Abstract
BackgroundBisphenol A (BPA), a high production chemical commonly found in plastics, has drawn great attention from researchers due to the substance’s potential toxicity. Using data from three National Health and Nutrition Examination Survey (NHANES) cycles, we explored the consistency and robustness of BPA’s reported effects on coronary heart disease and diabetes.Methods And FindingsWe report the use of three different statistical models in the analysis of BPA: (1) logistic regression, (2) log-linear regression, and (3) dose-response logistic regression. In each variation, confounders were added in six blocks to account for demographics, urinary creatinine, source of BPA exposure, healthy behaviours, and phthalate exposure. Results were sensitive to the variations in functional form of our statistical models, but no single model yielded consistent results across NHANES cycles. Reported ORs were also found to be sensitive to inclusion/exclusion criteria. Further, observed effects, which were most pronounced in NHANES 2003-04, could not be explained away by confounding.ConclusionsLimitations in the NHANES data and a poor understanding of the mode of action of BPA have made it difficult to develop informative statistical models. Given the sensitivity of effect estimates to functional form, researchers should report results using multiple specifications with different assumptions about BPA measurement, thus allowing for the identification of potential discrepancies in the data.
Highlights
Bisphenol A (BPA) is an organic compound, commonly used in the synthesis of plastics and epoxy resins [1]
Unadjusted mean BPA concentrations dropped across survey cycles from 4.78 to 4.16 to 3.76 ng/ml in 03-04, 05-06, and 07-08 respectively
The controversy expanded beyond the teratogenic effects of BPA when Lang et al reported statistically significant associations between BPA and self-reported coronary heart disease (CHD) and diabetes in the 03-04 National Health and Nutrition Examination Survey (NHANES) cycle [21]
Summary
Bisphenol A (BPA) is an organic compound, commonly used in the synthesis of plastics and epoxy resins [1]. High levels of BPA exposure have been reported in Canadian, European, and Asian populations [6,7]. Bisphenol A (BPA), a high production chemical commonly found in plastics, has drawn great attention from researchers due to the substance’s potential toxicity. Using data from three National Health and Nutrition Examination Survey (NHANES) cycles, we explored the consistency and robustness of BPA’s reported effects on coronary heart disease and diabetes. Conclusions: Limitations in the NHANES data and a poor understanding of the mode of action of BPA have made it difficult to develop informative statistical models. Given the sensitivity of effect estimates to functional form, researchers should report results using multiple specifications with different assumptions about BPA measurement, allowing for the identification of potential discrepancies in the data
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