title: Bisphenol A exposure is associated with decreased lung function.
abstract: OBJECTIVE
  To examine the associations of bisphenol A (BPA) exposure with lung function measures and exhaled nitric oxide (FeNO) in children.
  
  
  METHODS
  We performed a cross-sectional analysis of a subsample of US children age 6-19 years who participated in the 2007-2010 National Health and Nutrition Examination Survey. We assessed univariate and multivariable associations of urinary BPA concentration with the predicted pulmonary function measures for age, sex, race/ethnicity and height (forced expiratory volume in 1 second [FEV1], forced vital capacity [FVC], forced expiratory flow 25%-75%, and FEV1 divided by FVC) and with FeNO.
  
  
  RESULTS
  Exposure and outcome data were available for 661 children. Median BPA was 2.4 ng/mL (IQR: 1.3, 4.1). In multivariable analysis, a larger urinary BPA concentration was associated with significantly decreased percent predicted forced expiratory flow 25%-75% (%FEF2575) (3.7%, 95% CI 1.0, 6.5) and percent predicted FEV1 divided by FVC (%FEV1/FVC) (0.8%, 95% CI 0.1, 1.7) but not percent predicted FEV1, percent predicted FVC, or FeNO. A child in the top quartile of BPA compared with the bottom quartile had a 10% decrease in %FEF2575 (95% CI -1, -19) and 3% decrease in %FEV1/FVC (95% CI -1, -5).
  
  
  CONCLUSIONS
  BPA exposure was associated with a modest decrease in %FEF2575 (small airway function) and %FEV1/FVC (pulmonary obstruction) but not FEV1, FVC, or FeNO. Explanations of the association cannot rule out the possibility of reverse causality.
authors.affiliation: Department of Pediatrics, Penn State University, Hershey, PA; Department of Public Health Sciences, Penn State University, Hershey, PA. Electronic address: aspanier@hmc.psu.edu.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Spanier
authors.affiliation: Department of Pediatrics, Cohen Children's Medical Center, Hofstra North Shore-LIJ School of Medicine, New York, NY.
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Fiorino
authors.affiliation: Department of Pediatrics, New York University School of Medicine, New York, NY; Department of Environmental Medicine, New York University School of Medicine, New York, NY; New York University Wagner School of Public Service, New York, NY; New York University Steinhardt School of Culture, Education, and Human Development, New York, NY.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Trasande
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000704:Analysis of Variance; D001559:Benzhydryl Compounds / Q000009:adverse effects* / Q000652:urine; D001944:Breath Tests; D002648:Child; D003430:Cross-Sectional Studies; D004781:Environmental Exposure / Q000009:adverse effects; D004785:Environmental Pollutants / Q000009:adverse effects*; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009569:Nitric Oxide / Q000378:metabolism*; D010636:Phenols / Q000009:adverse effects* / Q000652:urine; D011237:Predictive Value of Tests; D011379:Prognosis; D012129:Respiratory Function Tests; D012131:Respiratory Insufficiency / Q000209:etiology* / Q000503:physiopathology; D018570:Risk Assessment; D012737:Sex Factors; D016482:Urinalysis; D014797:Vital Capacity / Q000502:physiology; D055815:Young Adult; D000098826:Bisphenol A Compounds
chemical_list: D001559:Benzhydryl Compounds; D004785:Environmental Pollutants; D009569:Nitric Oxide; D010636:Phenols; C006780:bisphenol A; D000098826:Bisphenol A Compounds