A Review of Biomonitoring of Phthalate Exposures

Molecular Design and Mechanism Analysis of Phthalic Acid Ester Substitutes: Improved Biodegradability in Processes of Sewage Treatment and Soil Remediation

Phthalic acid esters (PAEs) have the characteristics of environmental persistence. Therefore, improving the biodegradability of PAEs is the key to reducing the extent of ecological harm realized. Firstly, the scoring function values of PAEs docking with various degrading enzymes in sewage treatment were calculated. Based on this, a 3D-quantitative structure-activity relationship (3D-QSAR) model for PAE biodegradability was built, and 38 PAE substitutes were created. By predicting the endocrine-disrupting toxicity and functions of PAE substitutes, two types of PAE substitutes that are easily degraded by microorganisms, have low toxicity, and remain functional were successfully screened. Meanwhile, the differences in the mechanism of molecular degradation difference before and after PAE modification were analyzed based on the distribution characteristics of amino acid residues in the molecular docking complex. Finally, the photodegradability and microbial degradability of the PAE substitutes in the soil environment was evaluated. From the 3D-QSAR model design perspective, the modification mechanism of PAE substitutes suitable for sewage treatment and soil environment degradation was analyzed. We aim to improve the biodegradability of PAEs at the source and provide theoretical support for alleviating the environmental hazards of using PAEs.

Phenols, Parabens, Phthalates and Puberty: a Systematic Review of Synthetic Chemicals Commonly Found in Personal Care Products and Girls' Pubertal Development

PURPOSE OF REVIEW

Exposure to endocrine disrupting chemicals through personal care products (PCPs) is widespread and may disrupt hormone-sensitive endpoints, such as timing of puberty. Given the well-documented (and ongoing) decline in age at menarche in many populations, we conducted a systematic review of the epidemiological literature on exposure to chemicals commonly found in PCPs (including certain phthalates, phenols, and parabens) in relation to girls' pubertal development.

RECENT FINDINGS

The preponderance of research on this topic has examined phthalate exposures with the strongest evidence indicating that prenatal monoethyl phthalate (MEP) concentrations may be associated with slightly earlier timing of puberty, including age at menarche. Findings examining peri-pubertal phthalate exposures and pubertal outcomes were less consistent as were studies of prenatal and peri-pubertal phenol exposures. Very few studies had examined parabens in relation to girls' pubertal development. Common study limitations included potential exposure misclassification related to use of spot samples and/or mistimed biomarker assessment with respect to the outcomes. The role of body size as a mediator in these relationships remains unresolved. Overall, evidence of associations between chemical exposures in PCPs and girls' pubertal development was conflicting. When associations were observed, effect sizes were small. Nevertheless, given the many environmental, social, and behavioral factors in the modern environment that may act synergistically to accelerate timing of puberty, even marginal changes may be cause for concern, with implications for cancer risk, mental health, and cardiometabolic disease in later life.

Di(2-ethylhexyl) phthalate induced thyroid toxicity via endoplasmic reticulum stress: In vivo and in vitro study

Di(2-ethylhexyl) phthalate (DEHP) could induce thyroid injury but the mechanism was unclear. This study combined in vivo and in vitro experiments to clarify the mechanism. In vivo, the offspring of Sprague Dawley rats were gavaged with different doses of DEHP (5, 50, and 250 mg/[kg⋅d]) from in utero to 12 weeks-old. Transcriptome sequencing was used to detect the mRNA expression profile of the offspring's thyroids. Differentially expressed genes were identified, followed by Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. In vitro, Nthy-ori 3-1 cells were exposed to DEHP's metabolite mono (2-ethylhexyl) phthalate (MEHP) to verify the pathway we found by KEGG analysis. The results indicated that DEHP could disorder the thyroid hormones. Compared with the offspring in control group, the mRNA levels of 656 genes were upregulated in the offspring exposed to 50 mg/(kg⋅d) DEHP. The upregulated genes were enriched in the pathway of "protein processing in the endoplasmic reticulum (ER)." It indicated that the ER stress might play significant role in the thyroid toxicity induced by DEHP. In vitro, the mitochondrial membrane potential (ΔΨm) level of cells was decreased while the reactive oxygen species level was increased after MEHP exposure. MEHP increased the intracellular Ca²⁺ level and induced ER stress. After ER stress was inhibited by the 4-phenylbutyric acid, the thyroid toxicity caused by MEHP was alleviated. Taken together, our results indicated that DEHP could induce thyroid toxicity by activating ER stress.

