Characterizing everyday exposure to volatile organic compounds and upper respiratory health effects.

Volatile organic compounds (VOCs) are relatively understudied pollutants compared to particulate matter but are ubiquitous in outdoor and indoor environments. Prior studies on VOCs on sinonasal health have been difficult to generalize due to limitations in their definitions of VOC exposures. We took a novel, holistic approach to characterize a major fraction of daily VOC exposure and its link to sinonasal health. Our study included 981 participants (mean ages = 58.8 years, ranges = 40-80 years) from the 2013-2014 National Health and Nutrition Examination Survey (NHANES) with available urinary VOC metabolites (mVOC) data. We used two unsupervised techniques to address the association between VOC exposure and sinonasal health outcomes. First, we applied factor analysis to identify the sources of urinary mVOCs. Logistic regression was employed to analyze associations between each source and sinonasal health questionnaires. Uniform Manifold Approximation and Projection (UMAP) was used to identify and compare the exposure patterns in subgroups. Factor analysis found three likely sources of exposure: "household goods", "occupation contaminants", and "fuel emissions". Logistic regression showed that exposure to "household goods" was associated with a 22.2% higher likelihood of multiple sinus infections (p = 0.003), while "fuel emissions" were linked to a 16.4% increase (p = 0.026). UMAP identified subgroups where individuals with lower socioeconomic status, coupled with specific behavioral and lifestyle habits, may face an increased risk of VOC exposure and negative sinonasal health outcomes. Our findings provide evidence that usage of certain everyday goods, exposure to fuel emissions, and the characteristics of one's home and built environment could play a prominent role in an individual's overall VOC exposure and the manifestation of upper respiratory disease.