Association of Urinary Phthalate Metabolites With Pulmonary Function in Children: A Study Based on the NHANES

Abstract

Objective: The aim of the study was to evaluate the links between single and combined urinary phthalate metabolites and respiratory function in children.

Methods: We analyzed the data from National Health and Nutrition Examination Survey (2007-2012) with the final analysis encompassed 1644 participants, those divided into four groups on average. This study investigated the correlation between ten prevalent phthalate metabolites in pediatric urine samples and four pulmonary function indices, employing multivariable linear regression, segmented linear regression, and the weighted quantile sum methodologies for analysis.

Results: Significant negative correlations between eight phthalate metabolites. Additionally, the remaining seven phthalate metabolites showed significant negative associations with the predicted percentage of the ratio of forced expiratory volume in 1 second to forced vital capacity.

Conclusions: The combined effects of various phthalate metabolites are the primary contributors to the decline in lung function.

Keywords: NHANES; children; ppFVC; pulmonary function; urinary phthalate metabolites.

Graphical abstract

FIGURE 1

Flow chart of individuals included in our final analysis. NHANES 2007–2012.

FIGURE 2

Relationship between urinary levels of phthalate metabolites and pulmonary function indicators. The regression coefficients and their 95% confidence intervals for each phthalate metabolite with respect to each pulmonary function indicator were presented.

FIGURE 3

The results of the segmented linear regression models are presented, showing the regression coefficients and 95% confidence intervals for each phthalate metabolite with respect to each pulmonary function indicator, along with the breakpoint values of phthalate metabolite concentrations.

FIGURE 4

Relationship between urinary phthalate metabolite co-exposure with pulmonary function indicators.