Associations of Lifestyle and Dietary Factors with Urinary Bisphenol A, S, and F: Evidence from the Korean National Environmental Health Survey IV (2018–2020)

Bisphenol A, Bisphenol S, and Bisphenol F are widely used plastic additives and endocrine-disrupting chemicals with potential adverse health effects. Limited research has examined lifestyle and dietary factors influencing human exposure to these compounds. This study investigated associations between urinary bisphenol concentrations and demographic, lifestyle, dietary, and food-handling factors in 4239 Korean adults aged 19 to 82 years (1889 men, 44.6%; 2350 women, 55.4%) from the Korean National Environmental Health Survey (2018-2020). Median urinary concentrations with interquartile ranges were 1.15 µg/L (IQR: 0.45-2.27) for BPA, 0.17 µg/L (IQR: 0.06-0.41) for BPF, and 0.15 µg/L (IQR: 0.06-0.38) for BPS. Urinary bisphenol concentrations differed significantly by gender, age, smoking status, alcohol consumption, and education level (<i>p</i> < 0.001), with higher concentrations in younger males, smokers, and alcohol consumers. Frequent consumption of instant noodles, microwaveable foods, canned foods, and plastic-wrapped takeout was significantly associated with elevated bisphenol levels (<i>p</i> < 0.001). Use of plastic containers, coated cookware, and electric rice cookers was linked to higher urinary BPA and BPS concentrations. BPA showed statistically significant but weak positive correlations with serum creatinine (r = 0.044, <i>p</i> < 0.05) and height (r = 0.037, <i>p</i> < 0.05), as assessed using Pearson's correlation test. BPF was negatively correlated with aspartate aminotransferase (AST) levels (r = -0.042). Public health strategies should prioritize safer food storage practices and enhance awareness of health risks associated with these chemicals.