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Urinary 2,5-dicholorophenol and 2,4-dichlorophenol concentrations and prevalent disease among adults in the National Health and Nutrition Examination Survey (NHANES)
  1. Mary R Rooney1,
  2. Pamela L Lutsey1,
  3. Parveen Bhatti2,3,
  4. Anna Prizment1
  1. 1 Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
  2. 2 Cancer Control Research, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
  3. 3 Program in Epidemiology, Public Health Sciences Divisions, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
  1. Correspondence to Mary R Rooney, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55454, USA; roone166{at}


Objective To test cross-sectional associations between urinary concentrations of 2,5-dichlorophenol (2,5-DCP) and 2,4-dichlorophenol (2,4-DCP) with the prevalence of cardiovascular disease (CVD), cancer, lung disease, thyroid problems and liver conditions.

Methods Logistic regression was used to evaluate associations of urinary concentrations of 2,5-DCP and 2,4-DCP with prevalence of various medical conditions among 3617 National Health and Nutrition Examination Survey participants from 2007–2008 and 2009–2010. ORs and 95% CIs for each disease were estimated. All regression models were adjusted for urinary creatinine.

Results We observed a monotonically increasing association between quartiles of 2,5-DCP and prevalence of CVD. After adjustment for sociodemographic and lifestyle characteristics, participants with the highest versus lowest quartile of urinary 2,5-DCP had an OR=1.84 (95% CI 1.26 to 2.70) (p linear trend=0.006). The association was similar with further adjustment for established clinical CVD risk factors. Higher 2,5-DCP was also associated with prevalence of all cancers combined (ORQ4 vs Q1=1.50 (95% CI 1.00 to 2.26); p trend=0.05) and, in exploratory analyses, with gynaecological cancers (ORQ4 vs Q1=4.15 (95% CI 1.51 to 11.40; p trend=0.01)). No associations were detected between 2,5-DCP and lung diseases, thyroid problems or liver conditions, nor between 2,4-DCP and prevalent disease.

Conclusion In this nationally representative study, higher urinary 2,5-DCP concentrations were associated with greater prevalence of CVD and all cancers combined. Further examination may be warranted to assess whether chronic exposure to 2,5-DCP is associated with incidence of adverse health outcomes.

  • cross sectional studies
  • cardiovascular
  • cancer
  • epidemiology
  • endocrine disrupters

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  • Contributors MRR, PLL and AP designed the analysis; MRR performed the statistical analysis and drafted the first version of the manuscript; all authors critically revised the manuscript and contributed to interpreting the data.

  • Funding Research reported in this publication was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under Award Number T32HL007779.

  • Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.