Longitudinal study of age of menarche in association with childhood concentrations of persistent organic pollutants

An assessment of the (anti)androgenic properties of hexachloronaphthalene (HxCN) in male rats

The persistent organic pollutants (POPs) defined by the Stockholm Convention include polychlorinated naphthalenes (PCNs); of these, the most toxic, persistent, abundant, dioxin-like congeners found in human tissues are the hexachloronaphthalenes (HxCNs). Recent research also indicates that PCNs may disrupt hormonal homeostasis. The aim of this study was to evaluate the (anti)androgenic action of HxCN. Immature, castrated male Wistar rats were exposed per os to HxCN in corn oil at daily doses ranging from 0.3 to 3.0 mg kg-1 for 10 days. According to the OECD 441 protocol (Hershberger Bioassay), the anti-androgenic assay groups were co-exposed with testosterone propionate (TP), while the androgenic groups were not. TP was used as the reference androgen (subcutaneous daily doses of 0.4 mg kg-1), and flutamide (FLU) as the reference antiandrogen (per os daily doses of 3.0 mg kg-1). Five assessory sex tissues (ASTs) were weighed: ventral prostate, seminal vesicles, levator ani-bulbocavernosus muscle (LABC), Cowper's glands and glans penis. HxCN + TP significantly decreased the weight of the ventral prostate and seminal vesicle indicating an anti-androgenic action via 5α-reductase inhibition. These weight changes were also accompanied by abnormalities in cell morphology and hormonal disturbances: lowered levels of the testosterone and thyroid hormones thyroxine and triiodothyronine. Disturbances were also noted in the lipid profile, viz. total cholesterol, triglycerides and high-density lipoprotein and non-HDL fraction content. However, the direction of these changes differed depending on the size of the HxCN dose. No dose-effect relationship was noted for most of the obtained results; as such, exposure to even small HxCN doses run the risk of anti-androgenic effects in the general population, especially when encountered in combination with other POPs and endocrine-disrupting chemicals in the environment.

Safety evaluation of organochlorine pesticides and polybrominated diphenyl ethers in imported canned fish in Nigeria

Organochlorine pesticide (OCP) and polybrominated diphenyl ether (PBDE) concentrations were measured in thirty popular brands of imported canned fish (mackerel, sardines, and tuna) in Nigeria to ascertain potential threats to humans arising from their consumption. The Σ20 OCP concentrations in mackerel ranged from 0.47 to 7.36 ng g-1, while those of tuna and sardines varied from 1.06 to 2.19 and 0.11 to 12.7 ng g-1, respectively. The Σ39 PBDE concentrations in mackerel varied from 0.06 to 4.21 ng g-1, while those of tuna and sardines ranged from 0.19 to 3.18 and 0.04 to 8.26 ng g-1, respectively. The estimated daily intake (EDI) of OCPs and PBDEs from ingestion of the canned fish by adults and children were in the magnitude of 0.03 to 17.6 ng kg-1 bw day-1 and 9.9 × 10-3 to 11.5 ng kg-1 bw day-1 respectively. The hazard index (HI) and total cancer risk (TCR) values for OCPs and PBDEs from ingestion of the canned fish were less than 1 and 10-6, respectively. The dietary intakes of OCPs and PBDEs from these brands of canned fish by adults and children result in no adverse non-cancer and cancer risks.

Association between exposure to persistent organic pollutants and pubertal timing in boys and girls: A systematic review and meta-analysis

In recent years, the phenomenon of abnormal pubertal timing in children has become increasingly common worldwide. Persistent organic pollutants (POPs) may be one of the risk factors contributing to this phenomenon, but the relationship between them is unclear based on current evidence. The purpose of this study was to determine the association of POPs exposure with pubertal timing in girls and boys by conducting a systematic review and meta-analysis. We searched PubMed and Embase databases for studies before June 1, 2023. Meta-analysis was performed by pooling relative risk (RR) or odds ratio (OR) or prevalence ratio (PR) or hazard ratio (HR) estimates with 95 % confidence intervals (CIs). Subgroup analysis, publication bias assessment and sensitivity analysis were also carried out. A total of 21 studies were included, involving 2479 boys and 8718 girls. The results of meta-analysis showed that exposure to POPs was significantly associated with delayed pubertal timing in girls (RR: 0.85; 95 % CI: 0.79-0.91; p < 0.001). There was no statistically significant association between exposure to POPs and pubertal timing in boys (RR: 1.18; 95 % CI: 0.99-1.40; p = 0.070). Subgroup analysis showed that there may be gender differences in the effects of exposure to POPs on pubertal timing. Our results suggested that exposure to POPs could delay pubertal timing in girls. However, based on current evidence, no significant association was found between POPs exposure and pubertal timing in boys.

