Blood volatile organic aromatic compounds concentrations across adulthood in relation to total and cause specific mortality: A prospective cohort study

Objective We aimed to evaluate the relationship between blood volatile organic aromatic compounds (VOACs) across adulthood and mortality. Methods A total of 16,968 participants from the National health and Nutrition Examination Surveys (NHANES 1988–1994 and 1999–2014) were included in the present study. Cox proportional hazards models were used to explore the associations between VOACs and total or cause-specific mortality. Results A total of 1,282 deaths occurred among 16,968 participants with a median follow-up of 8.06 years. We observed significant positive dose-response relationship between VOACs including benzene, ethylbenzene, o-xylene, m-/p-xylene and BEX (the sum of benzene, ethylbenzene, m-/p-and o-xylene concentrations) and total mortality, the multiple adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were 1.24 (1.13, 1.36), 1.15 (1.04, 1.27), 1.10 (1.00, 1.23), 1.09 (1.01, 1.19) and 1.21 (1.08, 1.35), respectively. In addition, all VOACs significantly elevated risk of the mortality from cancer, and benzene was associated with risk of the mortality from heart disease and the HRs and 95% CIs was 1.39 (1.09–1.77). For non-smokers, benzene, ethylbenzene and BEX were associated with elevated risk of total mortality and the mortality from cancer, and benzene was associated with risk of the mortality from heart disease. Conclusions Blood VOACs are associated with increased risks of total and specific-cause mortality, which are also observed among non-smokers.