Personal care product use among adults in NHANES: associations between urinary phthalate metabolites and phenols and use of mouthwash and sunscreen

Correlates of exposure to phenols, parabens, and triclocarban in the Study of Environment, Lifestyle and Fibroids

We performed a cross-sectional analysis to identify correlates of urinary concentrations of seven phenols (bisphenols A, F, and S; 2,4-dichlorophenol; 2,5-dichlorophenol; benzophenone-3; triclosan), triclocarban, and four parabens (butyl, ethyl, methyl, and propyl). We analyzed baseline data from 766 participants in the Study of Environment, Lifestyle, and Fibroids, a prospective cohort study of 1693 Black women aged 23-34 years residing in Detroit, Michigan (2010-2012). We collected data on demographic, behavioral, and anthropometric factors via telephone interviews, clinic visits, and self-administered questionnaires. For each biomarker, we used linear regression models to estimate mean differences in log-transformed, creatinine-corrected concentrations across factors of interest. Each biomarker was detected in >50% of participants. Median creatinine-corrected concentrations were the highest for methyl paraben (116.8 μg/g creatinine), propyl paraben (16.8 μg/g creatinine), and benzophenone-3 (13.4 μg/g creatinine). Variables most strongly associated with biomarker concentrations included season of urine collection, education, and body mass index (BMI). BMI was positively associated with bisphenol A and S and triclocarban concentrations and inversely associated with butyl and methyl paraben concentrations. In this cohort of Black women, exposure to phenols, parabens, and triclocarban was prevalent and several factors were associated with biomarker concentrations.

Phthalate and BPA Exposure in Women and Newborns through Personal Care Product Use and Food Packaging

Phthalates and bisphenol A (BPA) are used in some personal care products (PCPs) and containers for food processing and packaging. The Plastics and Personal-Care Product use in Pregnancy (P4) Study (2009-10) explored the association between PCP use during pregnancy and the postpartum period among 80 pregnant women and 55 infants and BPA and phthalate concentrations in multiple maternal and infant urine specimens collected throughout the study (n = 1260 samples). The type, frequency, and timing of PCP and food packaging use 24 h before and during the urine collection period was collected at 5 time points for the mother using prospective diaries. Infant urine was collected up to 2 times before 3 months of age, and mothers answered questions about infant feeding and PCP use on their baby. In mothers, monoethyl phthalate (MEP) metabolite concentrations were significantly higher when women reported using makeup or body lotion in the last 24 h. MEP concentrations were consistently higher when the usage occurred within 0-6 h before the urine sample collection for almost all of the PCP categories. Infant lotion or baby powder application in the previous 24 h was associated with higher phthalate metabolite concentrations in infants. Total BPA metabolite concentrations were lower in exclusively breastfed infants compared to those who were exclusively formula fed or breastfed with supplementation. Given that PCPs tend to undergo frequent formulation changes, which could impact the relative importance of a certain product type as a source of exposure, continued research of this type is warranted.

Urinary concentrations of benzophenone-3 and reproductive outcomes among women undergoing infertility treatment with assisted reproductive technologies

Benzophenone-3 is used in a variety of cosmetic products as a sunscreen, and has shown weak estrogenic and antiandrogenic activity in animal and in vitro studies. Few studies have evaluated whether benzophenone-3 is associated with reproductive outcomes among women. We studied 304 women undergoing infertility treatment (2007-2017) in the prospective Environment and Reproductive Health cohort study and who underwent 449 treatment cycles (n = 788 urines). Generalized linear mixed models were used with random intercepts to account for multiple cycles, and adjusting for confounders including physical activity. Analyses were also stratified by self-reported moderate/heavy outdoor work. The cycle-specific median (IQR) urinary benzophenone-3 concentration was 147 (58, 462) μg/L, and 98% samples had detectable concentrations. Self-reported sunscreen use, physical activity, and time spent on moderate/heavy outdoor work were positively associated with urinary benzophenone-3. Adjusted probabilities of implantation, clinical pregnancy and live birth were higher in increasing quartiles of benzophenone-3, but these associations were restricted to women who reported spending time outdoors performing moderate/heavy work. Specifically, among these women, those in the highest quartile of benzophenone-3 concentrations had 51% higher implantation (p,trend = 0.02), 68% higher clinical pregnancy (p,trend = 0.01) and 75% higher live birth (p,trend = 0.02) adjusted probabilities than women in the lowest quartile. Benzophenone-3 was unrelated to these outcomes among women who did not report doing moderate/heavy work outdoors. These results confirm that sunscreen use is a source of benzophenone-3 exposure, and show positive associations between benzophenone-3 and pregnancy outcomes, especially among women who reported engaging in outdoor work. Since these associations may be subject to important residual confounding by lifestyle factors, further research is needed to confirm these novel results in other populations, and to investigate whether other factors may be affecting the relation of benzophenone-3 with fertility and other health outcomes.

