Skip to main content
SpringerLink
Log in

Association between co-exposure of polycyclic aromatic hydrocarbons and chronic obstructive pulmonary disease among the US adults: results from the 2013–2016 National Health and Nutrition Examination Survey

  • Research Article
  • Published:
Environmental Science and Pollution Research Aims and scope Submit manuscript

Abstract

Although existing epidemiological studies have reported the relationship between single polycyclic aromatic hydrocarbon (PAH) exposure and chronic obstructive pulmonary disease (COPD), little is known about the impact of PAH mixture exposure on COPD. Therefore, we aimed to evaluate the associations of single and mixed exposures to PAHs with COPD in US adults using data from NHANES 2013–2016 by fitting three statistical methods, including multiple logistic regression, Bayesian kernel machine regression (BKMR), and quantile-based g-computation (qgcomp) models. This study included 1836 participants aged 40 and older. Multiple logistic regression showed that 2-FLU, 1-PHE, 1-PYR, and 2&3-PHE increased the risk of COPD after adjusting for all covariates. The BKMR model identified positive trends between PAH mixture and the risk of COPD in all adults and males when all PAHs were at or above their 55th percentile compared to all PAHs at their 50th percentile. The qgcomp model suggested that PAH co-exposure increased the risk of COPD (OR:1.44, 95%CI:1.09, 1.90) when each quartile increased in PAH mixture concentration, with 2-FLU having the highest weight. The combined impact also be observed in men. In conclusion, PAHs co-exposure was associated with a higher risk of COPD, especially in males, with the positive impact of 2-FLU being the most important.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Data Availability

The data used in this study were obtained for free from NHANES.

References

  • Abdel-Shafy HI, Mansour M (2016) A review on polycyclic aromatic hydrocarbons: source, environmental impact, effect on human health and remediation. Egypt J Pet 25:107–123

    Article  Google Scholar 

  • Alhamdow A, Zettergren A, Kull I, Hallberg J, Andersson N, Ekstrom S, Berglund M, Wheelock CE, Essig YJ, Krais AM, Georgelis A, Lindh CH, Melen E, Bergstrom A (2021) Low-level exposure to polycyclic aromatic hydrocarbons is associated with reduced lung function among Swedish young adults. Environ Res 197:111169

    Article  CAS  Google Scholar 

  • Alshaarawy O, Zhu M, Ducatman A, Conway B, Andrew ME (2013) Polycyclic aromatic hydrocarbon biomarkers and serum markers of inflammation. A positive association that is more evident in men. Environ Res 126:98–104

    Article  CAS  Google Scholar 

  • Barnes PJ, Shapiro SD, Pauwels RA (2003) Chronic obstructive pulmonary disease: molecular and cellular mechanisms. Eur Respir J 22:672–688

    Article  CAS  Google Scholar 

  • Barnes PJ (2016) Sex differences in chronic obstructive pulmonary disease mechanisms. Am J Respir Crit Care Med 193:813–814

    Article  CAS  Google Scholar 

  • Bayman EO, Dexter F (2021) Multicollinearity in logistic regression models. Anesth Analg 133:362–365

    Article  Google Scholar 

  • Bentayeb M, Norback D, Bednarek M, Bernard A, Cai G, Cerrai S, Eleftheriou KK, Gratziou C, Holst GJ, Lavaud F, Nasilowski J, Sestini P, Sarno G, Sigsgaard T, Wieslander G, Zielinski J, Viegi G, Annesi-Maesano I, Study G (2015) Indoor air quality, ventilation and respiratory health in elderly residents living in nursing homes in Europe. Eur Respir J 45:1228–38

    Article  Google Scholar 

  • Bobb JF, Valeri L, Claus Henn B, Christiani DC, Wright RO, Mazumdar M, Godleski JJ, Coull BA (2015) Bayesian kernel machine regression for estimating the health effects of multi-pollutant mixtures. Biostatistics 16:493–508