Exposure to Particulate Matter Air Pollution and Age of Menarche in a Nationwide Cohort of U.S. Girls

BACKGROUND

It remains unclear whether in utero and childhood exposure to air pollution affects pubertal development, particularly age of menarche in girls.

OBJECTIVE

The aim of this study was to determine whether residential ambient particulate matter (PM) exposure in utero and during childhood is associated with age of menarche.

METHODS

We studied 5,201 girls in the Growing Up Today Study 2 (2004-present) who were 10-17 y of age at enrollment (47.7% premenarchal; 52.3% postmenarchal). Exposure to three size fractions of PM [fine PM with aerodynamic diameter ≤ 2.5 μ m (PM 2.5 ), PM with aerodynamic diameters between  2.5 μ m  and  10 μ m (PM 2.5 - 10 ), and PM with aerodynamic diameter 10 μ m (PM 10 )] was assigned based on maternal residential address, updated every 2 y, using nationwide spatiotemporal models. We estimated average PM exposure in utero, and time-varying windows: annual average exposure in the prior 1 and 2 y and cumulative average from birth. Age of menarche was self-reported on three surveys administered in 2004, 2006, and 2008. We calculated hazard ratios (HR) for menarche for an interquartile range (IQR) increase in PM exposure using Cox proportional hazard models adjusting for potential confounders.

RESULTS

Girls attained menarche at 12.3 y of age on average. In the adjusted model, higher residential exposure to ambient PM 2.5 during all time windows was associated with earlier age of menarche. The HRs of menarche for each IQR (4   μ g / m 3 ) increase in exposure to PM 2.5 during the in utero period, 1 y prior to menarche, and throughout childhood were 1.03 [95% confidence interval (CI): 1.00, 1.06], 1.06 (95% CI: 1.02, 1.10) and 1.06 (95% CI: 1.02, 1.10), respectively. Effect estimates for PM 10 exposure were similar, albeit attenuated, for all time windows. PM 2.5 - 10 exposure was not associated with age of menarche.

DISCUSSION

Among a large, nationwide, prospective cohort of U.S. girls, higher exposure to PM 2.5 and PM 10 in utero and throughout childhood was associated with an earlier age of menarche. Our results suggest that PM 2.5 and PM 10 may have endocrine-disrupting properties that could lead to altered timing of menarche. https://doi.org/10.1289/EHP12110.

Exposure to Perfluoroalkyl Substances and Associations with Pubertal Onset and Serum Reproductive Hormones in a Longitudinal Study of Young Girls in Greater Cincinnati and the San Francisco Bay Area

BACKGROUND

Per- and polyfluoroalkyl substances (PFAS), endocrine disrupting chemicals with worldwide exposure, cause changes in mammary gland development in rodents. A few human studies report delay in pubertal events with increasing perfluorooctanoic acid (PFOA) exposure, but to our knowledge none have examined reproductive hormone levels at thelarche.

METHODS

In a cohort of Greater Cincinnati (GC) and San Francisco Bay Area (SFBA) girls recruited at 6-8 years of age, clinical examinations were conducted annually or semiannually with sequential Tanner staging. PFAS concentrations were measured in the first serum sample of 704 girls. In 304 GC girls, estradiol (E 2 ), estrone (E 1 ), testosterone (T), and dihydroepiandrosterone sulfate (DHEAS) were measured in serum at four time points around puberty. Relationships between PFAS and age at thelarche, pubarche, and menarche were analyzed using survival and structural equation models. The association between PFAS and reproductive hormones was assessed using linear regression models.

RESULTS

Median PFOA serum concentrations in GC (N = 353 , 7.3  ng / mL ) and the SFBA (N = 351 , 5.8  ng / mL ) were higher than in the U.S.

