Prenatal exposure to environmental bisphenols over time and their association with childhood asthma, allergic rhinitis and atopic dermatitis in the ECHO consortium

Abstract

Concerns persist about the potential impact of prenatal exposure to bisphenols (BP) and their replacement analogues on childhood asthma and allergies. Previous studies on single and small cohorts had limited statistical power, few investigated analogues BPF and BPS, and even fewer examined atopic outcomes. Our objective was to assess whether prenatal exposures to individual environmental bisphenols (BPA, BPF, BPS) influence risk of childhood asthma, allergic rhinitis, and atopic dermatitis. Data from the U.S. Environmental Influences on Child Health Outcomes (ECHO) consortium were harmonized on measures of prenatal urinary BPA, BPF and BPS and asthma and allergic rhinitis (ages 5-9 years) and atopic dermatitis (up to age 3 years) from 1905 mother-child pairs that were collected between 1998 and 2017. Across the 2012 federal ban of BPA from certain infant products, median BPA levels decreased from 1.11 ng/ml to 0.86 ng/ml; median BPF levels decreased from 0.51 ng/ml to 0.39 ng/ml; and median BPS levels increased from 0.23 ng/ml to 0.31 ng/ml (dilution adjusted; p < 0.001 for all three median comparisons). Prenatal measures of BPA, BPF, and BPS were unrelated to the risk of childhood asthma, allergic rhinitis, or atopic dermatitis in the total population. Modest sex-dependent effects were observed: only among girls, second tertile levels of BPF was associated with a reduced odds of asthma (odds ratio (OR) 0.27, 95% confidence interval (CI) 0.08, 0.93); a continuous index of prenatal BPS was associated with reduced odds of atopic dermatitis (OR 0.64, 95% CI 0.44, 0.93). The ongoing and changing patterns of exposure to bisphenols in the U.S. population require further study with additional attention to time windows of exposure and co-occurring social determinants of health, to continue to inform current policies and evaluate the importance of limiting exposure to BPA and its analogues on childhood asthma, allergic rhinitis, and atopic dermatitis.

Keywords: Bisphenols; Childhood allergy; Childhood asthma; Environmental influences on child health outcomes; Prenatal chemical exposure.

Fig. 1.

Flow chart. The study inclusion criteria were a biological mother with at least one bisphenol measured in urine during pregnancy with a live birth and child followed for atopic dermatitis, allergic rhinitis or asthma through the specified ages. Those children with information on these outcomes are numbered in the dashed boxes. N = 1905 mother-child pairs had at least one bisphenol measure and child outcome.

Fig. 2.

Maternal prenatal urinary bisphenol measures prior to and following the 2012 federal BPA. Y axis was plotted based on square root-transformed scale. Box plots with lines marking the dilution adjusted medians derived from raw values are shown.