Exposure to low doses of oxybenzone during perinatal development alters mammary gland morphology in male and female mice

Oxybenzone (benzophenone-3) is an ultraviolet radiation filter commonly used in personal care products including sunscreens, textiles and inks, and food and beverage containers, among others. Due to its widespread use, human exposures to oxybenzone are widespread. Oxybenzone is considered an endocrine disrupting chemical due to its antiestrogenic and antiandrogenic properties. We evaluated the effects of oral exposures to oxybenzone on the growth and morphology of the mammary gland, body weight and anogenital distance in BALB/c mice exposed to 30, 212 or 3000 μg/kg/day in utero and during lactation. Developmental exposures to oxybenzone reduced the size and growth of mammary gland in males prior to and during puberty. In exposed females, oxybenzone reduced mammary cell proliferation, decreased the number of cells expressing estrogen receptor α, and altered mammary gland morphology in adulthood. These results suggest that even low doses of oxybenzone can disrupt hormone sensitive organs during critical windows of development.

Use of antibacterial toothpaste is associated with higher urinary triclosan concentrations in Asian immigrant women living in Vancouver, Canada

BACKGROUND

Triclosan is an antibacterial added to consumer products including toothpastes, cosmetics, and plastic cutting boards. Known to disrupt reproductive and hormonal functioning in animals, epidemiological studies indicate that exposure to triclosan may have similar effects on human health.

METHODS

100 women aged 19 to 45 years born in India or China, Hong Kong, and Taiwan new to the Vancouver (Canada) area were recruited in 2015-2016 by word of mouth, public advertisements, and contacts in health and cultural organizations. Participants completed an interview which queried potential sources of triclosan exposure at home and at work and their urine was tested for triclosan by GC-MS. Determinants of urinary triclosan were assessed by Wilcoxon signed-rank test.

RESULTS

Triclosan was detected in 62% of urine samples, with an overall GM of 14.5 μg/L (95% CI: 9.7-21.7 μg/L; range: <LOD to 1900 μg/L). Colgate Total® toothpaste users had higher urinary triclosan concentrations (median = 34.0 μg/L) than non-users (median = 2.5 μg/L, ρ < 0.001), a result which was unaffected by adjustment for age, income, BMI, and country of birth. South Asian born women had elevated urinary triclosan compared to East Asian born women.

CONCLUSION

Triclosan exposure via a specific antibacterial toothpaste brand was identified in reproductive age newcomer women in Canada. Health education around brushing teeth well while using lower toothpaste volumes or choosing triclosan-free toothpaste would reduce triclosan exposure.

Variations, Determinants, and Coexposure Patterns of Personal Care Product Chemicals among Chinese Pregnant Women: A Longitudinal Study

Exposure to mixtures of personal care product chemicals (PCPCs) is commonplace among the Chinese population; yet, limited data are available on the variations, determinants, and coexposure patterns of PCPCs, particularly among pregnant women at multiple time points during gestation. Here, we measured concentrations of 11 most common PCPCs (five parabens, five benzophenones, and triclosan) in 2823 urine samples collected from 941 pregnant women over three trimesters. Based on the quantification results, we calculated the intraclass correlation coefficient (ICC) to assess within-person variability of targeted compounds, applied linear mixed mode models to explore associations between urinary concentrations of PCPCs and exposure-related factors, and used percentile analysis to evaluate exposure to specific or multiple chemicals at one or three trimesters. Seven targeted compounds: methylparaben (MeP), ethylparaben (EtP), propylparaben (PrP), 4-hydroxybenzophenone (4-OH-BP), 2,4-dihydroxybenzophenone (BP-1), 2-hydroxy-4-methoxybenzophenone (BP-3), and triclosan (TCS) were detected in over 66% of samples. The median urinary concentrations (ng/mL) of MeP, EtP, PrP, 4-OH-BP, BP-1, BP-3, and TCS were 15.44, 0.49, 0.61, 0.16, 0.25, 0.53, and 0.48, respectively. We observed that benzophenones (ICC: 0.46-0.55) and triclosan (ICC: 0.50) were less variable than parabens (ICC: 0.35-0.40). Urinary levels of parabens were related to physical activity frequency; urinary levels of benzophenones were associated with the refurbishment of homes and household income, and urinary levels of triclosan were contingent upon the personal basic information (prepregnancy body mass index and age). Notably, higher levels of benzophenones and triclosan but lower paraben levels were observed in summer than in winter. Both coexposure to high percentiles of multiple pollutants at one trimester and exposure to one pollutant at high-dose through three trimesters were rare in the study population. Our findings suggest that these exposure-related factors should be taken into consideration, and health risks should be assessed on mixtures of pollutants in future epidemiological studies.

