Association between brominated flame retardants and heart failure in U.S. adults: A cross-sectional analysis of national health and nutrition examination survey 2005-2016

Abstract

Background

Brominated flame retardants (BFRs) are environmental pollutants widely used in consumer products, which accumulate in human tissues. Despite their prevalence, the potential impact of BFRs on cardiovascular health, particularly heart failure (HF), remains insufficiently explored.

Objectives

This study aims to investigate the association between BFR exposure and the prevalence of HF in U.S. adults.

Methods

Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2005–2016. To assess the relationship between BFR exposure and HF prevalence, weighted generalized linear regressions (GLMs) were applied. Restricted cubic splines (RCS) were used to examine potential nonlinear associations. Additionally, quantile-weighted quantile sum (WQS) regression and quantile g-computation (QGC) analysis were performed to evaluate the overall effect of BFR mixtures on HF.

Results

A total of 6,931 individuals participated, with 219 diagnosed with HF. In the adjusted Model 3, BFRs including PBDE28, PBDE47, PBDE85, PBDE99, PBDE100, PBDE154, and PBB153 were significantly associated with increased odds of HF (all p < 0.05). RCS analysis revealed a significant nonlinear relationship between serum BFRs and HF. The WQS analysis showed a positive association between combined BFR exposure and HF (OR: 1.694; 95 % CI: 1.264, 2.270; p < 0.001), and QGC analysis similarly showed a significant positive association (OR: 1.365; 95 % CI: 1.094, 1.705; p = 0.006).

Conclusion

This study suggests a link between BFR exposure and an increased risk of HF. Further research is needed to explore the causal relationship and underlying mechanisms.