Published online: July 28, 2020
Bisphenol A (BPA), a synthetic chemical used to manufacture polycarbonate plastics and epoxy resins, can be present in canned food and beverage linings, dental sealants, and other consumer goods (e.g., plastic dinnerware, toys, building materials). Its widespread use has resulted in ubiquitous exposure in the U.S. general population. Diet is the main exposure route, although other routes, including inhalation, are possible. BPA exposure is typically higher among U.S. children than adults, and among low-income and African American communities compared to other socioeconomic or ethnic groups. BPA is also a xenoestrogen and concerns exist that environmental contaminants with hormone disrupting properties could play a role in the development or exacerbation of allergic diseases like asthma. This is of potential concern as disparate exposures to BPA are currently reported among minority populations who often suffer a disproportionate asthma burden. Still, little is known about the effects of BPA on asthma morbidity as well as the effects of other structural analogues that may be replacing BPA, including bisphenol F (BPF) and bisphenol S (BPS).
In this study published by Quirós-Alcalá et al. in The Journal of Allergy and Clinical Immunology (JACI) researchers investigated whether higher concentrations of BPA, BPF and BPS in urine were associated with an increased risk of asthma morbidity in a group of 148 predominantly African American children with established asthma. The study took place in Baltimore, Maryland between 2007 and 2010. Participating children were between the ages of 5 and 17 years and mostly low-income. In this study, authors measured exposure to target chemicals in a total of 660 urine samples and collected data on respiratory symptoms, healthcare utilization, and pulmonary function and inflammation every 3 months over 1 year.
Authors observed consistent positive associations between BPA exposure and asthma morbidity measures, including increased odds of general symptom days, maximal symptom days, and emergency department visits per 10-fold increase in urinary BPA concentrations. These associations between BPA and asthma morbidity were found to differ by sex, whereby BPA exposure among boys was associated with increased asthma morbidity but was not among girls. Findings with BPS and BPF did not consistently point to associations with asthma symptoms or healthcare utilization in this group of children.
This is the first study to examine whether exposure to BPA and its analogues could increase the risk of asthma morbidity among children with asthma. There was evidence to suggest that exposure to BPA in a predominantly low-income, minority pediatric cohort is associated with asthma morbidity and that associations may differ by sex. Findings support additional studies given the high pediatric asthma burden and widespread exposure to BPA in the United States.
The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.