Racial disparity in maternal phthalates exposure; Association with racial disparity in fetal growth and birth outcomes

Experimental and observational data implicate phthalates as developmental toxicants. However, few data are available to assess the maternal risks of gestational exposure by race and infant sex. To begin to address this data gap, we characterized associations between maternal urinary phthalate metabolites and birth outcomes among African American and white mothers from a southeastern U.S. population. We enrolled pregnant African American (n = 152) and white (n = 158) women with singleton live births between 18 and 22 weeks gestation. We measured phthalate metabolites (mono-n-butyl phthalate (MBP), monoisobutyl phthalate (MiBP), monobenzyl phthalate (MBzP), mono(2-ethylhexyl) phthalate (MEHP), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono-2-ethyl-5-hydroxyhexyl phthalate (MEHHP), monoethyl phthalate (MEP), monomethyl phthalate (MMP), and the sums of DEHP (ΣDEHP) and DBP (ΣDBP) metabolites) in up to two gestational urine specimens from mothers, and evaluated confounder-adjusted associations per natural log unit greater concentration with birth weight for gestational age z-score, small for gestational age (SGA; <10th %tile), preterm birth (PTB; <37 weeks gestation), and low birth weight (LBW; <2500 g). We also tested for interactions by maternal race and infant sex. We found that lower z-scores were associated with greater MiBP (β = -0.28; 95% CI: -0.54, -0.02) and MMP (β = -0.30; 95% CI: -0.52, -0.09) concentrations, while MEP interacted with race (p = 0.04), indicating an association among whites (β = -0.14; 95% CI: -0.28, 0.001) but not among African Americans (β = 0.05; 95% CI = -0.09, 0.19). Greater MiBP (OR = 2.82; 95% CI: 1.21, 6.56) and MEOHP (OR = 2.80; 95% CI: 1.05, 7.42) were associated with an overall higher SGA risk, greater MEHP was associated with higher SGA risk (p = 0.10) in whites (OR = 3.26 95% CI: 0.64, 16.56) but not in African Americans (OR = 0.71 95% CI: 0.07, 7.17), and the associations for MiBP (p = 0.02) and ΣDBP (p = 0.02) varied by infant sex. We detected interactions for PTB in which African Americans were at higher risk than whites for greater MiBP (p = 0.08) and MEP (p = 0.02) although lower risk for greater MEHP (p = 0.09). Greater MEP was associated with an overall higher LBW risk (OR = 1.33; 95% CI: 0.95, 1.86), and males were at higher risk than females with greater MBP (p = 0.002), MiBP (p = 0.02), MBzP (p = 0.01), MEP (p = 0.002), MMP (p = 0.09), and ΣDBP (p = 0.01) concentrations. Overall, our results suggest that gestational phthalate exposure is associated with adverse maternal birth outcomes, and that the effects vary by maternal race and infant sex.

Prenatal exposure to parabens and anthropometric birth outcomes: A systematic review

Parabens are ubiquitous substances commonly used as preservatives because of their antibacterial activity. The estrogenic activity of parabens may cause undesirable health effects and adverse birth outcomes. The objective of the present systematic review was to investigate the association between prenatal exposure to parabens and anthropometric birth outcomes. PubMed, Web of Science, Scopus, and Embase databases were systematically searched until April 18, 2018. Of 326 records that remained after removing duplicates, 6 original articles were included in the final analysis after excluding irrelevant articles. The included studies indicated that most of the pregnant mothers were exposed to parabens, especially methyl and propyl parabens. However, no definitive association was found between the prenatal urinary concentration of parabens and birth weight or head circumference. In addition, a positive but non-significant association was detected between birth length and maternal exposure to parabens. The present systematic review revealed that assessment of significant associations in current epidemiological studies is impermissible due to methodological limitations and absence of inter-study consistency. Furthermore, because of the complexity of the effect of environmental factors on health, future large-scale studies with proper study design are required to investigate the effect of parabens exposure on birth outcomes.

Use of dietary supplements in relation to urinary phthalate metabolite concentrations: Results from the National Health and Nutrition Examination Survey

BACKGROUND

Research suggests that dietary supplements may be a source of exposure to phthalates, given that diethyl phthalate (DEP) or di-n-butyl phthalate (DBP) can be components of coatings that facilitate extended release or encapsulate dietary supplements.

METHODS

Using nationally representative data on a population of 12,281 adults ages 20 y + surveyed between 1999 and 2014 from the National Health and Nutrition Examination Survey (NHANES), we evaluated the association between dietary supplement use in relation to urinary phthalate metabolites of DEP (monoethyl phthalate, MEP) and DBP (mono-n-butyl phthalate, MBP). We examined associations pertaining to regular use of multivitamin/multimineral (MVMM) supplements, as well as regular use of any other non-MVMM supplement products, the number of non-MVMM supplement products used, as well as individual supplements potentially containing phthalates (exclusive of MVMM). For each urinary phthalate metabolite, results are presented as the minimally-adjusted and multivariable-adjusted ratio, comparing the geometric mean among users to non-users.

