Relationships between bisphenol A and paraben exposure, oxidative stress, and the activity of outer hair cells in the cochlea in children with hearing loss

This study aimed to determine the associations of childhood exposure to bisphenol A (BPA) and parabens (PBs) with oxidative stress and the activity of outer hair cells (OHCs) in the cochlea of children with hearing loss (HL). A total of 641 children were enrolled in this cross-sectional study. Urinary concentrations of BPA and four PBs including methyl paraben (MP), ethyl paraben (EP), propyl paraben (PP), and butyl paraben (BP) were quantified by using liquid chromatography–tandem mass spectrometry (LC/MSMS). Four urinary biomarkers of oxidative stress, 8-hydroxy-2′-deoxyguanosine (8-OHdG), 8-nitroguanine (8-NO₂Gua), 4-hydroxynonenal mercapturic acid (HNE-MA), and 8-isoprostaglandin F2α (8-iso-PGF_2α), were measured using high-performance liquid chromatography-electrospray ionization mass spectrometry. Hearing tests were conducted by an audiologist in the audiometric test room, and the results were confirmed by an otolaryngologist. The activity of OHCs in the cochlea was measured by distortion product otoacoustic emissions (DPOAEs). The associations of BPA/PB exposure and oxidative stress with the activity of OHCs at different frequencies were evaluated in the multivariable linear regression models. There were 91 children with HL, for an incidence of approximately 14.2 %. There was a significant negative association between the presence of EP (1.5 K Hz, 3 K Hz) or PP (2 K Hz) or 8-OHdG (1 K Hz, 1.5 K Hz, 2 K Hz) and the activity of OHCs in the left ear. Significant results were also observed for BPA (2 K Hz), MP (1 K Hz, 1.5 K Hz, 2 K Hz), EP (3 K Hz), and 8-OHdG (2 K Hz) in the right ear. This study revealed that exposure to BPA/PBs reduces the activity of OHCs, especially at middle frequencies, in children.