PMID- 31026035 OWN - NLM STAT- MEDLINE DCOM- 20200213 LR - 20200309 IS - 2574-3805 (Electronic) IS - 2574-3805 (Linking) VI - 2 IP - 4 DP - 2019 Apr 5 TI - Association of Exposure to Persistent Organic Pollutants With Mortality Risk: An Analysis of Data From the Prospective Investigation of Vasculature in Uppsala Seniors (PIVUS) Study. PG - e193070 LID - 10.1001/jamanetworkopen.2019.3070 [doi] LID - e193070 AB - IMPORTANCE: It has been suggested that persistent organic pollutants (POPs) are harmful to human health. OBJECTIVE: To investigate if POP levels in plasma are associated with future mortality. DESIGN, SETTING, AND PARTICIPANTS: Cohort study using data from the population-based Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study, collected between May 2001 and June 2004 when participants reached age 70 years. Participants were followed up for 5 years after the first examination. Mortality was tracked from age 70 to 80 years. Data analysis was conducted in January and February 2018. EXPOSURES: Eighteen POPs identified by the Stockholm Convention, including polychlorinated biphenyls (PCBs), organochlorine pesticides, and a brominated flame retardant, were measured in plasma levels by gas chromatography-mass spectrometry. MAIN OUTCOMES AND MEASURES: All-cause mortality. RESULTS: The study sample initially included 992 individuals (497 [50.1%] men) aged 70 years, who were examined between 2001 and 2004. At the second examination 5 years later, 814 individuals (82.1%; 412 [50.7%] women) completed follow-up. During a follow-up period of 10.0 years, 158 deaths occurred. When updated information on POP levels at ages 70 and 75 years was associated with all-cause mortality using Cox proportional hazard analyses, a significant association was found between hexa-chloro- through octa-chloro-substituted (highly chlorinated) PCBs and all-cause mortality (except PCB 194). The most significant association was observed for PCB 206 (hazard ratio [HR] for 1-SD higher natural log-transformed circulating PCB 206 levels, 1.55; 95% CI, 1.26-1.91; P < .001). Following adjustment for hypertension, diabetes, smoking, body mass index, and cardiovascular disease at baseline, most associations were no longer statistically significant, but PCBs 206, 189, 170, and 209 were still significantly associated with all-cause mortality (PCB 206: adjusted HR, 1.47; 95% CI, 1.19-1.81; PCB 189: adjusted HR, 1.29; 95% CI, 1.08-1.55; PCB 170: adjusted HR, 1.24; 95% CI, 1.02-1.52; PCB 209: adjusted HR, 1.29; 95% CI, 1.04-1.60). In a secondary analysis, these associations were mainly because of death from cardiovascular diseases rather than noncardiovascular diseases. Three organochlorine pesticides, including dichlorodiphenyldichloroethylene, and the brominated flame retardant diphenyl ether 47 were also evaluated but did not show any significant associations with all-cause mortality. CONCLUSIONS AND RELEVANCE: Higher levels of highly chlorinated PCBs were associated with an increased mortality risk, especially from cardiovascular diseases. These results suggest that public health actions should be undertaken to minimize exposure to highly chlorinated PCBs. FAU - Lind, P Monica AU - Lind PM AD - Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden. FAU - Salihovic, Samira AU - Salihovic S AD - Inflammatory Response and Infection Susceptibility Centre, School of Medical Sciences, Orebro University, Orebro, Sweden. AD - Man-Technology-Environment (MTM) Research Center, School of Science and Technology, Orebro University, Orebro, Sweden. FAU - Stubleski, Jordan AU - Stubleski J AD - Man-Technology-Environment (MTM) Research Center, School of Science and Technology, Orebro University, Orebro, Sweden. AD - Now with Wellington Laboratories Inc, Guelph, Ontario, Canada. FAU - Karrman, Anna AU - Karrman A AD - Man-Technology-Environment (MTM) Research Center, School of Science and Technology, Orebro University, Orebro, Sweden. FAU - Lind, Lars AU - Lind L AD - Cardiovascular Epidemiology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden. LA - eng PT - Evaluation Study PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20190405 PL - United States TA - JAMA Netw Open JT - JAMA network open JID - 101729235 RN - 0 (Environmental Pollutants) SB - IM MH - Aged MH - Aged, 80 and over MH - Cardiovascular Diseases/chemically induced/mortality MH - *Cause of Death MH - Environmental Exposure/*adverse effects MH - Environmental Pollutants/*blood MH - Female MH - Humans MH - Male MH - Proportional Hazards Models MH - Prospective Studies MH - Risk Assessment MH - Risk Factors MH - Sweden/epidemiology PMC - PMC6487572 COIS- Conflict of Interest Disclosures: None reported. EDAT- 2019/04/27 06:00 MHDA- 2020/02/14 06:00 PMCR- 2019/04/26 CRDT- 2019/04/27 06:00 PHST- 2019/04/27 06:00 [entrez] PHST- 2019/04/27 06:00 [pubmed] PHST- 2020/02/14 06:00 [medline] PHST- 2019/04/26 00:00 [pmc-release] AID - 2731690 [pii] AID - zoi190135 [pii] AID - 10.1001/jamanetworkopen.2019.3070 [doi] PST - epublish SO - JAMA Netw Open. 2019 Apr 5;2(4):e193070. doi: 10.1001/jamanetworkopen.2019.3070.