Impact of BPA on asthma morbidity

Bisphenol A (BPA) has been linked to a number of adverse health outcomes and previous studies in animals have indicated that BPA has a tie to the development of pediatric asthma and allergic airway inflammation. However, the jury has remained out on whether BPA or its structural analogs bisphenol S (BPS) and bisphenol F (BPF) had ties to asthma morbidity. A study in the Journal of Allergy and Clinical Immunology may have some answers.¹

Researchers collected 660 urine samples from 148 children who were predominantly low-income, Black, aged 5 to 17 years, and had established asthma. They quantified the concentrations of BPA, BPS, and BPF in each sample. The data on health care utilization, symptoms, and pulmonary function and inflammation were collected every 3 months over a year.

The investigators overall saw consistent positive association between exposure to BPA and measures of asthma morbidity. They saw increased odds of emergency department visits (adjusted odd ratio [aOR] = 2.12 [95% CI =1.28-3.51]), general symptom days (aOR = 1.40 [95% C = 1.02-1.92], and maximal symptom days (aOR = 1.36 [95% CI = 1.00-1.83]) per 10-fold increase in BPA concentrations. There was observed evidence of sexually dimorphic effects. Bisphenol A concentrations were tied to increased chances of health care use and symptom days among only the male participants. No consistent association with asthma symptoms and health care utilization was found with either BPS or BPF.

The study’s strengths included the fact that it was the first study to compare BPA, BPS, and BPF exposure in connection to the measures of asthma morbidity in the pediatric population. The study’s prospective design and evaluation of repeated exposure were also strengths as well as the prospective data collection that minimized the potential for recall bias. One of the limitations was the lack of information on pubertal stage as puberty could affect how BPA interacts with asthma morbidity.

The researchers concluded that their study’s findings indicate that exposure to BPA in a cohort that is mainly minority and low-income is linked with asthma morbidity. The link could differ by sex. They said that the studies should spur further studies because of widespread BPA exposure and asthma burden in the United States.

Reference

1. Quirós-Alcalá L, Hansel N, McCormack M, et al. Exposure to bisphenols and asthma morbidity among low-income urban children with asthma. Journal of Allergy and Clinical Immunology. July 28, 2020. Epub ahead of print. doi:10.1016/j.jaci.2020.05.031