Concentrations of bisphenol-A in adults from the general population: A systematic review and meta-analysis

Background: Human bisphenol-A (BPA) exposure has been linked to adverse health effects even at low doses, which may be of potential public health concern. Objective: To summarize BPA concentrations in general human population and their variability according to sex, geographic area, and analytical method. Methods: Systematic review and meta-analysis of studies reporting BPA concentrations in adult human populations. Separate meta-analyses of median values were carried out for BPA in serum, creatinine-adjusted urinary BPA, and unadjusted urinary BPA concentrations using a random-effects model. Cochran's Q-statistic, I2 index, 95% prediction intervals (PIs), between-studies standard deviation (τ), and forest plots were applied to verify study heterogeneity. Sensitivity and subgroup analyses and weighted ANOVAs and meta-regressions were conducted. Funnel plots and Egger's tests were used to examine publication bias. Results: Fifteen studies were included in the meta-analysis, totaling 28,353 participants. BPA was detected in over 90% of participants. The pooled creatinine-adjusted urinary BPA concentration was 1.76 μg/g (95% PI: 0.79–2.73), with individual estimates ranging between 1.20 and 2.41. The pooled estimate for unadjusted urinary BPA was 1.91 μg/l (95% PI: 0–3.97), ranging between 0.81 and 3.50, while the pooled estimate for serum BPA was 1.75 μg/l (95% PI: 0–10.58), ranging between 0.34 and 3.76. No differences were found by sex, geographic area or analytical technique. Larger sample sizes were associated with lower BPA concentrations. There was large heterogeneity across studies, whereas data for urinary BPA levels suggested a publication bias affecting research in low exposed populations. Conclusion: This first meta-analysis of human BPA concentrations highlights a widespread population exposure to BPA. Although there was high heterogeneity across studies, the expected range of estimated human BPA concentrations suggests that potential health risks are unlikely. Further studies are warranted to better characterize the epidemiology of human BPA exposure, accounting for ethnic, geographic, individual and environmental variability.This work was supported by the AECC-Junta Provincial de Murcia (FFIS-2006), and received partial funding from the Murcia Biomedical Research Institute (IMIB)-FFIS and the Spanish Biomedical Research Network Center (CIBER) (BOE-A-2020-6018)