RESULTS

In multivariable models, we observed a significant positive association between regular use of MVMM use and MEP, with persons using MVMM supplements having 11% higher geometric mean MEP than non-users (Ratio: 1.11; 95% CI: 1.04-1.20); no association was observed for MVMM in relation to MBP. No other significant multivariable-adjusted associations were observed, although power was limited in analyses of individual supplements. Associations did not markedly vary by gender; however, the associations of garlic supplement use with MEP and MBP varied by calendar time, with statistically significant positive associations observed in later years.

CONCLUSIONS

A modest significant association was observed between MVMM use and MEP. No other significant associations were observed in our overall multivariable models. Follow-up on the positive association observed between garlic and urinary phthalate metabolite concentrations observed in later years in a well-powered, prospective study would further clarify study findings.

Biomarkers of exposure to SVOCs in children and their demographic associations: The TESIE Study

Semi-volatile organic compounds (SVOCs) are used extensively in consumer and personal care products; electronics; furniture; and building materials and are detected in most indoor environments. As a result, human exposure to mixtures of SVOCs is wide-spread. However, very few studies have measured biomarkers of exposure to multiple SVOC classes, and exposure determinants have not been thoroughly explored, particularly for young children. In this study, we investigated biomarkers of exposure to SVOCs among children (age 3-6 years), who may experience higher exposures and be more susceptible to adverse health outcomes than other age groups. We enrolled 203 participants in the Toddlers Exposure to SVOCs in Indoor Environments (TESIE) study (181 provided urine samples and 90 provided serum samples).We quantified 44 biomarkers of exposure to phthalates, organophosphate esters (OPEs), parabens, phenols, antibacterial agents and per- and polyfluoroalkyl substances (PFASs); we detected 29 of the 44 biomarkers in >95% of samples, and many biomarkers were detected at higher median concentrations than those previously reported in the U.S. general population. Demographic characteristics were associated with differences in concentrations. In general, non-Hispanic white race and higher maternal education were associated with lower concentrations, even after adjusting for other potential confounding variables. Our results suggest that outdoor temperature at the time of biospecimen collection may be a particularly important and under-evaluated predictor of biomarker concentrations; statistically significant relationships were observed between 10 biomarkers and outdoor temperature at the time of collection. A complex correlation structure was also observed among the biomarkers assessed. By and large, statistically significant correlations between biomarkers of exposure to phthalates, parabens, phenols, and OPEs were positive. Conversely, although PFASs were positively correlated with one another, they tended to be negatively correlated with other biomarkers where significant associations were observed. Taken together, our results provide evidence that the assessments of SVOC-associated health impacts should focus on chemical mixtures.

Impacts of bisphenol A (BPA) and phthalate exposures on epigenetic outcomes in the human placenta

The placenta guides fetal growth and development. Bisphenol A (BPA) and phthalates are widespread environmental contaminants and endocrine disruptors, and the placental epigenetic response to these chemicals is an area of growing research interest. Therefore, our objective was to summarize research linking BPA or phthalate exposure to placental outcomes in human pregnancies, with a particular focus on epigenetic endpoints. In PubMed, studies were selected for review (without limiting start date and ending on 1 May 2018) if they reported any direct effects of BPA or phthalates on the placenta in humans. Collectively, available studies suggest that BPA and phthalate exposures are associated with changes to placental micro-RNA expression, DNA methylation, and genomic imprinting. Furthermore, several studies suggest that fetal sex may be an important modifier of placental outcomes in response to these chemicals. Studies in humans demonstrate associations of BPA and phthalate exposure with adverse placental outcomes. Moving forward, more studies should consider sex differences (termed "placental sex") in the measured outcomes, and should utilize appropriate statistical approaches to assess modification by fetal sex. Furthermore, more consistent sample collection and molecular outcome assessment paradigms will be indispensable for making progress in the field. These advances, together with improved non-invasive tools for measuring placental function and outcomes across pregnancy, will be critical for understanding the mechanisms driving placental epigenetic disruption in response to BPA and phthalates, and how these disruptions translate into placental and fetal health.

Preconception and prenatal urinary concentrations of phenols and birth size of singleton infants born to mothers and fathers from the Environment and Reproductive Health (EARTH) study

BACKGROUND

Although pregnancy concentrations of some phenols have been associated with infant size at birth, there is limited data on the effect of preconception exposure.

OBJECTIVE

We aimed to examine paternal and maternal preconception and maternal prenatal urinary phenol concentrations in relation to birth weight and head circumference.

