Exposure to flame retardant chemicals and occurrence and severity of papillary thyroid cancer: A case-control study.
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BACKGROUND: Thyroid cancer is the fastest increasing cancer in the U.S., and papillary thyroid cancer (PTC) accounts for >80% of incident cases. Increasing exposure to flame retardant chemicals (FRs) has raised concerns about their possible role in this 'epidemic'. The current study was designed to test the hypothesis that higher exposure to FRs is associated with increased odds of PTC. METHODS: PTC patients at the Duke Cancer Institute were approached and invited to participate. Age- and gender-matched controls were recruited from the Duke Health System and surrounding communities. Because suitable biomarkers of long-term exposure do not exist for many common FRs, and levels of FRs in dust are significantly correlated with exposure, relationships between FRs in household dust and PTC were evaluated in addition to available biomarkers. PTC status, measures of aggressiveness (e.g. tumor size) and BRAF V600E mutation were included as outcomes. RESULTS: Higher levels of some FRs, particularly decabromodiphenyl ether (BDE-209) and tris(2-chloroethyl) phosphate in dust, were associated with increased odds of PTC. Participants with dust BDE-209 concentrations above the median level were 2.29 times as likely to have PTC [95% confidence interval: 1.03, 5.08] compared to those with low BDE-209 concentrations. Associations varied based on tumor aggressiveness and mutation status; TCEP was more strongly associated with larger, more aggressive tumors and BDE-209 was associated with smaller, less aggressive tumors. CONCLUSIONS: Taken together, these results suggest exposure to FRs in the home, particularly BDE-209 and TCEP, may be associated with PTC occurrence and severity, and warrant further study.
Flame retardant chemicals
Papillary thyroid cancer
Tris(2-chloroethyl) phosphate (TCEP)
Published Version (Please cite this version)10.1016/j.envint.2017.06.021
Publication InfoButt, C; Hammel, Stephanie; Henderson, Brittney; Hoffman, Kate; Lorenzo, Amelia; Roman, Sanziana Alina; ... Stapleton, Heather M (2017). Exposure to flame retardant chemicals and occurrence and severity of papillary thyroid cancer: A case-control study. Environ Int, 107. pp. 235-242. 10.1016/j.envint.2017.06.021. Retrieved from https://hdl.handle.net/10161/15444.
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Assistant Research Professor in Environmental Sciences and Policy
Professor of Surgery
Associate Professor of Surgery
Professor of Surgery
Julie Ann Sosa, MD MA FACS is Chief of Endocrine Surgery at Duke University and leader of the endocrine neoplasia diseases group in the Duke Cancer Institute and the Duke Clinical Research Institute. She is Professor of Surgery and Medicine. Her clinical interest is in endocrine surgery, with a focus in thyroid cancer. She is widely published in outcomes analysis, as well as cost-effectiveness analysis, meta-analysis, and survey-based research, and she is director of health services research for
Dan and Bunny Gabel Associate Professor of Environmental Ethics and Sustainable Environmental Management
Dr. Stapleton's research focuses on understanding the fate and transformation of organic contaminants in aquatic systems and in indoor environments. Her main focus has been on the bioaccumulation and biotransformation of brominated flame retardants, and specifically polybrominated diphenyl ethers,(PBDEs). Her current research projects explore the routes of human exposure to flame retardant chemicals and examine the way these compounds are photodegraded and metabolized using mass spectrometry to
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