    Article  Google Scholar 

  • Burstyn I, Boffetta P, Heederik D, Partanen T, Kromhout H, Svane O, Langard S, Frentzel-Beyme R, Kauppinen T, Stucker I, Shaham J, Ahrens W, Cenee S, Ferro G, Heikkila P, Hooiveld M, Johansen C, Randem BG, Schill W (2003) Mortality from obstructive lung diseases and exposure to polycyclic aromatic hydrocarbons among asphalt workers. Am J Epidemiol 158:468–478

    Article  Google Scholar 

  • Cao L, Zhou Y, Tan A, Shi T, Zhu C, Xiao L, Zhang Z, Yang S, Mu G, Wang X, Wang D, Ma J, Chen W (2020) Oxidative damage mediates the association between polycyclic aromatic hydrocarbon exposure and lung function. Environ Health 19:75

    Article  CAS  Google Scholar 

  • Carratt SA, Kovalchuk N, Ding X, Van Winkle LS (2019) Metabolism and lung toxicity of inhaled naphthalene: effects of postnatal age and sex. Toxicol Sci 170:536–548

    Article  CAS  Google Scholar 

  • Caspard H, Ambrose CS, Tran TN, Chipps BE, Zeiger RS (2020) Associations between individual characteristics and blood eosinophil counts in adults with asthma or COPD. J Allergy Clin Immunol Pract 8:1606-1613 e1

    Article  Google Scholar 

  • Chen M, Yang T, Meng X, Sun T (2015) Azithromycin attenuates cigarette smoke extract-induced oxidative stress injury in human alveolar epithelial cells. Mol Med Rep 11:3414–3422

    Article  CAS  Google Scholar 

  • Chichester CH, Buckpitt AR, Chang A, Plopper CG (1994) Metabolism and cytotoxicity of naphthalene and its metabolites in isolated murine Clara cells. Mol Pharmacol 45:664–672

    CAS  Google Scholar 

  • Christenson SA, Smith BM, Bafadhel M, Putcha N (2022) Chronic obstructive pulmonary disease. Lancet 399:2227–2242

    Article  Google Scholar 

  • Faerk G, Colak Y, Afzal S, Nordestgaard BG (2018) Low concentrations of 25-hydroxyvitamin D and long-term prognosis of COPD: a prospective cohort study. Eur J Epidemiol 33:567–577

    Article  CAS  Google Scholar 

  • Fei Q, Weng X, Liu K, Liu S, Chen J, Guo X, Jing C (2022) The relationship between metal exposure and chronic obstructive pulmonary disease in the general US population: NHANES 2015–2016. Int J Environ Res Public Health 19(4):2085

    Article  CAS  Google Scholar 

  • Gao P, da Silva E, Hou L, Denslow ND, Xiang P, Ma LQ (2018) Human exposure to polycyclic aromatic hydrocarbons: metabolomics perspective. Environ Int 119:466–477

    Article  CAS  Google Scholar 

  • Gearhart-Serna LM, Tacam M Jr, Slotkin TA, Devi GR (2021) Analysis of polycyclic aromatic hydrocarbon intake in the US adult population from NHANES 2005–2014 identifies vulnerable subpopulations, suggests interaction between tobacco smoke exposure and sociodemographic factors. Environ Res 201:111614

    Article  CAS  Google Scholar 

  • Gordon SB et al (2014) Respiratory risks from household air pollution in low and middle income countries. Lancet Respir Med 2:823–860

    Article  Google Scholar 

  • Hudson-Hanley B, Smit E, Branscum A, Hystad P, Kile ML (2021) Trends in urinary metabolites of polycyclic aromatic hydrocarbons (PAHs) in the non-smoking US population, NHANES 2001-2014. Chemosphere 276:130211

    Article  CAS  Google Scholar 

  • Hwang J, Xu C, Grunsted P, Agnew RJ, Malone TR, Clifton S, Thompson K, Xu X (2022) Urinary Metabolites of Polycyclic Aromatic Hydrocarbons in Firefighters: a systematic review and meta-analysis. Int J Environ Res Public Health 19

