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Synthetic Chemicals and Cardiometabolic Health Across the Life Course Among Vulnerable Populations: a Review of the Literature from 2018 to 2019


Purpose of Review

Although vulnerable populations are disproportionately exposed to synthetic chemicals with endocrine disrupting properties, few recent reviews have summarized the impact of synthetic chemicals on cardiometabolic health among these groups.

Recent Findings

Of 37 eligible epidemiological studies among vulnerable populations published between January 2018 and April 2019 in which over half were prospective, the most investigated populations were pregnant women and children. Racial/ethnic minorities, individuals of low socioeconomic status (SES), and those occupationally exposed were studied the least. The most studied persistent organic pollutants (POPs) were per-/poly-fluoroalkyl substances (PFAS), and the most studied non-POPs were phenols. Across chemical classes, studies found certain POPs (e.g., PFAS) and non-POPs (i.e., phenols, phthalates, and parabens) to be associated with gestational diabetes and dysregulated glucose metabolism. Results for other cardiometabolic health outcomes were inconsistent but suggested certain chemicals may negatively affect cardiometabolic health.


Synthetic chemicals likely adversely affect cardiometabolic health, but current findings were inconclusive. Few recent studies focused on racial/ethnic minorities, low SES, and occupationally exposed populations. To address poor cardiometabolic health and related disparities, more studies across vulnerable populations are warranted.

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Fig. 1



3-phenoxybenzoic acid




Bisphenol A


Bisphenol F


Bisphenol S


Chronic kidney disease


Cardiovascular disease






Endocrine disrupting compounds


Gestational diabetes mellitus


High-density lipoprotein cholesterol


High molecular weight phthalates


Low-density lipoprotein cholesterol




Organophosphate ester


Polychlorinated biphenyls


Polybrominated diphenyl ethers


Per- and poly-fluoroalkyl substances


Perfluorododecanoic acid


Perfluoroheptanoic acid


Perfluorohexanesulphonic acid


Perfluorononaoic acid


Perfluorooctanoic acid


Perfluorooctane sulfonic acid


Persistent organic pollutant


Socioeconomic status


Type 2 diabetes mellitus


Total cholesterol




United States


Papers of particular interest, published recently, have been highlighted as:• Of importance •• Of major importance

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The authors wish to thank the National Institute of Environmental Health Sciences library staff, Stacy Mantooth and Erin Knight, for assistance with the literature search. The authors also wish to thank Samuel Goldstein for assistance with the literature review and data extraction.


This work was funded by the Intramural Program at the NIH, National Institute of Environmental Health Sciences (Z1AES103325-01).

Author information

Symielle Gaston and Chandra Jackson contributed to the study conception and design. The review of the literature was completed by Symielle Gaston. Symielle Gaston and Chandra Jackson drafted the manuscript. Chandra Jackson obtained funding and supervised the study. Symielle Gaston, Linda Birnbaum, and Chandra Jackson provided critical revisions for important intellectual content, read, and approved the final manuscript.

Correspondence to Chandra L. Jackson.

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Gaston, S.A., Birnbaum, L.S. & Jackson, C.L. Synthetic Chemicals and Cardiometabolic Health Across the Life Course Among Vulnerable Populations: a Review of the Literature from 2018 to 2019. Curr Envir Health Rpt 7, 30–47 (2020).

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  • Endocrine disruptors
  • Metabolic diseases
  • Cardiovascular diseases
  • Minority health
  • Vulnerable populations
  • Pregnancy complications