Organophosphate esters (OPEs) are an emerging class of
chemicals
used in a variety of consumer products as flame retardants, plasticizers,
and additives. While prior epidemiologic studies suggest that OPEs
may impact respiratory health, results remain inconclusive. We examined
associations between urinary biomarkers of OPEs and symptoms of respiratory
morbidity in a panel study of 147 predominantly Black school-aged
children with asthma living in Baltimore City, Maryland. The study
consisted of up to four seasonal, week-long, in-home visits where
urine samples and self-reported asthma symptoms were collected on
days 4 and 7 (n
samples = 438). We quantified
concentrations of nine urinary OPE biomarkers: bis(2-chloroethyl)
phosphate (BCEtp), bis(1-chloro-2-propyl) phosphate (BCPP), bis(1,3-dichloro-2-propyl)
phosphate (BDCIPP), di-n-butyl phosphate (DBuP), di-benzyl phosphate
(DBzP), di-o-cresylphosphate (DOCP), di-p-cresylphosphate (DPCP),
di-(2-propylheptyl) phthalate (DPHP), and 2,3,4,5-tetrabromo benzoic
acid (TBBA). We estimated prevalence odds ratios (POR) of respiratory
morbidity symptoms using logistic regression with generalized estimating
equations to account for our repeated measure design. We assessed
BDCIPP and DPHP as continuous (log2) concentrations and
dichotomized exposure of BCEtP, DBuP, and DPCP (detect vs non-detect)
based on their lower detection frequencies. We adjusted models for
season, visit day, age, gender, caregiver education, health insurance
type, exposure to household smoking, atopy, and PM2.5.
Higher DPHP concentrations were significantly associated with odds
of daytime symptoms (POR: 1.26; 95% CI: 1.04–1.53; p = 0.02) where daytime symptoms consisted of trouble breathing
due to asthma, reporting bother caused by asthma, and/or limitation
in activities due to asthma. DBuP detection was associated with use
of rescue medication on the day of sample collection (POR: 2.36; 95%
CI: 1.05–5.29; p = 0.04). We also observed
several consistent, albeit non-significant (p >
0.05),
positive associations for BCEtP and DPCP and respiratory morbidity
measures. This is the first study to evaluate the relationship between
OPE biomarkers and respiratory morbidity symptoms in children with
asthma, and findings suggest that further studies are warranted to
confirm whether these associations are causal.