ArticlePloS one2021
Urinary polycyclic aromatic hydrocarbon metabolites and mortality in the United States: A prospective analysis.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Hazardous Environmental Pollutants and Cancer Disparities: A Systematic Review on the Consideration of Race and Ethnicity in Environmental Epidemiology Research.Current environmental health reports · 2025Pooled it
- Urinary Metabolites of Polycyclic Aromatic Hydrocarbons in Firefighters: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2022Pooled it
- Occupational polycyclic aromatic hydrocarbons (PAHs) exposure is associated with accelerated aging trajectories in Chinese coke oven workers.Scientific reports · 2026Article
- Ubiquitous Environmental Exposures and Risk of Hepatocellular Carcinoma: A Narrative Review.Digestive diseases and sciences · 2026Review
- Changing pattern of exposure to polycyclic aromatic hydrocarbons over time in the Central European population.Journal of exposure science & environmental epidemiology · 2026Article
- Urinary Polycyclic Aromatic Hydrocarbons and Advanced Cardiovascular-Kidney-Metabolic Syndrome: Inflammatory-Nutritional Pathways as Mediators.Mediators of inflammation · 2026Article
- Exposure-Response Associations of Ambient Heavy Metal and Persistent Organic Pollutant with All-Cause and Cause-Specific Mortality: A Prospective Cohort Study.Environment & health (Washington, D.C.) · 2025Article
- Polycyclic Aromatic Hydrocarbons Mediate the Association between Tobacco Smoking and Alcohol Use Disorder.Yonsei medical journal · 2024Article
- Serum metabolomic signatures of fatty acid oxidation defects differentiate host-response subphenotypes of acute respiratory distress syndrome.Respiratory research · 2023Article
- Vitamin D status in relation to inflammatory risk and albuminuria associated with polycyclic aromatic hydrocarbon exposure in the US population.Archives of environmental & occupational health · 2023Article
- The relationship between polycyclic aromatic hydrocarbons exposure and serum klotho among adult population.BMC geriatrics · 2022Article
- Factors Associated with Urinary 1-Hydroxypyrene and Malondialdehyde among Adults near a Petrochemical Factory: Implications for Sex and Lifestyle Modification.International journal of environmental research and public health · 2022Article
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Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundPolycyclic aromatic hydrocarbons (PAHs) are ubiquitous organic compounds associated with chronic disease in epidemiologic studies, though the contribution of PAH exposure on fatal outcomes in the U.S. is largely unknown.
objectivesWe investigated urinary hydroxylated PAH metabolites (OH-PAHs) with all-cause and cause-specific mortality in a representative sample of the U.S. population.
methodsStudy participants were ≥20 years old from the National Health and Nutrition Examination Survey 2001-2014. Concentrations (nmol/L) of eight OH-PAHs from four parent PAHs (naphthalene, fluorene, phenanthrene, pyrene) were measured in spot urine samples at examination. We identified all-cause, cancer-specific, and cardiovascular-specific deaths through 2015 using the National Death Index. We used Cox proportional hazards regression to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between ΣOH-PAHs and mortality endpoints. We assessed potential heterogeneity by age, gender, smoking status, poverty, and race/ethnicity. Additionally, we examined the overall mixture effect using quantile g-computation.
resultsIn 9,739 eligible participants, there were 934 all-cause deaths, 159 cancer-specific deaths, and 108 cardiovascular-specific deaths (median 6.75 years follow-up). A log10 increase in ΣOH-PAHs was associated with higher all-cause mortality (HRadj = 1.39 [95%CI: 1.21, 1.61]), and possibly cancer-specific mortality (HRadj = 1.15 [95%CI: 0.79, 1.69]), and cardiovascular-specific mortality (HRadj = 1.49 [95%CI: 0.94, 2.33]). We observed substantial effect modification by age, smoking status, gender, and race/ethnicity across mortality endpoints. Risk of cardiovascular mortality was higher for non-Hispanic blacks and those in poverty, indicating potential disparities. Quantile g-computation joint associations for a simultaneous quartile increase in OH-PAHs were HRadj = 1.15 [95%CI: 1.02, 1.31], HRadj = 1.41 [95%CI: 1.05, 1.90], and HRadj = 0.98 [95%CI: 0.66, 1.47] for all-cause, cancer-specific, and cardiovascular-specific mortalities, respectively. DISCUSSION: Our results support a role for total PAH exposure in all-cause and cause-specific mortality in the U.S. population.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.