Plastic additive components of PM_2.5 increase corrected QT interval: Screening for exposure markers based on airborne...

The impact of industrial chemical components of ambient fine particles (e.g. PM_2.5) on cardiovascular health has been poorly explored. Our study reports for the first time the associations between human exposure to complex plastic additive (PA) components of PM_2.5 and prolongation of heart rate-corrected QT (QT_C) interval by employing a screening-to-validation strategy based on a cohort of 373 participants (136 in the screening set and 237 in the validation set) recruited from 7 communities across China. The high-throughput airborne exposome framework revealed ubiquitous occurrences of 95 of 224 target PAs in PM_2.5, totaling from 66.3 to 555 ng m^-3 across the study locations. Joint effects were identified for 9 of the 13 groups of PAs with positive associations with QT_C interval. Independent effect analysis also identified and validated tris(2-chloroisopropyl) phosphate, di-n-butyl/diisobutyl adipate, and 3,5-di-tert-butyl-4-hydroxybenzaldehyde as the key exposure markers for QT_C interval prolongation and changes of selected cardiovascular biomarkers. Our findings highlight the important contributions of airborne industrial chemicals to the risks of cardiovascular diseases and underline the critical need for further research on the underlying mechanisms, toxic modes of action, and human exposure risks.