{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:04:10Z","timestamp":1785416650475,"version":"3.56.0"},"reference-count":23,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"unspecified","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University","award":["ZYGD23001"],"award-info":[{"award-number":["ZYGD23001"]}]},{"name":"Chengdu Science and Technology Program","award":["2024-YF05-00475-SN"],"award-info":[{"award-number":["2024-YF05-00475-SN"]}]},{"name":"he Programs from Science and Technology Department of Sichuan Province","award":["2025ZNSFSC0746"],"award-info":[{"award-number":["2025ZNSFSC0746"]}]},{"name":"he Programs from Science and Technology Department of Sichuan Province","award":["2026NSFSC1901"],"award-info":[{"award-number":["2026NSFSC1901"]}]},{"name":"National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University","award":["Z2024LC003"],"award-info":[{"award-number":["Z2024LC003"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82170784"],"award-info":[{"award-number":["82170784"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82370775"],"award-info":[{"award-number":["82370775"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82503729"],"award-info":[{"award-number":["82503729"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Postdoctoral Fellowship Program of CPSF","award":["GZC20241158"],"award-info":[{"award-number":["GZC20241158"]}]},{"name":"Qimingxing Research Fund for Young Talents, West China Hospital, Sichuan University","award":["HXQMX0059"],"award-info":[{"award-number":["HXQMX0059"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,17]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the association between exposure to specific endocrine-disrupting chemicals (EDCs), air pollutants and the risk of localised prostate cancer (PCa) and to evaluate the combined effect of mixed EDC exposures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A case\u2013control study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Secondary care; a single tertiary hospital in Western China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 580 patients with histologically confirmed localised PCa who underwent radical prostatectomy between May 2021 and June 2023 were included as cases. They were matched 1:2 with 1160 cancer-free controls from the same cohort on age (\u00b15 years) and date of biological sample collection. Key exclusion criteria were a history of other malignancies, androgen deprivation therapy prior to surgery or acute urinary infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>\n                      The primary outcome was the odds of PCa associated with individual and mixed exposures. Primary exposures were urinary concentrations of nine bisphenols (BPs) and nine phthalate metabolites (quantified via high-performance liquid chromatography\u2013tandem mass spectrometry) and estimated ambient air pollution exposure (sulphur dioxide (SO\n                      <jats:sub>2<\/jats:sub>\n                      ) and PM\n                      <jats:sub>\u2082.\u2085<\/jats:sub>\n                      ) based on geocoded residential addresses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 580 cases and 1160 controls were included in the final analysis. Exposure to the highest quartile of sulphur dioxide (SO\n                      <jats:sub>2<\/jats:sub>\n                      ) over 5 years (9.37\u201328.79 \u00b5g\/m\n                      <jats:sup>3<\/jats:sup>\n                      ) was significantly associated with PCa, yielding an OR of 1.65 (95% CI 1.08 to 2.72; p&lt;0.001) compared with the lowest quartile (3.61\u20136.89 \u00b5g\/m\n                      <jats:sup>3<\/jats:sup>\n                      ). Urinary concentrations of multiple phthalate metabolites (MECPP, MEHHP and MEHP) and BPs (bisphenol A (BPA) and BPZ) were significantly higher in cases (all p&lt;0.05). Weighted quantile sum (WQS) regression analysis demonstrated a significant positive association between the mixture of EDCs and PCa risk (WQS OR=1.26, 95% CI 1.20 to 1.33; p&lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Exposure to SO\n                      <jats:sub>2<\/jats:sub>\n                      and specific EDCs (both individually and as a mixture) is significantly associated with localised PCa.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ChiCTR1900024623.<\/jats:p>\n                  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