2, 1.65 – 2.96; 3, > 2.96 (ng/mL); age categories: 1, 18 – 31; 2, 32 – 45; 3, 46 – 77 (years old).