POPULATION

In multivariable Cox proportional hazard models [adjusted for race, body mass index (BMI)], increasing serum log-transformed PFOA was associated with a delay in pubarche [hazard ratio  ( HR ) = 0.83 ; 95% CI: 0.70, 0.99] and menarche (HR = 0.04 ; 95% CI: 0.01, 0.25). Structural equation models indicated a triangular relationship between PFOA, BMI percentile, and the age at the pubertal milestone. Increased PFOA had a statistically significant direct effect of delay on all three milestones, as did BMI. Perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDeA), and 2-(N -methyl-perfluorooctane sulfonamido) acetic acid (Me-PFOSA-AcOH) also were associated with later thelarche, and Me-PFOSA-AcOH also with later pubarche. PFOA was inversely associated with DHEAS (p < 0.01 ), E 1 (p = 0.04 ), and T (p = 0.03 ) concentrations at 6 months prior to puberty.

CONCLUSIONS

PFAS may delay pubertal onset through the intervening effects on BMI and reproductive hormones. The decreases in DHEAS and E 1 associated with PFOA represent biological biomarkers of effect consistent with the delay in onset of puberty. https://doi.org/10.1289/EHP11811.

Polybrominated Diphenyl Ethers (PBDEs) and Human Health: Effects on Metabolism, Diabetes and Cancer

There is increasing evidence of the role of endocrine disruptors (EDs) derived from commonly employed compounds for manufacturing and processing in altering hormonal signaling and function. Due to their prolonged half-life and persistence, EDs can usually be found not only in industrial products but also in households and in the environment, creating the premises for long-lasting exposure. Polybrominated diphenyl ethers (PBDEs) are common EDs used in industrial products such as flame retardants, and recent studies are increasingly showing that they may interfere with both metabolic and oncogenic pathways. In this article, a multidisciplinary panel of experts of the Italian Association of Medical Diabetologists (AMD), the Italian Society of Diabetology (SID), the Italian Association of Medical Oncology (AIOM), the Italian Society of Endocrinology (SIE) and the Italian Society of Pharmacology (SIF) provides a review on the potential role of PBDEs in human health and disease, exploring both molecular and clinical aspects and focusing on metabolic and oncogenic pathways.

Impact of Chemicals on the Age of Menarche: A Literature Review

A growing body of evidence suggests that chemicals interfere with the age of onset of menarche. We conducted a review in order to demonstrate the relationship between several categories of chemicals and menarche. We searched for English language papers using the Medline/PubMed database until April 2023. The chemical factors found to affect menarche were prenatal and antenatal smoke, phthalates, phenols, organochlorines, perfluoroalkyls and polyfluoroalkyls, metals, air pollutants and polybrominated diphenyl ethers. Low or high exposure to each chemical compound could affect the age of menarche, leading to early or delayed menarche. Furthermore, the results show that intrauterine exposure may have a different impact from antenatal exposure. There is evidence that endocrine-disrupting chemicals affect the age of menarche, but more research needs to be conducted.

Persistent Organic Pollutant Exposure and Thyroid Function among 12-Year-Old Children

INTRODUCTION

Polychlorobiphenyls (PCBs), organochlorine pesticides (OCPs), and per- and polyfluoroalkyl substances (PFASs) are persistent organic pollutants (POPs) having numerous toxicological properties, including thyroid endocrine disruption. Our aim was to assess the impact of POPs on thyroid hormones among 12-year-old children, while taking puberty into consideration.

METHODS

Exposure to 7 PCBs, 4 OCPs, and 6 PFASs (in µg/L), and free tri-iodothyronine (fT3, pg/mL), free thyroxine (fT4, ng/dL), and thyroid-stimulating hormones (TSH, mIU/L) were assessed through blood-serum measurements at age 12 years in 249 boys and 227 girls of the PELAGIE mother-child cohort (France). Pubertal status was clinically rated using the Tanner stages. For each POP, associations were estimated using linear regression, adjusted for potential confounders.

RESULTS

Among boys, hexachlorobenzene and perfluorodecanoic acid were associated with decreased fT3 (log-scale; β [95% confidence interval] = -0.07 [-0.12,-0.02] and β = -0.03 [-0.06,-0.00], respectively). Intermediate levels of perfluorohexanesulfonic acid (PFHxS) and PCB180 were associated, respectively, with increased and decreased fT4. After stratification on pubertal status, PCBs and OCPs were associated with decreased TSH only in the more advanced Tanner stages (3-5) and with decreased fT3 among early Tanner stages (1-2). Among girls, PFHxS was associated with decreased TSH (log-scale; β = -0.15 [-0.29,-0.00]), and perfluorooctanoic acid was associated with decreased fT3 (β2nd_tercile = -0.06 [-0.10,-0.03] and β3rd_tercile = -0.04 [-0.08,-0.00], versus. 1st tercile).

