Human exposure to drinking water disinfection by-products (DBPs) is potentially linked to high blood pressure (BP), which may be associated with abnormal platelet activation. This study investigated whether the relationship between DBP exposure with platelet change was mediated by BP. DBP biomarkers, such as urinary dichloroacetic acid (DCAA) and trichloroacetic acid (TCAA), BP and platelet indices from 505 adults from a hospital in Shijiazhuang, China were measured. The cross-sectional associations among DCAA and TCAA exposure, BP and platelet indices were explored through multivariable linear regressions, and the mediation effect of BP was evaluated using the Sobel–Goodman test. We observed that DCAA and TCAA were positively associated with systolic BP (all p for trends < 0.01), which was positively associated with platelet count (PLC) (p for trend < 0.05). Mediation analysis indicated that systolic BP fully mediated the associations of DCAA and TCAA with PLC. When BP was controlled, a previously inverse significant relation between DCAA and platelet distribution width (PDW) remained significant (p < 0.05). Obtained results suggested that exposure to DCAA may contribute to decreased PDW in humans. Systolic BP is a possible mediator of the association between DCAA exposure and PLC. TCAA may indirectly positively affect PLC by increasing systolic BP.

人体暴露于饮用水消毒副产物（DBP）可能与高血压（BP）有关，后者可能与血小板活化异常有关。这项研究调查了DBP暴露与血小板变化之间的关系是否由BP介导。测量了来自石家庄一家医院的505名成年人的DBP生物标志物，如尿二氯乙酸（DCAA）和三氯乙酸（TCAA），血压和血小板指数。通过多变量线性回归探索DCAA和TCAA暴露，BP和血小板指数之间的横断面关联，并使用Sobel–Goodman检验评估BP的介导作用。我们观察到DCAA和TCAA与收缩压呈正相关（所有p趋势<0.01），与血小板计数（PLC）呈正相关（趋势<0.05的p）。中介分析表明，收缩压完全介导了DCAA和TCAA与PLC的关联。当控制血压时，DCAA与血小板分布宽度（PDW）之间的先前负相关关系仍然很显着（p <0.05）。获得的结果表明，接触DCAA可能会导致人类的PDW降低。收缩压可能是DCAA暴露与PLC之间的关联的中介。TCAA可能通过增加收缩压而间接地影响PLC。