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Review
. 2025 Jun;133(6):66002.
doi: 10.1289/EHP15012. Epub 2025 Jun 12.

A State of the Science Review of Human Health Effects of the Michigan Polybrominated Biphenyl Contamination after Five Decades

Susan S Hoffman  1 , John A Kaufman  1 , Robert B Hood  1   2 , Tamar Wainstock  3 , Kathleen Hartnett  4 , Hillary Barton  1 , Melanie A Pearson  5 , Metrecia L Terrell  1 , Michele Marcus  1   5
Affiliations
Review

A State of the Science Review of Human Health Effects of the Michigan Polybrominated Biphenyl Contamination after Five Decades

Susan S Hoffman et al. Environ Health Perspect. 2025 Jun.

Abstract

Background: The Michigan Polybrominated Biphenyl (PBB) Registry, followed since 1976, was created after a 1973 chemical manufacturing mistake. The flame retardant PBB was accidentally mixed into animal feed and distributed to Michigan farms for nearly a year, exposing farm residents and animal product consumers.

Objective: We synthesized knowledge to date on health effects of PBB exposure within the Michigan PBB Registry and describe research findings in the context of literature on other persistent organic pollutants (POPs) and endocrine-disrupting chemicals (EDCs).

Methods: We reviewed literature published from 1973 to 2025 on human health effects of PBB following the Michigan contamination, using PubMed and Thompson Reuters (ISI) Web of Science databases. We excluded studies not in English; studies on exposures besides PBB; animal studies; reviews, abstracts, or letters to the editor; studies without a health outcome; and studies outside of Michigan or unrelated to the 1973 contamination. For each article, two researchers performed title and abstract screening, full article review, and data extraction.

Results: We included 79 publications out of 601 identified and screened. Early studies did not find many health outcomes associated with PBB, possibly because of methodological limitations. More recent studies on long-term and multigenerational impacts found an increased breast cancer risk, accelerated pubertal development and earlier menarche for girls exposed in utero, urogenital problems and slower pubertal development in boys exposed in utero, lower estrone 3-glucuronide and follicle-stimulating hormone among women exposed in childhood, and increased miscarriage risk among daughters of exposed women. Epigenetic and metabolomic research reported altered pathways related to estrogenic effects and immune function as well as the epigenetic alterations of spermatogenic cells.

Discussion: This unique community-academic partnership has produced insights into multigenerational consequences of EDC/POP exposures across the life course. The findings from this cohort underscore the broader relevance of critical windows of vulnerability, particularly during fetal development and childhood. https://doi.org/10.1289/EHP15012.

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Figures

Figure 1 is a scientific illustration of the life-course chronology for first (F0), second (F1), and third (F2) generation participants in the Michigan PBB Registry. The figure depicts a timeline of birth and follow-up periods for three generations (F0, F1, and F2) affected by polybrominated biphenyl (PBB) exposure in Michigan following a largescale agricultural contamination from 1973 to 1974. The timeline axis (horizontal) extends from 1900 to 2020, with a vertical orange bar representing the polybrominated biphenyl exposure event from 1973 to 1974. F0 Generation A: People born before 1973 who were exposed to polybrominated biphenyl as adults; the life-course bar starts with birth years before the mid 1950s and continues through follow-up years past 2020. F0 Generation B: People who were exposed as children; the life-course bar starts with birth years in the mid-1950s and continues through follow-up past 2020. F1 Generation: Children born to at least one F0 parent, including birth and follow-up years beginning shortly after 1973. F2 Generation: Children of at least one F1 parent; births and follow-ups begin in the 1990s and extend to the present. Left inset image: Illustration of generational transmission—F0 parent, F1 fetus, and F2 germ cells depicted in the silhouette of a pregnant woman. The legend shows F0 Generation A (adults during the 1973 to 1974 contamination), F0 Generation B (children during the 1973 to 1974 contamination), F1 Generation, and F2 Generation.
Figure 1.
Life course timeline for F0, F1, and F2 generations in the Michigan Polybrominated Biphenyl Registry.
Figure 2 is a flowchart of the study review and selection process with three phases, namely, identification, screening, and included. Step 1: Identification: Under record identified from, there were 594 records identified from PubMed and Web of Science databases, and 7 records identified from citations. Step 2: Screening: There were 601 records that underwent title and abstract review, and of those, a total of 486 records were excluded from full review. Of the excluded records, 174 studied an exposure other than PBB, 158 were animal studies, 58 were reviews, abstracts, and letters to the editor, 84 did not include a health outcome, and 12 focused on areas outside of Michigan. There were 115 reports included in the full text review, and 35 of these reports were excluded. Among those excluded were 18 reports of exposures other than PBB, 9 animal studies, 1 review, abstract, or letter to the editor, and 8 reports focused on areas outside of Michigan. Step 3: Included: There were 79 studies included in this review manuscript.
Figure 2.
The selection process for articles after reviewing the PubMed and Thomson Reuters (ISI) Web of Science databases for all studies on human health effects of PBB in Michigan residents after 1973, including articles up to 31 October 2023. Articles were excluded if they a) were not written in English, b) focused on a pollutant other than PBB, c) were animal studies, d) were not researching those exposed as a result of the 1973–1977 Michigan contamination and residing in Michigan, e) were reviews, abstracts, or letters to the editor (i.e., not an original research article), or f) were not focused on a health outcome. Two researchers screened each article for both screening steps. This figure was adapted from PRISMA reporting guidelines for scoping reviews. Note: PBB, polybrominated biphenyl.
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