  • Ibrahimou B, Azim SI, Sun N (2019) Interaction between blood lead level and chronic obstructive pulmonary disease (COPD) on risk of heart attack or stroke: USA NHANES, 2013–2014. Pulm Pharmacol Ther 58:101805

    Article  CAS  Google Scholar 

  • Jin X, Hua Q, Liu Y, Wu Z, Xu D, Ren Q, Zhao W, Guo X (2021) Organ and tissue-specific distribution of selected polycyclic aromatic hydrocarbons (PAHs) in ApoE-KO mouse. Environ Pollut 286:117219

    Article  CAS  Google Scholar 

  • Jones B, Donovan C, Liu G, Gomez HM, Chimankar V, Harrison CL, Wiegman CH, Adcock IM, Knight DA, Hirota JA, Hansbro PM (2017) Animal models of COPD: what do they tell us? Respirology 22:21–32

    Article  Google Scholar 

  • Kaluza J, Larsson SC, Orsini N, Linden A, Wolk A (2017) Fruit and vegetable consumption and risk of COPD: a prospective cohort study of men. Thorax 72:500–509

    Article  Google Scholar 

  • Kaluza J, Harris HR, Linden A, Wolk A (2019) Alcohol consumption and risk of chronic obstructive pulmonary disease: a prospective cohort study of men. Am J Epidemiol 188:907–916

    Article  Google Scholar 

  • Keil AP, Buckley JP, O’Brien KM, Ferguson KK, Zhao S, White AJ (2020) A quantile-based g-computation approach to addressing the effects of exposure mixtures. Environ Health Perspect 128:47004

    Article  Google Scholar 

  • Labaki WW, Rosenberg SR (2020) Chronic obstructive pulmonary disease. Ann Intern Med 173:ITC17–ITC32

    Article  Google Scholar 

  • Lag M, Ovrevik J, Refsnes M, Holme JA (2020) Potential role of polycyclic aromatic hydrocarbons in air pollution-induced non-malignant respiratory diseases. Respir Res 21:299

    Article  Google Scholar 

  • Li J, Qin C, Lv J, Guo Y, Bian Z, Zhou W, Hu J, Zhang Y, Chen J, Cao W, Yu C, Li L (2019) Solid fuel use and incident COPD in Chinese adults: findings from the China Kadoorie Biobank. Environ Health Perspect 127:57008

    Article  Google Scholar 

  • Li J, Li X, Xia Y, Fan H, Fan D, Xi X, Ye Q, Zhu Y, Xiao C (2021a) Subgroup analysis of the relationship between polycyclic aromatic hydrocarbons and rheumatoid arthritis: data from the National Health and Nutrition Examination Survey, 2003–2014. Sci Total Environ 775:145841

    Article  CAS  Google Scholar 

  • Li X, Zhong Y, He W, Huang S, Li Q, Guo C, Ma S, Li G, Yu Y (2021b) Co-exposure and health risks of parabens, bisphenols, triclosan, phthalate metabolites and hydroxyl polycyclic aromatic hydrocarbons based on simultaneous detection in urine samples from guangzhou. South China Environ Pollut 272:115990

    Article  CAS  Google Scholar 

  • Li Z, Sandau CD, Romanoff LC, Caudill SP, Sjodin A, Needham LL, Patterson DG Jr (2008) Concentration and profile of 22 urinary polycyclic aromatic hydrocarbon metabolites in the US population. Environ Res 107:320–331

    Article  CAS  Google Scholar 

  • Liang H, Wu X, Yao H, Weng X, Liu S, Chen J, Li Y, Wu Y, Wen L, Chen Q, Jing C (2022) Association of urinary metabolites of non-persistent pesticides with serum sex hormones among the US females: NHANES 2013–2014. Chemosphere 300:134577

    Article  CAS  Google Scholar 

  • Liu H, Tan X, Liu Z, Ma X, Zheng Y, Zhu B, Zheng G, Hu Y, Fang L, Hong G (2021a) Association between diet-related inflammation and COPD: findings from NHANES III. Front Nutr 8:732099