METHODS

We evaluated 346 singletons born to 346 mothers and 184 fathers (184 couples) from a prospective preconception cohort of subfertile couples from the Environment and Reproductive Health (EARTH) Study in Boston, USA. We used multiple urine samples collected before the index pregnancy in both men and women to estimate mean preconception urinary benzophenone-3, triclosan, butylparaben, propylparaben, methylparaben, or ethylparaben concentrations. We also estimated mean maternal prenatal urinary phenol concentrations by averaging trimester-specific urine samples. Birth weight and head circumference were abstracted from delivery records. We estimated the association of natural log-phenol concentrations with birth outcomes using multivariable linear regression models, adjusting for known confounders.

RESULTS

In adjusted models, each log-unit increase in paternal preconception benzophenone-3 concentration was associated with a 137 g increase in birth weight (95% CI: 60, 214). Additional adjustment for prenatal benzophenone-3 concentration strengthened this association. None of the maternal preconception phenol concentrations were associated with birth weight. However, maternal prenatal triclosan concentrations were associated with a 38 g decrease in birth weight (95% CI: -76, 0). Few associations were observed between phenols and head circumference except for a decrease of 0.27 cm (95% CI: -54, 0) in relation to maternal preconception methylparaben concentration.

CONCLUSIONS

Although our findings should be interpreted in light of inherent study limitations, these results suggest potential evidence of associations between some paternal or maternal phenol concentrations and birth size.

Childhood and adolescent phenol and phthalate exposure and the age of menarche in Latina girls

BACKGROUND

The age of menarche has been associated with metabolic and cardiovascular disease, as well as cancer risk. The decline in menarcheal age over the past century may be partially attributable to increased exposure to endocrine disrupting chemicals (EDCs).

METHODS

We assessed the influence of 26 phenol and phthalate biomarkers on the timing of menarche in a longitudinal cohort of Chilean girls. These EDCs were quantified in urine collected prior to the onset of breast development (Tanner 1; B1), and during adolescence (Tanner 4; B4). Multivariable accelerated failure time (AFT) models were used to analyze associations between biomarker concentrations and the age of menarche adjusting for body mass index (BMI) Z-score and maternal education, accounting for within-subject correlation.

RESULTS

Several biomarkers were significantly associated with the age at menarche; however, these associations were dependent on the timing of biomarker assessment. A log(ng/ml) increase in B1 concentrations of di(2-ethylhexyl) phthalate biomarkers was associated with later menarche (hazard ratio (HR): 0.77; 95% CI: 0.60, 0.98), whereas higher B1 concentrations of 2,5-dichlorophenol and benzophenone-3 were associated with earlier menarche (HR: 1.13; 95% CI: 1.01, 1.27; HR: 1.17; 95% CI: 1.06, 1.29, respectively). Elevated B4 concentrations of monomethyl phthalate were similarly associated with earlier menarche (HR: 1.30; 95% CI: 1.10, 1.53). The impact of monoethyl phthalate and triclosan concentrations on pubertal timing were significantly modified by BMI Z-score. Higher monoethyl phthalate and triclosan concentrations were associated with earlier menarche among overweight or obese girls, but not among those that were normal weight.

CONCLUSIONS

This study identifies modulation of sexual maturation by specific EDC biomarkers in Latina girls.

Distribution and predictors of urinary concentrations of phthalate metabolites and phenols among pregnant women in the Healthy Start Study

BACKGROUND

Phthalates and phenols are suspected endocrine disrupting chemicals that may adversely impact fetal outcomes following in utero exposure. Understanding predictors of exposure to phthalates and phenols during the prenatal period is important.

METHODS

We measured urinary concentrations of 15 phthalate metabolites and 11 phenols in 446 pregnant women enrolled in the Healthy Start pre-birth cohort. Creatinine-adjusted geometric means (GM) for each urinary biomarker were compared across categories of potential sociodemographic and dietary predictors. To assess the independent relationship between each significant food group predictor and biomarker we used multivariable models, adjusted for sociodemographic predictors.

RESULTS

The phthalate metabolites with the highest concentrations were monoethyl phthalate (GM: 41.1µg/g creatinine) and monocarboxyisooctyl phthalate (GM: 20.5µg/g creatinine). Benzophenone-3 (GM: 124.6µg/g creatinine) and methyl paraben (GM: 119.9µg/g creatinine) were the phenols with the highest concentrations. Concentrations of the metabolites of di-n-butyl phthalate and di(2-ethylhexyl) phthalate were significantly higher in younger, unmarried or unemployed mothers, those who were overweight or obese, those with lower educational attainment, or those of minority race/ethnicity (p-values < 0.05). Metabolites of di-n-butyl phthalate concentrations were 18% lower in those who consumed milk ≥ 7 times per week (95% CI: 30-4%). Benzophenone-3 and triclosan concentrations were significantly higher in older, married, or employed mothers, those with normal body mass index, higher educational attainment, higher household income, or who were non-Hispanic white (p-values < 0.05). Benzophenone-3 concentrations were 62% higher in those who consumed seafood ≥ 5 times per month (95% CI: 16-127%).

