Cardiometabolic Health Associated with Exposures to Mixtures of Chemical Pollutants: Results from the EHES-LUX Study

Background and aim: The recent decades have seen a worldwide increase in cardiometabolic diseases. This study analyses associations of mixtures of chemical pollutants with cardiometabolic health. Methods: We analysed information from 606 randomly selected adults from the European Health Examination Survey. We analysed 152 chemical pollutants in hair samples, of which 74 were present in more than 6% of the samples and classified into groups (subdivided into banned and currently used): 6 flame-retardants, industrial wastes and plasticizers, 32 insecticides, 21 herbicides and 15 fungicides. We used weighted quantile sum (WQS) regressions adjusted by age, education, job status and physical activity to estimate the associations of groups of chemicals and cardiometabolic outcomes in men and women separately. Results: In women, a quartile increase of mixtures of banned insecticides, currently used insecticides, banned herbicides and currently used fungicides was associated with risk of hyperglycemia (WQS adjusted odds ratio [95% Confidence Interval] 1.81 [1.06, 3.10], 3.05 [1.29, 7.21], 2.00 [1.18, 3.38], 3.77 [1.82, 7.81], respectively). We also observed a quartile increase of banned herbicides mixtures associated with risk of low HDL-cholesterol in women (1.68 [1.09, 2.60]). Additionally, a quartile increase of currently used insecticides mixtures and currently used herbicides mixtures was associated with an increased risk of hypertriglyceridemia in men (2.76 [1.25, 6.10], 3.09 [1.33, 7.18], respectively). A quartile increase of currently used herbicides mixtures was associated with lower risk of abdominal obesity in men (0.46 [0.23, 0.94]). The most highly weighted chemicals associated with hyperglycemia among women were γ-HCH, β-HCH, Cl2CA, imidacloprid, trifluraline, metolachlor, boscalid and prochloraz. Among men, the most highly weighted chemicals associated with hypertriglyceridemia were 2-ClBA, IMPy, 1-(3,4-dichlorophenyl)-3-methylurea and fenuron. Conclusions: This study contributes with further evidence on the possible negative effects of exposure to chemical mixtures on cardiometabolic health. Keywords: Chemical Mixtures; Pesticides; Exposome; Hair Analyses; Chronic Conditions