Environmental Toxicant Exposure and Height Among Children and Adolescents

Environmental toxicants may affect the height of children and adolescents. However, studies on the toxicological effects based on extensive internal exposure omics are still lacking. This study aimed to identify key toxicants associated with height and assess the mediating role of sex steroid hormones. To this end 1660 participants aged 6-19 years from subsample A in the National Health and Nutrition Examination Survey (NHANES) were included. Exposome was characterized by 58 toxicants within 12 families. After assessment by the exposome-wide association analysis and mixture models, we identified 17 toxicants inversely associated with height-for-age Z-scores (HAZ), predominantly metals and volatile organic compound (VOC) metabolites. Tin exhibited the strongest inverse association (β = -0.261), followed by lead (β = -0.230). The primary contributors to reduced height included tin, lead, the VOC metabolite 2-ATCA, ethylene oxide, and nitrate. Notably, males and younger children were the more susceptible subgroups. Furthermore, mediation analysis revealed that sex steroid hormones, particularly total testosterone and estradiol, mediated 8% to 37% of the associations. These findings suggest that endocrine-related pathways may link toxicant exposure to impaired linear growth, highlighting the necessity of reducing exposure during childhood.