    Article  Google Scholar 

  • Liu J, Chen X, Qiu X, Zhang H, Lu X, Li H, Chen W, Zhang L, Que C, Zhu T (2021b) Association between exposure to polycyclic aromatic hydrocarbons and lipid peroxidation in patients with chronic obstructive pulmonary disease. Sci Total Environ 780:146660

    Article  CAS  Google Scholar 

  • Liu S, Ben X, Liang H, Fei Q, Guo X, Weng X, Wu Y, Wen L, Wang R, Chen J, Jing C (2021c) Association of acrylamide hemoglobin biomarkers with chronic obstructive pulmonary disease in the general population in the US: NHANES 2013–2016. Food Funct 12:12765–12773

    Article  CAS  Google Scholar 

  • Manisalidis I, Stavropoulou E, Stavropoulos A, Bezirtzoglou E (2020) Environmental and health impacts of air pollution: a review. Front Public Health 8:14

    Article  Google Scholar 

  • Matera MG, Ora J, Calzetta L, Rogliani P, Cazzola M (2021) Sex differences in COPD management. Expert Rev Clin Pharmacol 14:323–332

    Article  CAS  Google Scholar 

  • Moorthy B, Chu C, Carlin DJ (2015) Polycyclic aromatic hydrocarbons: from metabolism to lung cancer. Toxicol Sci 145:5–15

    Article  CAS  Google Scholar 

  • Mosher CL, Nanna MG, Jawitz OK, Raman V, Farrow NE, Aleem S, Casaburi R, MacIntyre NR, Palmer SM, Myers ER (2022) Cost-effectiveness of pulmonary rehabilitation among US adults with chronic obstructive pulmonary disease. JAMA Netw Open 5:e2218189

    Article  Google Scholar 

  • Negewo NA, Gibson PG, McDonald VM (2015) COPD and its comorbidities: impact, measurement and mechanisms. Respirology 20:1160–1171

    Article  Google Scholar 

  • Nwaozuzu CC, Partick-Iwuanyanwu KC, Abah SO (2021) Systematic review of exposure to polycyclic aromatic hydrocarbons and obstructive lung disease. J Health Pollut 11:210903

    Article  Google Scholar 

  • Oliver JR, Kushwah R, Wu J, Cutz E, Yeger H, Waddell TK, Hu J (2009) Gender differences in pulmonary regenerative response to naphthalene-induced bronchiolar epithelial cell injury. Cell Prolif 42:672–687

    Article  CAS  Google Scholar 

  • Pathak U, Gupta NC, Suri JC (2020) Risk of COPD due to indoor air pollution from biomass cooking fuel: a systematic review and meta-analysis. Int J Environ Health Res 30:75–88

    Article  Google Scholar 

  • Rabe KF, Watz H (2017) Chronic obstructive pulmonary disease. Lancet 389:1931–1940

    Article  Google Scholar 

  • Raherison C, Girodet PO (2009) Epidemiology of COPD. Eur Respir Rev 18:213–221

    Article  CAS  Google Scholar 

  • Rahman HH, Niemann D, Munson-McGee SH (2022) Association between environmental toxic metals, arsenic and polycyclic aromatic hydrocarbons and chronic obstructive pulmonary disease in the US adult population. Environ Sci Pollut Res Int 29:54507–54517

    Article  CAS  Google Scholar 

  • Rosario Filho NA, Urrutia-Pereira M, D’Amato G, Cecchi L, Ansotegui IJ, Galan C, Pomes A, Murrieta-Aguttes M, Caraballo L, Rouadi P, Chong-Neto HJ, Peden DB (2021) Air pollution and indoor settings. World Allergy Organ J 14:100499

    Article  CAS  Google Scholar 

  • Salvi S (2014) Tobacco smoking and environmental risk factors for chronic obstructive pulmonary disease. Clin Chest Med 35:17–27

    Article  Google Scholar 

  • Shang T, Zhao LJ, Pei LI, Zeng XY, Zhi-Qiang Y (2019) Determination of 10 kinds of monohydroxylated polycyclic aromatic hydrocarbons in human urine by supported liquid extraction followed by liquid chromatography- tandem mass spectrometry Chin J Anal Chem