Long-term stability of several endocrine disruptors in the first morning urine samples and their associations with lifestyle characteristics

Parabens, triclosan (TCS), bisphenols, benzophenones, and phthalates are typical endocrine disruptors (EDs) with short half-lives in the human body. The concentration levels of those EDs in a spot urine sample are frequently used in exposure assessment studies, and the reproducibility of urinary levels of these nonpersistent EDs should be considered. In the present study, we consecutively collected 45-day first morning void (FMV) urine samples, as well as daily questionnaires, in six recruited participants and measured the urinary concentrations of six parabens, TCS, nine bisphenols, five benzophenones, and ten phthalate metabolites by using high-performance liquid chromatography-tandem mass spectrometry. MeP, EtP, PrP, TCS, BPA, BPS, BPF, and most phthalate metabolites were frequently detected (over 62 % of samples). The intraclass correlation coefficients (ICCs) for ED concentrations in FMV urine samples ranged from fair to excellent for MeP (0.683), EtP (0.702), BPA (0.505), BPS (0.908), BPF (0.887), BP-3 (0.712), mMP (0.661), mEP (0.523), mBP (0.500), miBP (0.724), mBzP (0.961) and all metabolites of DEHP (0.867-0.957), whereas they were low for PrP (0.321) and TCS (0.306). After creatinine adjustment, the values of ICCs for most target EDs were increased with mild to significant improvement. The stability of ED concentrations was affected by daily diet (MeP, TCS, BPA, mMP, miBP, mBP and mBzP), food containers (PrP and mECPP), use of personal care products (HMWP metabolites), pharmaceuticals (EtP) and recorded activities (BPS, mEHP, mBzP, mEHHP and mEOHP), as confirmed by a general linear mixed model. Furthermore, extending the FMV sampling period improved the probability of acceptable reproducibility (ICCs > 0.40) of MeP, EtP, BP-3 and mEP concentrations. For BPS, BPF and HMWP metabolite concentrations showed high probabilities (>80 %) of acceptable reproducibility in the last three days, and the increasing sample size slowly improved the ability to discriminate the subjects. The results were exactly the opposite for BPA concentrations.

Associations between repeated measures of urinary phthalate metabolites and biomarkers of oxidative stress in a rural agricultural cohort of children with asthma

Phthalate exposure is widespread, and studies suggest an adverse relationship with asthma morbidity, including some support for oxidative stress as an underlying pathophysiological mechanism. Urinary phthalate metabolites have been associated with biomarkers of oxidative stress, but data are few in children diagnosed with asthma. We used participant data from the Home Air in Agriculture Pediatric Intervention Trial (HAPI) to examine longitudinal relationships between phthalates and oxidative stress in a cohort of Latino children with asthma residing in an agricultural community. We used linear mixed-effects models to estimate associations between 11 urinary phthalate metabolites (and one summed measure of di-2-ethylhexyl phthalate (DEHP) metabolites, ∑DEHP) and two urinary biomarkers of oxidative stress: a biomarker of lipid peroxidation via measure of 8-isoprostane and a biomarker of DNA/RNA oxidative damage via combined measure of 8-hydroxydeoxyguanosine (8-OHdG), 8-hydroxyguanosine (8-OHG), and 8-hydroxyguanine. Seventy-nine participants provided 281 observations. In covariate-adjusted models, we observed significant positive relationships between all phthalate metabolites and 8-isoprostane, effect sizes ranging from a 9.3 % (95 % CI: 4.2 %-14.7 %) increase in 8-isoprostane for each 100 % increase (i.e., doubling) of mono-(carboxy-isooctyl) phthalate (MCIOP), to a 21.0 % (95 % CI: 14.3 %-28.2 %) increase in 8-isoprostane for each doubling of mono-n-butyl phthalate (MNBP). For each doubling of mono-(carboxy-isononyl) phthalate (MCINP) and mono-ethyl phthalate (MEP), the DNA/RNA oxidative damage biomarker increased by 6.0 % (95 % CI: 0.2 %-12.2 %) and 6.5 % (95 % CI: 1.4 %-11.9 %), respectively. In conclusion, we provide unique data suggesting phthalate exposure is positively associated with oxidative stress in children with asthma. Our repeat measures provide novel identification of a consistent effect of phthalates on oxidative stress in children with asthma via lipid peroxidation. Confirmation in future studies of children with asthma is needed to enhance understanding of the role of phthalates in childhood asthma morbidity.

