Self-rated health and chronic conditions are associated with blood concentrations of persistent organic pollutants in the general population of Catalonia, Spain.
BACKGROUND
Self-rated health (SRH) is a powerful predictor of mortality, morbidity, and need for health services. SRH generally increases with educational level, and decreases with age, number of chronic conditions, and body mass index (BMI). Because human concentrations of most persistent organic pollutants (POPs) also vary by age, education, and BMI, and because of the physiological and clinical effects of POPs, we hypothesized that body concentrations of POPs are inversely associated with SRH.


OBJECTIVE
To analyze the relation between serum concentrations of POPs and SRH in the general population of Catalonia, Spain, taking into account sociodemographic factors and BMI, as well as chronic health conditions and mental disorders, measured by the General Health Questionnaire-12 (GHQ-12).


METHODS
POP serum concentrations were measured by gas chromatography with electron-capture detection in 919 participants of the Catalan Health Interview Survey.


RESULTS
Individuals with higher concentrations of POPs had significantly poorer SRH; e.g., the median concentration of HCB in subjects with poor SRH was twice as high as in subjects with excellent SRH (366 ng/g vs. 169 ng/g, respectively; p-value<0.001). In crude models and in models adjusted for sex and BMI, the POPs-SRH association was often dose-dependent, and the likelihood of poor or regular SRH was 2 to 4-times higher in subjects with POP concentrations in the top quartile. In models adjusted for age or for chronic conditions virtually all ORs were near unity. No associations were found between POP levels and GHQ-12.


CONCLUSIONS
Individuals with higher concentrations of POPs had significantly poorer SRH, an association likely due to age and chronic conditions, but not to sex, education, social class, BMI, or mental disorders.
Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain.
Magda
M
Gasull
Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain.
Natàlia
N
Pallarès
Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain.
Natalia
N
Salcedo
Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain.
José
J
Pumarega
Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Universitat Pompeu Fabra, Catalonia, Spain.
Jordi
J
Alonso
Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain. Electronic address: mporta@imim.es.
Miquel
M
Porta
D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002908:Chronic Disease / Q000453:epidemiology; D059026:Diagnostic Self Evaluation; D004522:Educational Status; D004785:Environmental Pollutants / Q000097:blood*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D009930:Organic Chemicals / Q000097:blood*; D012959:Socioeconomic Factors; D013030:Spain; D011795:Surveys and Questionnaires; D055815:Young Adult
D004785:Environmental Pollutants; D009930:Organic Chemicals
Chronic disorders; GHQ; Human biomonitoring; Persistent organic pollutants (POPs); Self-rated health