Environmental Science and Pollution Research

, Volume 26, Issue 8, pp 7665–7676 | Cite as

Co-exposure to environmental endocrine disruptors in the US population

  • Lin Chen
  • Kai Luo
  • Ruth Etzel
  • Xiaoyu Zhang
  • Ying Tian
  • Jun ZhangEmail author
Research Article


Exposure to environmental endocrine disruptors (EEDs) has been linked to adverse health outcomes. The vast majority of studies examined one class of EEDs at a time but humans often are exposed to multiple EEDs at the same time. It is, therefore, important to know the co-exposure status of multiple EEDs in an individual, to preclude and control for potential confounding effects posed by co-exposed EEDs. This study examined the concentrations of seven classes of EEDs in the US population utilizing the data from the National Health and Nutrition Examination Survey (NHANES), 2009–2014 survey cycles. We applied linear correlation and cluster analysis to characterize the correlation profile and cluster patterns of these EEDs. We found that EEDs with a similar structure are often highly correlated. Among between-class correlations, mercury and perfluoroalkyl substances (PFAS) and cadmium and polycyclic aromatic hydrocarbons (PAHs) were two significantly correlated EEDs. In epidemiologic studies, measurement and control for co-exposure to pollutants, especially those with similar biological effects, are critical when attempting to make causal inferences. Appropriate statistical methods to handle within- and between-class correlations are needed.


Environmental endocrine disruptors NHANES Cluster analysis Correlation Co-exposure PFAS Mercury PAHs Cadmium 



This study was partly funded by the National Basic Science Research Program Ministry of Science and Technology of China (Grant No. 2014CB943300), the National Natural Science Foundation of China (81530086) and the clinical research capacity improvement programs of postgraduate from Shanghai Jiao Tong University School of Medicine.

Compliance with ethical standards

Competing interests

The authors declare that they have no conflicts of interest.

Supplementary material

11356_2018_4105_MOESM1_ESM.docx (48 kb)
ESM 1 (DOCX 48 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Xinhua HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
  2. 2.School of Public HealthShanghai Jiao Tong UniversityShanghaiChina
  3. 3.Milkin Institute School of Public HealthThe George Washington UniversityWashingtonUSA

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