CONCLUSIONS

We observed differences in urinary concentrations of phthalates and phenol biomarkers by sociodemographic predictors in an ethnically diverse cohort of pregnant women. These results and future analyses from this prospective cohort will help inform targeted interventions to reduce exposure to these potential endocrine disrupting chemicals during pregnancy.

Characterization of phthalates exposure and risk for cosmetics and perfume sales clerks

High levels of phthalates in name-brand cosmetics products have raised concerns about phthalate exposure and the associated risk for cosmetics sales clerks. We assessed the exposure and risk of phthalates in 23 cosmetics, 4 perfume, and 9 clothing department store sales clerks. We collected 108 urine samples pre- and post-shift and analyzed for phthalate monoesters through liquid chromatography-electrospray ionization-tandem mass spectrometry. Phthalates in 32 air samples were collected and analyzed through gas chromatography-mass spectrometry. Demographic characteristics and information on the exposure scenarios were obtained through questionnaires. Principal component analysis, cluster and risk analysis were applied to identify the exposure profile and risk of phthalate. Median post-shift levels of urinary mono-2-ethylhexyl phthalate (MEHP) and monomethyl phthalate (MMP) were significantly higher than the corresponding pre-shift levels in cosmetics group (53.3 vs. 30.9 μg/g-c for MEHP; 34.4 vs. 22.5 μg/g-c for MMP; both P < 0.05) and the post-shift levels of urinary MMP was significantly higher than the corresponding pre-shift levels in perfume group (26.6 vs. 14.9 μg/g-c, P < 0.05). Median levels of air diethyl phthalate (DEP) in cosmetics (1.77 μg/m³) and perfume (1.75 μg/m³) groups and di-(2-ethylhexyl) phthalate (DEHP) in perfume group (6.98 μg/m³) were higher than those in clothing group (DEP: 0.89; DEHP: 2.16 μg/m³). Over half of cosmetic (70%) and perfume sale clerks had exceeded cumulative risk of phthalate exposure for anti-androgenic effect. We concluded that cosmetic and perfume workers had increased risks of reproductive or hepatic effects for DBP and DEHP exposure. We suggest that not only inhalation but dermal exposure is important route of phthalate exposure for cosmetics and perfume workers.

Predictors and correlations of phthalate metabolite concentrations in urine and seminal plasma among reproductive-aged men

BACKGROUND

Certain phthalates are suspected to be endocrine disruptors that are adversely associated with male reproductive health. However, the predictors and correlations of phthalate metabolite concentrations in urine and seminal plasma among reproductive-aged men have not been thoroughly studied.

OBJECTIVE

To investigate the predictors and correlations of phthalate metabolite concentrations in urine and seminal plasma among adult Chinese males.

METHOD

We measured mono-n-butyl phthalate (MBP), monobenzyl phthalate (MBzP), monomethyl phthalate (MMP), monoethyl phthalate (MEP), mono-n-octyl phthalate (MOP), mono(2-ethylhexyl) phthalate (MEHP), mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) and mono(2-ethyl-5-oxohexyl) phthalate (MEOHP) concentrations in seminal plasma and repeated spot-urine samples from 687 men who visited a reproductive center. Mixed-effect models were used to examine the associations of sociodemographic, lifestyle and medical factors with urinary metabolite concentrations. Linear regression models were used to identify predictors of metabolite concentrations in seminal plasma and correlations between metabolite concentrations in spot urine samples and seminal plasma.

RESULTS

Measurements taken from spot urine samples poorly predicted same-day seminal plasma concentrations (all R²<0.10). Inverse associations were observed between education level and urinary MBP and MEOHP and between household income and urinary MMP; receiving intravenous infusion therapy was associated with increased urinary MBP, MEHHP and MEOHP, use of facial cleanser/cream was associated with increased MEP, and smoking was associated with increased MEHP. The predictors of metabolite concentrations in seminal plasma differed from those in urine, except for the association of intravenous infusion therapy with MBP. BMI was associated with increased seminal plasma MBP, MEHP and MEOHP, smoking was associated with increased MEP, and contact with plastics was associated with increased MEOHP.

CONCLUSIONS

Phthalate metabolite concentrations in adult men varied in accordance with sociodemographic variables, lifestyle factors and intravenous therapy. Measures of metabolite levels in urine may not directly reflect the exposure status of the male reproductive system.

Pre-pubertal exposure with phthalates and bisphenol A and pubertal development

OBJECTIVE

Epidemiological studies indicate associations between childhood exposure with phthalates and bisphenol A (BPA) and the pubertal development. We examined associations between the pre-pubertal phthalate and BPA body burden and the longitudinally assessed sexual maturation of eight- to thirteen-year-old children.

