Blood Metal and Volatile Organic Compound Mixture Patterns and Prevalent Cancer Among Adults with a Construction Occupational History: An Exploratory NHANES Study

This cross-sectional, hypothesis-generating analysis examined six blood metal and volatile organic compound (VOC) biomarkers in relation to self-reported lifetime cancer history among 136 adults whose longest-held job was in construction in the 2009–2010 National Health and Nutrition Examination Survey (NHANES). The 16 participants reporting cancer contributed 17 cancer reports spanning 10 reported categories; among the 10 cases with an examination age below 80 years and a valid reported diagnosis age, the age-based interval from first reported diagnosis to biomarker measurement had a median of 17 years (range 2–25). Thus, recent blood measurements cannot represent exposure at diagnosis. Hierarchical Bayesian kernel machine regression (BKMR) was fitted to 20 multiply imputed data sets. VOC and metal group posterior inclusion probabilities (PIPs) were 0.586 and 0.474; these are model-dependent selection summaries, not effects or evidence of an occupational source. All primary overall-mixture, single-biomarker, and interaction contrasts had 95% credible intervals spanning zero. The existing model sensitivities included reduced covariates and a joint recode of structurally skipped smoking responses and unobserved alcohol values; in that joint recode, two overall contrasts excluded zero in the inverse direction by a narrow margin. Public NHANES smoking and cotinine files were linked for additional unweighted descriptive checks. Serum cotinine correlated with benzene (Spearman ρ = 0.75), consistent with a substantial recent tobacco-related component but not source attribution. With 16 heterogeneous cases, a time mismatch, unweighted analyses, and an originally imputed smoking skip pattern, the models cannot establish cancer associations or rank causal agents. The results describe this sampled group and remain exploratory.