ORIGINAL CONTRIBUTION AssociationofUrinaryBisphenolAConcentration With Medical Disorders and Laboratory Abnormalities in Adults

BISPHENOL A (BPA) IS ONE OF the world’s highest production–volume chemicals, with more than 2 million metric tons produced worldwide in 2003 and annual increase in demand of 6% to 10% annually. Bisphenol A is used extensively in epoxy resins lining food and beverage containers and as a monomer in polycarbonate plastics in many consumer products. Widespread and continuous exposure to BPA, primarily through food but also through drinking water, dental sealants, dermal exposure, and inhalation of household dusts, is evident from the presence of detectable levels of BPA in more than 90% of the US population. Most studies of the health effects of BPA have focused on well-documented estrogenic activity, but reports have highlighted additional modes of action, including liver damage, disrupted pancreatic -cell function, thyroid hormone disruption, and obesity-promoting effects. The potential for low-dose effects has added to the controversy about possible hazards and whether currently recommended exposure thresholds require revision. Debateabout thehealtheffectsofBPA inhumanshasbeenhinderedbythe lack of epidemiologic data of sufficient statisticalpower todetect low-doseeffects. The US National Health and Nutrition Examination Survey (NHANES) 2003Author Affiliations: Epidemiology and Public Health Group (Drs Lang and Melzer) and Environment and Human Health Group (Dr Depledge), Peninsula Medical School, Exeter, United Kingdom; School of Biosciences, University of Exeter, Exeter (Drs Galloway and Scarlett); School of Mathematics and Statistics, University of Plymouth, Plymouth, United Kingdom (Dr Henley); and University of Iowa College of Public Health, Iowa City (Dr Wallace). Corresponding Author: David Melzer, MB, PhD, Epidemiology and Public Health Group, Peninsula Medical School, Barrack Rd, Exeter EX2 5DW, UK (david [email protected]). Context Bisphenol A (BPA) is widely used in epoxy resins lining food and beverage containers. Evidence of effects in animals has generated concern over low-level chronic exposures in humans.