NHANES的趋势在颁布加利福尼亚州的主张65之后，在加利福尼亚和美国的暴露趋势

美国商务中有毒化学物质的流行促使一些州采用法律以减少暴露。一个具有广泛范围的是加利福尼亚的命题65（Prop 65），该命题建立了造成癌症，发育伤害或生殖毒性的化学物质清单。该法律旨在阻止企业使用这些化学物质并最大程度地减少消费者的接触。但是，一个关键问题仍未得到答复：在列出的化学物质中，人口水平的暴露量减少了65个吗？我们使用了来自疾病控制与预防中心（CDC）的国家生物监测数据来评估Prop 65对人口水平的暴露的影响。我们评估了37种化学物质的血液和尿液含量，包括拟态，phthalates，phthals，perfs，perfs evers，perf s，pers perf s，perf s，perf s，perf sem，perf and perf sem，perf sem p。和营养检查调查（NHANES）参与者与化学品65列表有关的参与者。其中，在生物监测期之前，在11期之前，11点和4个列出了11个。其余11个未列出，但与65上市化学物质密切相关。如果使用差异差异模型，与非卡利福尼亚人相比，我们估计加利福尼亚人的浓度随着时间的推移而估计的加利福尼亚人的浓度随着时间的流逝而估计，则可以使用生物监测数据。我们使用分位数回归来估计随着时间的推移暴露的变化，以及在第25、75％和第95个百分位数的加利福尼亚人和非加利福尼亚人之间的差异。我们发现，在ProP 65名单中纳入的生物监控化学物质的浓度通常随着时间的推移而在全国范围内下降。 BPA在Prop 65上上市后，双酚A（BPA）浓度降低了15％，而在同一时期，非列入但密切相关的双酚S（BPS）的浓度增加了20％，表明化学替代。加利福尼亚人通常比美国其他人口的生物监测化学物质水平较低。我们的发现表明，科学和法规的关注增加，以及公众对ProP 65上市化学物质的危害的认识，引发了产品配方的变化，从而减少了全国范围内这些化学物质的暴露。双酚和几种邻苯二甲酸盐的趋势表明，制造商用密切相关但未静置的化学物质取代了一些列出的化学物质，从而增加了对替代品的接触。我们的发现对减少有毒暴露的政策，生物监测计划的设计有影响，以告知政策干预措施以及对影响化学暴露的监管和市场力量的未来研究。 https://doi.org/10.1289/ehp13956。

The prevalence of toxic chemicals in US commerce has prompted some states to adopt laws to reduce exposure. One with broad reach is California's Proposition 65 (Prop 65), which established a list of chemicals that cause cancer, developmental harm, or reproductive toxicity. The law is intended to discourage businesses from using these chemicals and to minimize consumer exposure. However, a key question remains unanswered: Has Prop 65 reduced population-level exposure to the listed chemicals?We used national biomonitoring data from the Centers for Disease Control and Prevention (CDC) to evaluate the impact of Prop 65 on population-level exposures.We evaluated changes in blood and urine concentrations of 37 chemicals (including phthalates, phenols, VOCs, metals, PAHs, and PFAS), among US National Health and Nutrition Examination Survey (NHANES) participants in relation to the time of chemicals' Prop 65 listing. Of these, 11 were listed prior to, 11 during, and 4 after the biomonitoring period. The remaining 11 were not listed but were closely related to a Prop 65-listed chemical. Where biomonitoring data were available from before and after the date of Prop 65 listing, we estimated the change in concentrations over time for Californians compared with non-Californians, using a difference-in-differences model. We used quantile regression to estimate changes in exposure over time, as well as differences between Californians and non-Californians at the 25th, 75th, and 95th percentiles.We found that concentrations of biomonitored chemicals generally declined nationwide over time irrespective of their inclusion on the Prop 65 list. Median bisphenol A (BPA) concentrations decreased 15% after BPA's listing on Prop 65, whereas concentrations of the nonlisted but closely related bisphenol S (BPS) increased 20% over this same period, suggesting chemical substitution. Californians generally had lower levels of biomonitored chemicals than the rest of the US population.Our findings suggest that increased scientific and regulatory attention, as well as public awareness of the harms of Prop 65-listed chemicals, prompted changes in product formulations that reduced exposure to those chemicals nationwide. Trends in bisphenols and several phthalates suggest that manufacturers replaced some listed chemicals with closely related but unlisted chemicals, increasing exposure to the substitutes. Our findings have implications for the design of policies to reduce toxic exposures, biomonitoring programs to inform policy interventions, and future research into the regulatory and market forces that affect chemical exposure. https://doi.org/10.1289/EHP13956.