Wide
exposure to endocrine-disrupting chemicals (EDCs) poses a
great risk on human health. However, few large-scale cohort studies
have comprehensively estimated the association between EDCs exposure
and mortality risk. This study aimed to investigate the association
of urinary EDCs exposure with mortality risk and quantify attributable
mortality and economic loss. Multivariable Cox proportional hazards
regression models were performed to investigate the association of
38 representative EDCs exposure with mortality risk in the National
Health and Nutrition Examination Survey (NHANES). During a median
follow-up of 7.7 years, 47,279 individuals were enrolled. All-cause
mortality was positively associated with 1-hydroxynaphthalene, 2-hydroxynaphthalene,
cadmium, antimony, cobalt, and monobenzyl phthalate. Cancer mortality
was positively associated with cadmium. Cardiovascular disease (CVD)
mortality was positively associated with 1-hydroxynaphthalene, 2-hydroxynaphthalene,
and 2-hydroxyfluorene. Nonlinear U-shaped relationships were found
between all-cause mortality and cadmium and cobalt, which was also
identified between 2-hydroxyfluorene and CVD mortality. J-shaped association
of cadmium exposure with cancer mortality was also determined. EDCs
exposure may cause 56.52% of total deaths (1,528,500 deaths) and around
1,897 billion USD in economic costs. Exposure to certain phthalates,
polycyclic aromatic hydrocarbons, phytoestrogens, or toxic metals,
even at substantially low levels, is significantly associated with
mortality and induces high economic costs.