Racial/ethnic disparities in cumulative exposures to phthalates and parabens and implications for uterine fibroid size

摘要

In the U.S., black women are disproportionately impacted by uterine fibroids. They experience larger tumors and faster tumor growth, and consequently have a three-fold higher risk of hysterectomies than white women. However, the etiology of uterine fibroids and root causes of these racial/ethnic disparities remain poorly understood. The objective of this pilot study was to characterize racial/ethnic differences in exposures to phthalates and phenols and to examine their associations with uterine fibroid size, a marker of clinical severity. We recruited 29 premenopausal women with either small (<3 cm) or large fibroids (>=6cm) who were seeking surgical care for their fibroids in Washington DC. Spot urine samples were collected and measured for 17 phthalate metabolites, xx phenols, and xx phthalate alternatives. In addition to examining chemicals individually, we developed a cumulative phthalate score, cumulative phenol score, and cumulative EDC score. To calculate scores, participants' levels of each analyte were dichotomized as high (>25th percentile, assigned a "1") or low (<25th percentile, assigned a "0") and summed across chemicals. Our study sample was 59% black, highly educated, and privately insurance; 72% had large fibroids. Compared to white women, black women had higher cumulative chemical exposures and were more likely to have large fibroids (p<0.05). After adjusting from race and body mass index, cumulative phthalates exposure was associated with large fibroid size (adjusted odds ratio = 2.54 (95% CI: 1.00, 6.45)). These preliminary results suggest that racial/ethnic disparities in EDC exposures could have consequences for women's gynecological health.