DISCUSSION

This cross-sectional study highlights associations between some POPs and thyroid function disruption, which appears consistent with the literature. Considering that the associations were sex-specific and moderated by pubertal status in boys, complex endocrine interactions are likely involved.

Sex differences in the association of measures of sexual maturation to common toxicants: Lead, dichloro-diphenyl-trichloroethane (DDT), dichloro-diphenyl-dichloroethylene (DDE), and polychlorinated biphenyls (PCBs)

Many studies of human toxicant exposure examine the hypothesis that human sexual maturation can be affected through endocrine disruption. Within this body of literature there is significant variation in the findings. Variation may be related to the differential effects by toxicants between males and females as well as variation in sample size, toxicant levels, and the timing of exposure. We review sexual maturation outcomes between males and females when exposed to lead, dichlorodiphenyldichloroethylene (DDE), dichloro-diphenyl-trichloroethane (DDT), and polychlorinated biphenyls (PCBs) using a systematic process to gather peer-reviewed studies published from January 1994 through December 2019 on the NCBI website's PubMed search engine. The review includes 34 studies, some comprised of multiple analyses, to compare effects on sexual maturation by sex. The analysis shows that both boys and girls have delayed sexual maturation in relation to lead exposure. There are differences in the direction of effects associated with DDE/DDT and PCB exposure in boys and girls. PCBs exist as congeners of many structural forms, and that variation is considered in this review. Dioxin-like and non-dioxin-like PCBs exposure directionality differed between boys and girls as well. Future investigations into the basis of sex variation in DDE/DDT and PCB relationships to sexual maturation are warranted.

OUP accepted manuscript

BACKGROUND

Globally, the ages at pubertal onset for girls and boys have been decreasing during recent decades, partly attributed to excess body fat accumulation. However, a growing body of literature has recognized that endocrine disrupting chemicals (EDCs) may play an important role in this global trend, but the association has not yet been fully established.

OBJECTIVE AND RATIONALE

EDCs can interfere with normal hormone function and metabolism and play a role in pubertal onset. We aimed to systematically identify and evaluate the current evidence on the timing of pubertal onset in girls and boys following prenatal or postnatal exposures to xenobiotic EDCs.

SEARCH METHODS

Following PRISMA guidelines, we performed a systematic literature search of original peer-reviewed publications in the PubMed database through a block search approach using a combination of index MeSH and free text search terms. Publications were considered if they covered biomarkers of prenatal or postnatal exposures to xenobiotic EDCs (European Commission's list of category 1 EDCs) measured in maternal or child biospecimen and pubertal onset defined by the progression of the following milestones (and assessed in terms of the following measures): menarche (age), thelarche (Tanner staging) and pubarche (Tanner staging), in girls, and genital stage (Tanner staging), testicular volume (ml) and pubarche (Tanner staging), in boys.

OUTCOMES

The literature search resulted in 703 references, of which we identified 52 publications fulfilling the eligibility criteria for the qualitative trend synthesis and 23 publications for the meta-analysis. The qualitative trend synthesis provided data on 103 combinations of associations between prenatal or postnatal exposure to EDC compounds groups and puberty outcomes and the meta-analysis enabled 18 summary risk estimates of meta-associations.

WIDER IMPLICATIONS

Statistically significant associations in the qualitative trend synthesis suggested that postnatal exposure to phthalates may be associated with earlier thelarche and later pubarche. However, we did not find consistent evidence in the meta-analysis for associations between timing of pubertal onset in girls and boys and exposures to any of the studied xenobiotic EDCs. We were not able to identify specific pre- or postnatal windows of exposure as particularly critical and susceptible for effects of EDCs. Current evidence is subject to several methodological challenges and inconsistencies and evidence on specific exposure-outcome associations remains too scarce to firmly confirm EDC exposure as a risk factor for changes in age of pubertal onset in the general child population. To create a more uniform foundation for future comparison of evidence and to strengthen pooled studies, we recommend the use of more standardized approaches in the choice of statistical analyses, with exposure transformations, and in the definitions and assessments of puberty outcomes. The impact of mixtures of EDC exposures on the association also remains unestablished and would be valuable to elucidate for prenatal and postnatal windows of exposure. Future large, longitudinal epidemiological studies are needed to clarify the overall association.