METHODS

We started with eight- to ten-year-old children in the baseline study and quantified phthalate metabolites and BPA in 472 urine samples (250 boys; 222 girls; mean age: 8.8 years). Associations between the pubertal development, assessed in three annual follow-up studies by Puberty Development scale questionnaires (PD scales), and the chemical exposure from the baseline visit were longitudinally analyzed with generalized estimation equations.

RESULTS

The number of children with both chemical measures and PD scores (calculated from the PD scales) was 408. In the third follow-up, 49% of the girls and 18% of the boys had reached mid-puberty. For girls, we observed a delayed pubertal development with the di-hexyl-ethyl phthalate (DEHP) metabolites (β: -0.16 to -0.23; p ≤ 0.05 or p ≤ 0.1), mono-n-butyl phthalate (β: -0.15; 95% CI: -0.31; 0.01), mono-benzyl phthalate (β: -0.11; 95% CI: -0,24; -0,01), and mono-ethyl phthalate (MEP) (β: -0.15; 95% CI: -0.28; -0.01). In addition, significant non-linear associations of the DEHP metabolites and BPA with the PD scores were found, when their quadratic effects were included in the GEE models. In boys, no consistent relationships between the PD scores and the chemicals were detected except of an accelerated development with the ∑DEHP metabolites (β: 0.16; 95% CI: -0.02; -0.34).

CONCLUSION

We found indications that pre-pubertal exposures with phthalates and BPA were associated with pubertal timing in children, particularly in girls. For boys, associations were inconsistent, and not necessarily in line with the known anti-androgenicity of some phthalates during prenatal exposure.

Urinary BPA and Phthalate Metabolite Concentrations and Plasma Vitamin D Levels in Pregnant Women: A Repeated Measures Analysis

BACKGROUND

In addition to its well-established role in maintaining skeletal health, vitamin D has essential regulatory functions in female reproductive and pregnancy outcomes. Phthalates and bisphenol A (BPA) are endocrine disruptors, and previous research has suggested that these chemical agents may disrupt circulating levels of total 25(OH)D in adults.

OBJECTIVES

We investigated the relationships between repeated measures of urinary phthalate metabolites and BPA and circulating total 25(OH)D in a prospective cohort of pregnant women.

METHODS

The present study population includes participants (n=477) in a nested case-control study of preterm birth drawn from a prospective birth cohort of pregnant women at Brigham and Women's Hospital in Boston, Massachusetts. Urine and blood samples were collected for biomarker measurements at median 10 wk and 26 wk of gestation.

RESULTS

In repeated measures analysis, we observed that an interquartile range (IQR) increase in urinary mono-3-carboxypropyl phthalate (MCPP) was associated with a 4.48% decrease [95% confidence interval (CI): -7.37, -1.58] in total 25(OH)D. We also detected inverse associations for metabolites of di(2-ethylhexyl) phthalate (DEHP) [percent difference (%Δ)=-2.83 to -2.16]. For BPA, we observed a nonsignificant inverse association with total 25(OH)D in the overall population. Our sensitivity analysis revealed that the associations for some metabolites (e.g., MEHP) varied by race/ethnicity, which may reflect potential differences in susceptibility. In agreement with findings from repeated measures analysis, we reported that DEHP metabolites and BPA were significantly associated with an approximate 20% increase in the odds of vitamin D deficiency (≤20 ng/mL) [odds ratio (95% CI): 1.19 (1.06, 1.35) for molar sum of DEHP metabolites and 1.22 (1.01, 1.47) for BPA] at median 10 wk and 26 wk, respectively.

CONCLUSIONS

Our results provide suggestive evidence of the potential for environmental exposure to phthalates and/or BPA to disrupt circulating vitamin D levels in pregnancy. https://doi.org/10.1289/EHP1178.

Personal Care Product Use in Men and Urinary Concentrations of Select Phthalate Metabolites and Parabens: Results from the Environment And Reproductive Health (EARTH) Study

BACKGROUND

Personal care products (PCPs) are exposure sources to phthalates and parabens; however, their contribution to men's exposure is understudied.

OBJECTIVES

We examined the association between PCP use and urinary concentrations of phthalate metabolites and parabens in men.

METHODS

In a prospective cohort, at multiple study visits, men self-reported their use of 14 PCPs and provided a urine sample (2004-2015, Boston, MA). We measured urinary concentrations of 9 phthalate metabolites and methylparaben, propylparaben, and butylparaben. We estimated the covariate-adjusted percent change in urinary concentrations associated with PCP use using linear mixed and Tobit mixed regressions. We also estimated weights for each PCP in a weighted binary score regression and modeled the resulting composite weighted PCP use.

