Persistent organic pollutants (POPs) remain a major point of concern worldwide, and surveillance monitoring of these contaminants presents a significant challenge. Here, we conducted an assessment of combined exposure to multiple POPs components [10 perfluoroalkyl acids (PFAAs), seven polybrominated diphenyl ethers (PBDEs), six polychlorinated biphenyls (PCBs) and 29 dioxin-like compounds (DLCs)] in relation to gestational diabetes mellitus (GDM) risk, and determined the identification and prioritization of potent components in these POPs mixtures. The results indicated a significant mixture effect and the combined exposure index estimated from multiple POPs components was associated with GDM and glucose homeostasis (P < 0.001). Based on the mixture effects on GDM, the procedure of prioritization identified DLCs as the components of the greatest concern, although at the lowest body burden in the population compared with PBDEs, PFAAs, and PCBs. For glucose homeostasis, BDE-153 was the chemical of top-ranked priority of concern. The final effect-based prioritized list of POPs was DLCs > PBDEs >PFAAs > PCBs. This prioritization is important for developing a more cost-effective regulation framework focusing on the POPs components of the greatest concern to human health.
Keywords: Combined exposure; GDM risk; Glucose homeostasis; POPs mixture; Prioritization.
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