  • Sheikh K, Coxson HO, Parraga G (2016) This is what COPD looks like. Respirology 21:224–236

    Article  Google Scholar 

  • Shen J, Gao S (2008) A solution to separation and multicollinearity in multiple logistic regression. J Data Sci 6:515–531

    Article  Google Scholar 

  • Sin DD, Cohen SB, Day A, Coxson H, Pare PD (2007) Understanding the biological differences in susceptibility to chronic obstructive pulmonary disease between men and women. Proc Am Thorac Soc 4:671–674

    Article  CAS  Google Scholar 

  • Smith JN, Gaither KA, Pande P (2022) Competitive metabolism of polycyclic aromatic hydrocarbons (PAHs): an assessment using in vitro metabolism and physiologically based pharmacokinetic (PBPK) modeling. Int J Environ Res Public Health 19

  • Stading R, Gastelum G, Chu C, Jiang W, Moorthy B (2021) Molecular mechanisms of pulmonary carcinogenesis by polycyclic aromatic hydrocarbons (PAHs): implications for human lung cancer. Semin Cancer Biol 76:3–16

    Article  CAS  Google Scholar 

  • Sun L, Ye Z, Ling Y, Cai S, Xu J, Fan C, Zhong Y, Shen Q, Li Y (2020) Relationship between polycyclic aromatic hydrocarbons and rheumatoid arthritis in US general population, NHANES 2003–2012. Sci Total Environ 704:135294

    Article  CAS  Google Scholar 

  • Tam A, Morrish D, Wadsworth S, Dorscheid D, Man SF, Sin DD (2011) The role of female hormones on lung function in chronic lung diseases. BMC Womens Health 11:24

    Article  Google Scholar 

  • Tian J, Zhou F, Zhang XG, Wang HY, Peng SH, Li X, Cao J, Zhang H (2022) Experience of physical activity in patients with COPD: a systematic review and qualitative meta-synthesis. Geriatr Nurs 47:211–219

    Article  Google Scholar 

  • Tooker BC, Quinn K, Armstrong M, Bauer AK, Reisdorph N (2021) Comparing the effects of an exposure to a polycyclic aromatic hydrocarbon mixture versus individual polycyclic aromatic hydrocarbons during monocyte to macrophage differentiation: mixture exposure results in altered immune metrics. J Appl Toxicol 41:1568–1583

    Article  CAS  Google Scholar 

  • Van Winkle LS, Gunderson AD, Shimizu JA, Baker GL, Brown CD (2002) Gender differences in naphthalene metabolism and naphthalene-induced acute lung injury. Am J Physiol Lung Cell Mol Physiol 282:L1122–L1134

    Article  Google Scholar 

  • Vogel CFA, Van Winkle LS, Esser C, Haarmann-Stemmann T (2020) The aryl hydrocarbon receptor as a target of environmental stressors - implications for pollution mediated stress and inflammatory responses. Redox Biol 34:101530

    Article  CAS  Google Scholar 

  • Vogelmeier CF, Roman-Rodriguez M, Singh D, Han MK, Rodriguez-Roisin R, Ferguson GT (2020) Goals of COPD treatment: focus on symptoms and exacerbations. Respir Med 166:105938

    Article  Google Scholar 

  • Wang S, Bai Y, Deng Q, Chen Z, Dai J, Li X, Zhang W, Zhang X, He M, Wu T, Guo H (2016) Polycyclic aromatic hydrocarbons exposure and lung function decline among coke-oven workers: a four-year follow-up study. Environ Res 150:14–22

    Article  CAS  Google Scholar 

  • Wang Y, Meng L, Pittman EN, Etheredge A, Hubbard K, Trinidad DA, Kato K, Ye X, Calafat AM (2017) Quantification of urinary mono-hydroxylated metabolites of polycyclic aromatic hydrocarbons by on-line solid phase extraction-high performance liquid chromatography-tandem mass spectrometry. Anal Bioanal Chem 409:931–937