Effects on Puberty of Nutrition-Mediated Endocrine Disruptors Employed in Agriculture

Pesticide residues are largely found in daily consumed food because of their extensive use in farming and their long half-life, which prolongs their presence in the environment. Many of these pesticides act as endocrine-disrupting chemicals after pre- or postnatal exposure, significantly affecting, among other things, the time of puberty onset, progression, and completion. In humans, precocious or delayed puberty, and early or delayed sexual maturation, may entail several negative long-term health implications. In this review, we summarize the current evidence on the impact of endocrine-disrupting pesticides upon the timing of the landmarks of female and male puberty in both animals (vaginal opening, first estrus, and balanopreputial separation) and humans (thelarche, menarche, gonadarche). Moreover, we explore the possible mechanisms of action of the reviewed endocrine-disrupting pesticides on the human reproductive system. Access to safe, healthy, and nutritious food is fundamental for the maintenance of health and wellbeing. Eliminating the presence of hazardous chemicals in largely consumed food products may increase their nutritional value and be proven beneficial for overall health. Consequently, understanding the effects of human exposure to hazardous endocrine-disrupting pesticides, and legislating against their circulation, are of major importance for the protection of health in vulnerable populations, such as children and adolescents.

Effects of Polychlorinated Biphenyls on Animal Reproductive Systems and Epigenetic Modifications

Polychlorinated biphenyls (PCBs) are a group of highly toxic endocrine-disrupting chemicals comprising 209 homologs. PCBs are extensively found in the environment and can induce typical estrogenic and profound, long-lasting effects on animals. In this article, the introduction of PCB residues into the environment and the pathways of PCB enrichment in animals are described. PCBs are widely deposited and eventually accumulate in human tissues and body fluids through biomagnification. PCBs can significantly decrease animal fertility and interfere with endocrine processes, leading to the development of various diseases and even cancer. The effects of PCBs on the reproductive systems of animals can also be passed to their offspring, indicating that PCBs may affect the epigenetic modification process. There is currently no treatment to effectively inhibit the toxicity of PCBs in organisms; therefore, the severity of PCB toxicity needs to be widely recognized.

Menstrual Cycle Patterns and Irregularities in Hired Latinx Child Farmworkers

PURPOSE

This study identifies the menstrual cycle irregularities of Latinx child and adolescent farmworkers.

METHODS

Child and adolescent farmworkers aged 13 to 20 years completed questionnaires about menstrual cycle patterns in 2019, and wore silicone passive collection wristbands for pesticide detection in 2018. Menstrual cycle irregularities were determined from the American College of Obstetricians and Gynecologists committee opinion.

RESULTS

Half of participants experienced any menstrual cycle irregularity; the most frequent irregularities were cycle length (38.6%) and having gone 90 days or more without a menstrual period (20.4%). Pesticides were detected in 92.9% of the wristbands; most participants were exposed to an endocrine disrupting chemical (EDC) pesticide.

CONCLUSION

Half of Latinx children and adolescents hired farmworkers experience irregular menstrual cycles, and most are exposed to EDCs. Inclusion of occupational and menstrual histories in child and adolescent medical visits is critical.

Peripubertal serum levels of dioxins, furans and PCBs in a cohort of Russian boys: can empirical grouping methods yield meaningful exposure variables?

BACKGROUND

Dioxins, furans and polychlorinated biphenyls (PCBs) are endocrine disruptors with half-lives of months to years in humans. Peripubertal exposure to these chemicals may disrupt pubertal timing. Biomarker exposure metrics like the sum of non-dioxin-like PCBs in serum (∑NDL-PCBs) involve chemicals with different hypothetical effects. Empirical exposure metrics represent an alternative that requires no knowledge of biological mechanisms.

METHODS

From 2003 to 2005, 516 Russian boys aged 8-9 residing near a plant that historically produced organochlorine pesticides were enrolled in the Russian Children's Study. At enrollment, blood was collected for measurement of organochlorine chemicals by the Centers for Disease Control and Prevention (CDC). Variable cluster analysis was used to empirically group serum levels of 45 dioxins, furans and PCBs into eight cluster scores. These scores were compared to the sum of dioxin-like toxic equivalents (∑TEQs) and ∑NDL-PCBs using Spearman correlation coefficients.

