Exposure to flame retardant chemicals and occurrence and severity of papillary thyroid cancer: A case-control study.


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.





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Publication Info

Hoffman, Kate, Amelia Lorenzo, Craig M Butt, Stephanie C Hammel, Brittany Bohinc Henderson, Sanziana A Roman, Randall P Scheri, Heather M Stapleton, et al. (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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Kate Hoffman

Associate Research Professor in The Division of Environmental Sciences and Policy

Randall Paul Scheri

Professor of Surgery

Heather M. Stapleton

Ronie-Richele Garcia-Johnson Distinguished Professor

Professor Heather Stapleton is an environmental chemist and exposure scientist in the Nicholas School of the Environment at Duke University.  Her research interests focus on identification of halogenated and organophosphate chemicals in building materials, furnishings and consumer products, and estimation of human exposure, particularly in vulnerable populations such as pregnant women and children.  Her laboratory utilizes mass spectrometry, including targeted and nontargeted approaches, to characterize chemical burdens in both environmental samples and biological tissues to support environmental health research. Currently she serves as the Director for the Duke Superfund Research Center, and Director of the Duke Environmental Analysis Laboratory, which is part of NIH’s Human Health Environmental Analysis Resource.


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