The Total Picture: Multiple Chemical Exposures to Pregnant Women in the US – An NHANES Study of Data from 2003 through 2010

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Cabana, Teri
NHANES; chemical exposure; multiple chemical exposures; pregnant women; environmental chemicals; US pregnant women; exposure; environmental chemical exposure; phthalates; chemicals; Biostatistics
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INTRODUCTION: Chemical exposures to US pregnant women have been shown to have adverse health impacts on both mother and fetus. A prior paper revealed that US pregnant women in 2003-2004 had widespread exposure to multiple chemicals. The goal of this research is to examine how environmental chemical exposures to US pregnant women have changed from 2003 to 2010 and to look further at the extent of simultaneous exposure to multiple chemicals in US pregnant women using biomonitoring data available through NHANES (the National Health and Nutritional Examination Survey). METHODS: Using available NHANES data from the following cycles (2003-2004, 2005-2006, 2007-2008, 2009-2010), we analyzed how environmental chemical exposures changed over time. Covariates were used and data was weighted to reflect the population of pregnant US women. Each cycle was then compared to the 2003-2004 cycle in order to assess how exposures have changed over time. We then looked at the data in an entirely different fashion. We examined the total number of chemicals detected in a given pregnant woman by chemical group. Finally, we looked at the total number of detects across various chemical groups and used the Fisher Exact Test to study how the distribution of detections changed in 2009-2010 compared to 2003-2004. RESULTS: While at least one-third of the chemicals analyzed showed one cycle that differed, exposure rates of individual chemicals were generally not increasing from 2003-2010. Median number of detections over chemical groups also did not show much difference over time. However, analysis of the change in frequency distributions revealed that, for some chemical groups, the frequency of detects in US pregnant woman significantly increased in 2010 compared to 2003. CONCLUSIONS: Widespread chemical exposures were seen in US pregnant women from 2003 through 2010. The number of chemical analytes detected in US pregnant women’s bodies is rising. Many chemicals studied had similar mechanisms of action and/or similar adverse health outcomes upon exposure which is known to result in a cumulative health effect. This research suggests that we need to focus not only on exposure rates of individual chemicals but also on the overall number of chemicals detected when assessing the overall picture of environmental chemical exposures to pregnant women in the US.