RESULTS

Clustering appeared to reflect number and position of chlorine atoms. Clusters 4, 7 and 1 contained, respectively, tri/tetra-, tetra/penta-, and hexa/hepta-chlorinated PCBs with chlorines at the 4,4' positions. Clusters 2, 8 and 5 contained, respectively, tetra-to hexa-, hexa/hepta-, and hepta/octa-chlorinated PCBs with chlorines at the 2,2' positions. ∑NDL-PCBs were highly correlated with 4,4'-chlorinated clusters 1 and 7 (Spearman's ρ = 0.8) and less so with all other clusters (Spearman's ρ = 0.4-0.5).

CONCLUSIONS

In this cohort of Russian boys, baseline serum dioxins, furans and PCBs seemed to cluster by chlorination pattern, possibly reflecting shared persistence, metabolism or source of exposure. The widely used measure ∑NDL-PCB seemed most representative of 4,4'-chlorinated PCBs.

Genome-wide DNA methylation differences and polychlorinated biphenyl (PCB) exposure in a US population

Exposure to polychlorinated biphenyls (PCBs), an endocrine-disrupting compound, is ubiquitous despite decades-old bans on the manufacture and use of PCBs. Increased exposure to PCBs is associated with adverse health consequences throughout life, including type 2 diabetes and cancer. PCB exposure is also associated with alterations in epigenetic marks and gene transcription, which could lead to adverse health outcomes, but many of these are population-specific. To further investigate the association between PCB and epigenetic marks, DNA methylation was measured at 787,684 CpG sites in 641 peripheral blood samples from the Michigan Polybrominated Biphenyl (PBB) Registry. 1345 CpGs were associated with increased total PCB level after controlling for age, sex, and 24 surrogate variables (FDR < 0.05). These CpGs were enriched in active promoter and transcription associated regions (p < 0.05), and in regions around the binding sites for transcription factors involved in xenobiotic metabolism and immune function (FDR < 0.05). PCB exposure also associated with proportions of CD4T, NK, and granulocyte cell types, and with the neutrophil to lymphocyte ratio (NLR) (p < 0.05), and the estimated effect sizes of PCB on the epigenome were correlated with the effect sizes previously reported in an epigenome-wide study of C-reactive protein (r = 0.29; p = 2.22e-5), supporting previous studies on the association between PCB and immune dysfunction. These results indicate that PCB exposure is associated with differences in epigenetic marks in active regions of the genome, and future work should investigate whether these may mediate the association between PCB and health consequences.

Correlates of plasma concentrations of brominated flame retardants in a cohort of U.S. Black women residing in the Detroit, Michigan metropolitan area

BACKGROUND

Polybrominated diphenyl ethers (PBDEs) and polybrominated biphenyls (PBBs) are brominated flame retardant chemicals detectable in the environment and U.S. population, and are associated with adverse health outcomes over the life course. Correlates of these organic pollutants are understudied among U.S. Black women.

METHODS

Using baseline data from a prospective cohort study of U.S. Black women aged 23-35 years from the Detroit area of Michigan (2010-2012), we examined correlates of PBDEs and PBB-153. Non-fasting blood samples were collected from 742 participants at enrollment, a subset of women selected for a case-cohort study of environmental chemicals. Data on socio-demographics, behaviors, diet, medical history, and early-life exposures were collected via self-administered questionnaires, telephone interviews, and in-person clinic visits. We fit linear regression models to calculate percent differences and 95% confidence intervals in lipid adjusted plasma concentrations of 11 individual PBDE congeners and PBB-153 for each baseline predictor.

RESULTS

In models adjusted for all other correlates, a 5-year increase in age was inversely associated with most PBDE congeners (% differences ranged from 6 to 15% lower), and was positively associated with PBB-153 (52% higher). A 5-kg/m² increase in BMI was inversely associated with PBDE-153 and PBB-153 (16% lower for both), and 6% higher for PBDE-28. Compared with having never been breastfed in infancy, ≥3 months of breastfeeding in infancy was associated with 69% higher PBB-153 concentrations. Lower education, current smoking, and heavy alcohol use were associated with higher plasma concentrations of most flame retardants. Diet was not an important predictor.

CONCLUSION

Important correlates for elevated body burdens of PBB-153 were increasing age and a history of having been breastfed in infancy. Education, smoking, and heavy alcohol use were important predictors of elevated body burdens of most flame retardants. This study fills an important gap in the environmental health literature by focusing on an understudied population.