Chloroform associated with bone mineral density and bone mineral content in adults: a population-based cross-sectional research

Abstract Background According to a recent cross-sectional study, reduced Bone Mineral Density (BMD) in U.S. adults is associated with co-exposure to several Volatile Organic Compounds (VOCs), and contact with VOCs increases the risk of developing osteoporosis. However, the relationship between chloroform (an essential VOC component) and BMD remains unclear. Consequently, we aimed to explore the relationship between chloroform alone and Bone Mineral Density or Bone Mineral Content (BMD or BMC). Methods Herein, 2,553 individuals aged 18 and above from the National Health and Nutrition Examination Surveys (NHANES) in 2009-2010, 2013-2014, and 2017-2020, were included. We employed two independent t-tests and multi-linear regression models to statistically assess the relationship between chloroform exposure and BMD/BMC in the spine and femoral area. Results A “V”-shaped correlation between chloroform exposure and BMD/BMC was observed in the unadjusted model, particularly in the Ward’s triangle and femoral neck as a whole. A negative correlation was specifically observed for the Ward’s triangle BMD/BMC and L4 BMD/BMC. On the other hand, in the adjusted model, a dominantly negative correlation between the L4 BMC and chloroform exposure was observed over a range of exposure levels. The subgroup analysis revealed a negative correlation between chloroform concentrations and BMC in the femur and spine, especially in women and the 65-80 age population. Conclusion Our study revealed a “V” shaped correlation between chloroform and BMD/BMC of the femur and spine in U.S. adults. This finding highlights the fact that prolonged exposure to chloroform may increase the risk of developing osteoporosis.