    Article  CAS  Google Scholar 

  • Webber EM, Lin JS, Thomas RG (2022) Screening for chronic obstructive pulmonary disease: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA 327:1812–1816

    Article  Google Scholar 

  • World Health Organization (2019) Global health estimates: leading causes of death. Cause-specific mortality 2000–2019

  • Yang L, Wang WC, Lung SC, Sun Z, Chen C, Chen JK, Zou Q, Lin YH, Lin CH (2017) Polycyclic aromatic hydrocarbons are associated with increased risk of chronic obstructive pulmonary disease during haze events in China. Sci Total Environ 574:1649–1658

    Article  CAS  Google Scholar 

  • Yu G, Jin M, Huang Y, Aimuzi R, Zheng T, Nian M, Tian Y, Wang W, Luo Z, Shen L, Wang X, Du Q, Xu W, Zhang J, Shanghai Birth Cohort S (2021) Environmental exposure to perfluoroalkyl substances in early pregnancy, maternal glucose homeostasis and the risk of gestational diabetes: a prospective cohort study. Environ Int 156:106621

    Article  CAS  Google Scholar 

  • Zhou Y, Zou Y, Li X, Chen S, Zhao Z, He F, Zou W, Luo Q, Li W, Pan Y, Deng X, Wang X, Qiu R, Liu S, Zheng J, Zhong N, Ran P (2014) Lung function and incidence of chronic obstructive pulmonary disease after improved cooking fuels and kitchen ventilation: a 9-year prospective cohort study. PLoS Med 11:e1001621

    Article  Google Scholar 

  • Zysman M, Raherison-Semjen C (2021) Women’s COPD. Front Med (Lausanne) 8:600107

    Article  Google Scholar 

Download references

Acknowledgements

We acknowledged all participants involved in our analysis and the staff of the National Center for Health Statistics at the CDC who designed, collected, and managed the NHANES data.

Author information

Author notes

  1. Lin Wen, Xiaosong Ben, and Zhiyu Yang contributed equally to this work.

Authors and Affiliations

  1. Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No. 601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China

    Lin Wen, Zhiyu Yang, Yingying Wu, Yuxuan Tan, Qian Chen, Huanzhu Liang, Yexin Li, Xiaomei Wu, Shan Liu, Xueqiong Weng & Chunxia Jing

  2. Department of Thoracic Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China

    Xiaosong Ben & Dan Tian

  3. Guangdong Key Laboratory of Environmental Exposure and Health, Jinan University, Guangzhou, 510632, Guangdong, China

    Chunxia Jing

Authors
  1. Lin Wen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xiaosong Ben
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zhiyu Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yingying Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yuxuan Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Qian Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Huanzhu Liang
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yexin Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Xiaomei Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Shan Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Xueqiong Weng
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Dan Tian
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Chunxia Jing
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Lin Wen, Xiaosong Ben, and Zhiyu Yang: formal analysis, writing (original draft and reviewing and editing), conceptualization, and methodology

Yingying Wu and Yuxuan Tan: software, validation, and visualization

Qian Chen, Huanzhu Liang, and Yexin Li: data curation and validation

Xiaomei Wu, Shan Liu, Xueqiong Weng, and Dan Tian: software and investigation

Chunxia Jing: resources, validation, supervision, writing (reviewing and editing), and project administration

Corresponding author

Correspondence to Chunxia Jing.

Ethics declarations

Ethics approval and consent to participate

The NHANES agreement has been reviewed and approved by the NCHS Research Ethics Committee. All participants provided written informed consent prior to participation.

Consent for publication

The manuscript is approved by all authors for publication.

Competing interests

The authors declare no competing interests.

Additional information

Responsible Editor: Lotfi Aleya

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 34 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wen, L., Ben, X., Yang, Z. et al. Association between co-exposure of polycyclic aromatic hydrocarbons and chronic obstructive pulmonary disease among the US adults: results from the 2013–2016 National Health and Nutrition Examination Survey. Environ Sci Pollut Res 30, 62981–62992 (2023). https://doi.org/10.1007/s11356-023-26413-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11356-023-26413-7

Keywords

Search

Navigation