Abstract
BACKGROUND: The relationship between brominated flame retardants (BFRs) exposure and arthritis and its subtypes remains unclear. This study aimed to investigate the potential association between BFRs exposure and arthritis, osteoarthritis, and rheumatoid arthritis (RA) in American adults. METHODS: A cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) 2005-2016. Logistic regression models were applied to examine the association between BFRs and arthritis, osteoarthritis, and RA. Subgroup analyses were performed to assess the modifying effects of gender, age, and body mass index (BMI). The overall association of BFR mixtures with arthritis and its subtypes were evaluated using quantile g-computation (QGC) analyses and weighted quantile sum (WQS) regression. RESULTS: A total of 5,717 participants without arthritis and 2,106 participants with arthritis were enrolled in the study. Of these, 801 were diagnosed with osteoarthritis, and 422 with RA. Logistic regression models indicated that PBB153 and seven polybrominated diphenyl ethers (PBDEs) were positively associated with arthritis. PBB153 was positively associated with osteoarthritis and RA. WQS and QGC analyses confirmed that BFR mixtures were positively associated with arthritis, osteoarthritis and RA. WQS regression indicated that PBB153 contributed the most on the overall effect on arthritis, osteoarthritis and RA (75.8%, 75.6% and 82.3%). CONCLUSION: This study suggested that exposure to specific kinds of BFRs was positively associated with arthritis, osteoarthritis, and RA. Further research is warranted to explore the underlying mechanisms.