The associations between organophosphate esters and urinary incontinence in the general US population

Mingjing He,Lu Yang,Zeyu Chen,Xiaonan Zheng,Jianzhong Ai,Qiang Wei,Shi Qiu,Zhongyuan Jiang,Xinyang Liao,Dan Hu,Kun Jin

doi:10.1007/s11356-021-14153-5

Abstract

Organophosphate esters (OPEs) impact health in many ways. Since its relationship with urinary incontinence remains unknown, we aimed to explore their associations in the US general population. We combined the results of urine specimens test and self-reported urinary incontinence conditions from the National Health and Nutrition Examination Survey (NHANES) 2013–2014 among 2666 participants and then conducted linear regression and logistic regression to analyse associations between log2-transformed OPE concentrations and urinary incontinence. We found that 0.92% of men and 15.74% of women complained of mixed urinary incontinence (MUI). The concentrations of diphenyl phosphate (DPHP) were significantly correlated to MUI among women when treated as a continuous variable (adjusted odds ratio (OR) = 1.15; 95% confidence interval (CI), 1.01–1.31; p = 0.0369) and as a categorical variable (adjusted OR = 1.24; 95% CI, 1.03–1.49; p for trend = 0.0245), whereas no positive correlation was found in males. There were no significant associations between the other three OPEs: bis(2-chloroethyl) phosphate (BCEP), bis(1,3-dichloro-2-propyl) phosphate (BDCPP) and dibutyl phosphate (DBUP). The association of DPHP with an increased prevalence OR of MUI in women is a public health concern; future prospective studies are needed to explore its potential mechanism.

Highlights

Organophosphate esters (OPEs) are a group of synthetic chemicals that have been widely used as replacements for brominated flame retardants (Kemmlein et al 2003) in construction materials, in furniture, and in the outer shells of electronics
The analytic cohort was restricted to participants with collected urine specimens (n = 2666) who were randomly chosen by the National Center for Health Statistics (NCHS) for OPE analysis, and participants with complete data on the following four widely distributed OPEs were included: diphenyl phosphate (DPHP), bis(2-chloroethyl) phosphate (BCEP), bis(1,3-dichloro-2-propyl) phosphate (BDCPP) and dibutyl phosphate (DBUP)
DPHP showed a significant association with mixed urinary incontinence (MUI); a 1 ng/mL increase in DPHP was associated with 15% increased prevalence odds ratio (OR) for MUI (OR = 1.15; 95% confidence interval (CI), 1.02–1.31; p = 0.026)

Summary

Introduction

Organophosphate esters (OPEs) are a group of synthetic chemicals that have been widely used as replacements for brominated flame retardants (Kemmlein et al 2003) in construction materials, in furniture, and in the outer shells of electronics. They are known as plasticisers when used in consumer products (e.g. food packages, beverage containers, children’s products and cosmetics) (Luo et al 2020; Mendelsohn et al 2016). The symptoms or signs of MUI include involuntary loss of urine associated with SUI and UUI. These are both affected by lifestyle and urinary

Objectives

Methods

Results

Discussion

Conclusion