There is an argument that BPA substitutes may have the same or more deleterious health effects as BPA due to their structural similarity. This study explored the association between urinary BPA substitutes and precocious puberty among girls by including 120 girls with precocious puberty (cases) aged 2–10 years enrolled at Nanjing Children’s Hospital Department of Endocrinology in China between April 2021 to September 2021 and 145 healthy girls (controls) recruited from a primary school. Logistic regression was used to evaluate the effect of single exposures, and Bayesian kernel machine regression (BKMR) and quantile-based g-computation were used for the mixed effect. In the multivariate logistic regression, BPS (bisphenol S), TBBPA (tetrabromobisphenol A), and BPFL (bisphenol-FL) were significantly associated with increased risk of precocious puberty (odds ratio (OR) = 1.75, 95% confidence interval (CI): 1.13, 2.76, p = 0.014), (OR = 1.46, CI: 1.06, 2.05; p = 0.023), and (OR = 1.47, CI: 1.01, 2.18; p = 0.047), respectively. The BMKR and quantile-based g-computation models revealed consistent associations for single exposures and there was insufficient evidence for the associations of the mixed exposure of bisphenols with precocious puberty. In conclusion, BPA substitutes such as BPS, TBBPA, and BPFL may be associated with an increased risk of precocious puberty in girls.

Human exposure to disinfection by-products (DBPs) primarily occurs through the consumption of drinking water. Haloacetamides (HAcAms) are an emerging class of nitrogenous DBPs with higher levels of cytotoxicity and genotoxicity compared to those of regulated DBPs. Detecting ultra-trace levels of HAcAms in drinking water remains challenging despite the availability of multiple detection methods. This paper reports the first use of ultra-performance liquid chromatography–mass spectrometry/mass spectrometry (UPLC-MS/MS) to quantify 13 HAcAms in drinking water without pretreatment. Results from the analysis of water samples collected from four cities in East China showed total HAcAm concentrations of 0.21–6.12 μg L⁻¹, which were comparable to previously reported data from other countries. Further, 11 out of 13 HAcAms were detected in 60 water samples, with diHAcAms being the predominant subclass. DCAcAm and BCAcAm were the primary HAcAms targeted for detection and two Iodo-HAcAms were detected. The average total HAcAm concentration in water samples disinfected with chloramine was significantly higher than that in water samples disinfected with chlorine. Additionally, the total HAcAm concentrations in water samples from a treatment plant (WTP) using the ozone-biological activated carbon (ozone-BAC) process were lower than those in water samples from WTPs that did not use this treatment process. The results of this study have significant implications for monitoring water quality and protecting human health.