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  4. Vol 6, Issue 1, 2026

Association between exposure to flame retardants, methylmercury, phthalates, and perfluoroalkyl mixtures and depression in US adults

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DOI: 10.23977/phpm.2026.060104 | Downloads: 5 | Views: 194

Author(s)

Qiao Zhang 1, Qiancheng Zhao 1, Mimi Xiao 1

Affiliation(s)

1 Research Center for Medical and Social Development, School of Public Health, Chongqing Medical University, Chongqing, China

Corresponding Author

Mimi Xiao

ABSTRACT

Environmental pollutants often coexist in a mixed form and have neurotoxicity, but previous studies have mostly focused on the association between a single or a certain type of pollutant and depression. This study systematically assessed the individual and mixed effects of environmental chemical mixtures on depressive symptoms using data from 2,986 adults in the 2017–2018 U.S. NHANES. Depression prevalence was 11.3%. Weighted generalized linear regression and restricted cubic splines (RCS) revealed significant associations: MBzP (β=0.05, 95% CI: 0.01–0.08), BCEP (β=−0.04, 95% CI: −0.06–−0.01), and TBBA (β=0.12, 95% CI: 0.07–0.18) showed positive correlations with depressive symptoms, while PFNA (β=−0.04, 95% CI: −0.07–−0.01) exhibited negative correlations, CH₃Hg (β=−0.11, 95% CI: −0.18–−0.04) was shown a negative correlation in the overall mixed effects. Nonlinear relationships were identified for PFNA and CH₃Hg. Mixed-effect models (weighted quantile sum regression and Bayesian kernel machine regression) demonstrated a dose-dependent positive association between chemical mixtures and depressive symptoms, with MBzP, PFNA, and TBBA as key contributors. The exposure-response function indicated increasing trends for MBzP and TBBA, decreasing trends for PFNA and CH₃Hg, and a flat trend for BCEP. Subgroup analyses highlighted different groups of people's effects: PFNA showed stronger associations in older adults (p=0.003) and individuals with high-fasting blood glucose (p=0.027), CH₃Hg in smokers (interaction p=0.017), and BCEP in other race populations (p=0.005). Findings suggest that mixed environmental chemicals exert individual and joint effects on depression, with threshold effects observed for PFNA, CH₃Hg, and BCEP.

KEYWORDS

Chemical mixture, Depression, Mixed exposure, Weighted quantile sum (WQS) regression, Bayesian kernel machine regression (BKMR)

CITE THIS PAPER

Qiao Zhang, Qiancheng Zhao, Mimi Xiao. Association between exposure to flame retardants, methylmercury, phthalates, and perfluoroalkyl mixtures and depression in US adults. MEDS Public Health and Preventive Medicine (2026). Vol. 6, No.1, 23-31. DOI: http://dx.doi.org/10.23977/phpm.2026.060104.

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