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. 2025 Feb 21:13:1498919.
doi: 10.3389/fpubh.2025.1498919. eCollection 2025.

Associations between blood ethylene oxide levels and serum neurofilament light chain concentrations in adults: evidence from the NHANES

Shikun Li #  1 , Wenchen Li #  1 , Jis Huang Liu  2 , Jing Ma  2 , Yan Juan  2 , Bo Chen  1
Affiliations

Associations between blood ethylene oxide levels and serum neurofilament light chain concentrations in adults: evidence from the NHANES

Shikun Li et al. Front Public Health. .

Abstract

Background: Ethylene oxide (EO) is a widely used industrial chemical recognized for its health risks, potentially posing threats to human health, including neurotoxicity, cardiovascular damage, and carcinogenic effects. Neurofilament light chain (NfL) is a protein released into the blood following axonal damage. To date, no studies have investigated the relationship between EO exposure and NfL levels. Therefore, we selected 5,902,013-2014 National Health and Nutrition Examination Survey (NHANES) participants to examine the relationship between blood EO levels and serum NfL concentrations.

Methods: According to the data from NHANES, this cross-sectional study used multiple regression analysis, subgroup analysis, and smooth curve fitting to explore the relationship between Ethylene oxide and Neurofilament light chain.

Results: The results of the present study indicate a positive association between EO exposure and NfL concentrations. Greater EO exposure was correlated with increased serum NfL concentrations in the fully adjusted model [β = 0.28, 95% CI (0.16, 0.40)]. Each additional unit of EO exposure was linked to a 0.28-unit increase in the serum NfL level. Additionally, IN sensitivity analysis by changing EO exposure from a continuous variable to a categorical variable. The serum NfL concentrations increased with increasing tertiles of EO levels. Compared with the lowest tertile, the highest EO exposure tertile was associated with a 0.28-unit increase in serum NfL concentrations (β = 0.28, 95% CI 0.16, 0.40; P for trend = 0.0138).

Conclusion: Our results indicate a link between increased EO levels and higher serum NfL concentrations in a sample of US adults aged 20 years and older. Although the directionality and clinical significance of this observation remain uncertain, our results emphasize the importance of conducting additional studies to investigate the possible causes and neurological effects of exposure to EO in adults.

Keywords: HbEO; NHANES; epidemiology; ethylene oxide; neurofilament light chain.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of participant selection. NHANES, National Health and Nutrition Examination Survey.
Figure 2
Figure 2
The nonlinear relationship was depicted as a smooth curve fit. The red line represents the curve fit of EO to Nfl and the blue line represents the execution interval of the curve fit.
See this image and copyright information in PMC

References

    1. Shintani H. Ethylene oxide gas sterilization of medical devices. Biocontrol Sci. (2017) 22:1–16. doi: 10.4265/bio.22.1, PMID: - DOI - PubMed
    1. Kolman A, Chovanec M, Osterman-Golkar S. Genotoxic effects of ethylene oxide, propylene oxide and epichlorohydrin in humans: update review (1990-2001). Mutat Res. (2002) 512:173–94. doi: 10.1016/s1383-5742(02)00067-4, PMID: - DOI - PubMed
    1. Agency for Toxic Substances and Disease Registry . Toxicological profile for ethylene oxide. Atlanta, GA: Agency for Toxic Substances and Disease Registry (US) (2022). - PubMed
    1. Guo J, Wan Z, Cui G, Pan A, Liu G. Association of exposure to ethylene oxide with risk of diabetes mellitus: results from NHANES 2013-2016. Environ Sci Pollut Res Int. (2021) 28:68551–9. doi: 10.1007/s11356-021-15444-7, PMID: - DOI - PubMed
    1. Sarto F, Törnqvist MA, Tomanin R, Bartolucci GB, Osterman-Golkar SM, Ehrenberg L. Studies of biological and chemical monitoring of low-level exposure to ethylene oxide. Scand J Work Environ Health. (1991) 17:60–4. doi: 10.5271/sjweh.1733, PMID: - DOI - PubMed

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