RESULTS

Four hundred men contributed 1,037 urine samples (mean of 3/man). The largest percent increase in monoethyl phthalate (MEP) was associated with use of cologne/perfume (83%, p-value<0.01) and deodorant (74%, p-value<0.01). In contrast, the largest percent increase for parabens was associated with the use of suntan/sunblock lotion (66-156%) and hand/body lotion (79-147%). Increases in MEP and parabens were generally greater with PCP use within 6 h of urine collection. A subset of 10 PCPs that were used within 6 h of urine collection contributed to at least 70% of the weighted score and predicted a 254-1,333% increase in MEP and parabens concentrations. Associations between PCP use and concentrations of the other phthalate metabolites were not statistically significant.

CONCLUSIONS

We identified 10 PCPs of relevance and demonstrated that their use within 6 h of urine collection strongly predicted MEP and paraben urinary concentrations. https://doi.org/10.1289/EHP1374.

Ultrasound gel as an unrecognized source of exposure to phthalates and phenols among pregnant women undergoing routine scan

BACKGROUND

Systemic absorption of phthalates and parabens has been demonstrated after dermal application of body lotion, and medical devices such as intravenous bags and tubing have been identified as a source of exposure to di(2-ethylhexyl) phthalate (DEHP). However, use of products during medical procedures such as aqueous gel applied during obstetrical ultrasound in pregnancy has not been investigated as a potential source of endocrine disrupting chemical (EDC) exposure. Human studies have associated EDCs with various adverse pregnancy outcomes. There is a need to identify sources of inadvertent exposure to EDCs especially during vulnerable developmental periods such as pregnancy.

OBJECTIVES

We conducted a pilot study to determine whether use of gel during routine obstetrical ultrasound increased urinary concentrations of phthalate and phenol biomarkers.

METHODS

We recruited 13 women from the Massachusetts General Hospital who provided spot urine samples at the time of their second trimester anatomic survey. The first sample was collected prior to the procedure (pre-exposure, time 1), and two additional samples were obtained at approximately 1-2h (time 2) and 7-12h (time 3) post-exposure following the scan.

RESULTS

Urinary concentrations of several DEHP metabolites and metabolite of diisononyl cyclohexane-1,2-dicarboxylate (DINCH) increased across time. For example, the geometric mean concentrations of mono(2-ethyl-5-hydroxyhexyl) phthalate increased from 3.1ng/ml to 7.1ng/ml (p-value=0.03) between time 1 and time 3. We also observed significant differences in concentrations of metabolites of butylbenzyl phthalate (BBzP), di-n-butyl phthalate (DnBP), and di-isobutyl phthalate (DiBP). For example, mono-n-butyl phthalate (metabolite of DnBP) decreased from 3.5ng/ml to 1.8ng/ml (p-value=0.04) between time 1 and time 2, but then increased to 6.6ng/ml (p-value=0.002) at time 3. Propylparaben concentrations increased from 8.9ng/ml to 33.6ng/ml between time 1 and time 2 (p-value=0.005), followed by a decrease to 12.9ng/ml at time 3 (p-value=0.01). However, we cannot rule out the possibility that some of the observed differences are due to other sources of exposure to these compounds.

CONCLUSIONS

While additional research is needed, this pilot study potentially identifies a previously unknown source of phthalate and paraben exposure among pregnant women undergoing routine ultrasound examination.

Early Phthalates Exposure in Pregnant Women Is Associated with Alteration of Thyroid Hormones

Introduction

Previous studies revealed that phthalate exposure could alter thyroid hormones during the last trimester of pregnancy. However, thyroid hormones are crucial for fetal development during the first trimester. We aimed to clarify the effect of phthalate exposure on thyroid hormones during early pregnancy.

Method

We recruited 97 pregnant women who were offered an amniocentesis during the early trimester from an obstetrics clinic in southern Taiwan from 2013 to 2014. After signing an informed consent form, we collected amniotic fluid and urine samples from pregnant women to analyze 11 metabolites, including mono-ethyl phthalate (MEP), mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP), mono-(2-ethylhexyl) phthalate (MEHP), mono-butyl phthalate (MnBP), of 9 phthalates using liquid chromatography/ tandem mass spectrometry. We collected blood samples from each subject to analyze serum thyroid hormones including thyroxine (T₄), free T₄, and thyroid-binding globulin (TBG).

Results

Three phthalate metabolites were discovered to be >80% in the urine samples of the pregnant women: MEP (88%), MnBP (81%) and MECPP (86%). Median MnBP and MECPP levels in pregnant Taiwanese women were 21.5 and 17.6 μg/g-creatinine, respectively, that decreased after the 2011 Taiwan DEHP scandal. Results of principal component analysis suggested two major sources (DEHP and other phthalates) of phthalates exposure in pregnant women. After adjusting for age, gestational age, TBG, urinary creatinine, and other phthalate metabolites, we found a significantly negative association between urinary MnBP levels and serum T₄ (β = –5.41; p-value = 0.012; n = 97) in pregnant women using Bonferroni correction.

Conclusion

We observed a potential change in the thyroid hormones of pregnant women during early pregnancy after DnBP exposure. Additional study is necessitated to clarify these associations.