The Association of Urinary Phosphorous-Containing Flame Retardant Metabolites and Self-Reported Personal Care and Household Product Use among Women from the Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) Study

Abstract

Background Phosphorous-containing flame retardants (PFRs) are widely detected among pregnant women in the U.S. PFRs have been associated with endocrine disruption and adverse reproductive health outcomes. Although mainly used as a flame retardant, increased PFR exposure has been associated with personal care product (PCP) use.Methods Pregnant women 18-40 yrs. were recruited from two hospitals and five prenatal clinics in Northern Puerto Rico (n=148). Metabolites bis-2chloroethyl phosphate (BCEtP), bis-(1-chloro-2propl) phosphate, bis-(1-chloro-2propl) phosphate, bis(1,3-dichloro-2-propyl) phosphate (BDCIPP), di-n-butyl phosphate (DBNP), di-benzyl phosphate (DBzP), di-cresyl phosphate (DCP) and diphenyl phosphate (DPHP) were measured in urine three times during pregnancy. Participants completed a 48-hour recall questionnaire of PCP and household product (HP) use (visits 1&3). Associations among products and metabolites (n=296) were assessed using linear mixed models, adjusted for specific gravity, age, BMI, income and season.Results BCEtP, BCPP, BDCPP and DPHP were highly detected (79%≥LOD), yet correlations among metabolites (0.16≤r≤0.35) and within women (0.03≤r≤0.34) were weak-to-moderate. Correlations among visits were moderate (0.20≤r≤0.43). Suntan lotion use was associated with a 110% increase in BDCPP levels while DPHP increased with reported perfume (51%), nail polish (49%) and cosmetic (45%) use (p<0.05). BCPP levels increased 46% with pesticide use in home, yet DPHP decreased 27% with use of vinyl shower curtain (p<0.05). Furniture polish use was associated with an increase in BCEtP (62%) and BCPP (70%).Conclusion PFRs among pregnant women were highly detected, yet concentrations were weakly correlated with high temporal variability between visits 1&3. Associations with PCP and HP suggests PFRs are possibly being used as plasticizers, specifically in perfume, nail polish and cosmetics. Further investigation into these products is warranted.