Loading ...

Phthalates are chemical compounds found in many everyday consumer products, such as plastic food packaging, polyvinyl chloride (PVC) articles, and certain cleaning or cosmetic products. They are considered endocrine and metabolic disruptors, and their use is regulated in toys, electronic devices, food packaging, medical devices, and cosmetics. Some phthalates are classified as toxic to reproduction. Prenatal exposure could disrupt the development of certain tissues or organs, thus promoting potential health consequences in adulthood that could persist over several generations through epigenetic mechanisms.

Numerous studies have also suggested that phthalates influence the course of pregnancy and may lead to premature birth. However, the proportion of the risk for premature birth attributable to these chemical compounds has not yet been quantified.

Significant Increase in Risk  

That is why a prospective study was conducted in the United States, involving > 5000 women in whom phthalate metabolites were found in urine samples. The concentrations of phthalate metabolites are roughly the same, regardless of the stage of pregnancy. The data confirm the link between phthalate concentration in urine and the risk of premature birth.

Bis(2-ethylhexyl) phthalate (DEHP) was the most widely used phthalate in PVC objects before it was regulated. DEHP is associated with a 45% increase in the risk for premature birth. The most significant increase in risk is associated with urine levels of phthalic acid, diisodecyl phthalate, di-n-octyl phthalate, and diisononyl phthalate. These compounds replaced DEHP after the establishment of regulations limiting the use of the latter.

Premature Births, Substantial Costs

The contribution of phthalates to the occurrence of premature births is far from negligible. Nearly 57,000 preventable premature births occur each year in the United States, with an associated cost of $3.84 billion.

Safer alternatives exist, but the barrier to their use seems to be cost. Therefore, the authors attempted to estimate the environmental burden and health cost of phthalate use, including not only the short- and medium-term consequences of premature births but also child obesity and chronic diseases related to phthalates, such as adult obesity and diabetes, endometriosis, male infertility, and cardiovascular mortality. They estimated that for the United States, this total cost amounts to approximately $100 billion annually, in addition to the cost of the environmental impact of plastic in the United States, which was recently estimated at $250 billion each year.

The authors encouraged individual initiatives to reduce exposure to phthalates. They particularly recommended choosing cosmetics labeled as phthalate-free and replacing plastic-wrapped foods with fresh products.

This story was translated from JIM, which is part of the Medscape professional network, using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.