Application of wastewater-based epidemiology for estimating population-wide human exposure to phthalate esters, bisphenols, and terephthalic acid

Phthalates, bisphenols (BPs), and terephthalic acid (TPA) are widely used plasticizers and monomers in plastic manufacturing. Most of them are known to have an adverse effect on the human body, functioning as endocrine disruptors and suspected carcinogens. Access to near real-time data on population exposure to plasticizers is essential for identifying vulnerable communities and better protecting and managing public health locally. The objective of the present study was to evaluate population-level exposure to phthalates, BPs, and TPA by measuring urinary metabolites in community wastewater. Composited community wastewater (24-h samples) from five sewer sub-catchments of a southwestern city within the United States were analyzed for urinary biomarkers of phthalates, BPs, and TPA using solid-phase extraction-liquid chromatography-tandem mass spectrometry in conjunction with the isotope dilution method for absolute quantification. Ten of 16 analytes were detected at least once in community wastewater above the method detection limit (MDL), with MDLs ranging from 37 to 203 ng/L. The population normalized mass load of TPA was the highest, followed by the human metabolite of di-(2-ethylhexyl) phthalate (DEHP). Bisphenol S and monoethyl phthalate were detected with the highest frequency. Study findings suggest that analyzing municipal wastewater for chemical indicators of human exposure to plastic constituents is feasible, practicable, and informative, as long as appropriate steps are taken to determine, quantify and account for background levels of plastic analytes in the laboratory environment.

Phthalates cause a low-renin phenotype commonly found in premature infants with idiopathic neonatal hypertension

Since the 1970s, when the initial reports of neonatal hypertension related to renal artery thromboembolism were published, other secondary causes of neonatal hypertension have been reported. Those infants with no identifiable cause of hypertension were labeled with a variety of terms. Herein, we describe such infants as having idiopathic neonatal hypertension (INH). Most, but not all, of these hypertensive infants were noted to have bronchopulmonary dysplasia (BPD). More recently, reports described common clinical characteristics seen in INH patients, whether or not they had BPD. This phenotype includes low plasma renin activity, presentation near 40 weeks postmenstrual age, and a favorable response to treatment with spironolactone. A small prospective study in INH patents showed evidence of mineralocorticoid receptor activation due to inhibition of 11β-HSD2, the enzyme that converts cortisol to the less potent mineralocorticoid-cortisone. Meanwhile, phthalate metabolites have been shown to inhibit 11β-HSD2 in human microsomes. Premature infants can come in contact with exceptionally large phthalate exposures, especially those infants with BPD. This work describes a common low-renin phenotype, commonly seen in patients categorized as having INH. Further, we review the evidence that hypertension in INH patients with the low-renin phenotype may be mediated by phthalate-associated inhibition of 11β-HSD2. Lastly, we review the implications of these findings regarding identification, treatment, and prevention of the low-renin hypertension phenotype seen in premature infants categorized as having INH.

Microbiome alterations associated with phthalate exposures in a US-based sample of Latino workers

Low-wage service sector jobs are largely occupied by racial/ethnic minority workers who often experience an increased risk of elevated chemical exposures, including chemicals like phthalates, compared to the general public. Phthalates have been linked with adverse health effects, including increased risk of atopy and asthma. An important etiological component in respiratory disease, including asthma, is the role of the upper respiratory microbiota in atopic disease development. However, it is unclear how the upper respiratory microbiome is affected by chemical exposures, and how this may impact respiratory outcomes. As Latino workers are often disproportionately exposed to increased concentrations of chemicals and Hispanics have higher rates of adverse respiratory health conditions such as asthma, the aim of this pilot study was to evaluate the effects of 10 unique phthalate urinary biomarkers on the 16S rRNA nasal microbiome. Nasal and urinary samples were collected from 20 facility workers (plumbers, landscapers, electricians) and 20 custodial workers. Our analysis revealed altered microbial composition and diversity according to phthalate urinary biomarker concentration within the two worker groups. Higher urinary biomarker concentrations of select phthalates (MBP, MBIP, and ∑DEHP) were associated with increased Moraxella relative abundance, which has been positively associated with asthma. Within-sample alpha diversity levels were decreased in facility workers and were generally inversely associated with most phthalate urinary biomarker concentrations. Our research suggests that exposure to chemicals in this vulnerable worker group may impact the respiratory microbiome, which may increase risk of development of adverse health conditions. Further research is warranted to refine the mechanistic pathways that underpin the relationships between phthalate exposures and respiratory microbial communities to provide key insights on respiratory pathologies and, most importantly, to identify modifiable risk factors that can be used to direct mitigation efforts aimed at ameliorating the harmful effects of chemical exposures in this understudied occupational population.

Composting and green technologies for remediation of phthalate (PAE)-contaminated soil: Current status and future perspectives

Phthalate esters (PAEs) are hazardous organic compounds that are widely added to plastics to enhance their flexibility, temperature, and acidic tolerance. The increase in global consumption and the corresponding environmental pollution of PAEs has caused broad public concerns. As most PAEs accumulate in soil due to their high hydrophobicity, composting is a robust remediation technology for PAE-contaminated soil (efficiency 25%-100%), where microbial activity plays an important role. This review summarized the roles of the microbial community, biodegradation pathways, and specific enzymes involved in the PAE degradation. Also, other green technologies, including biochar adsorption, bioaugmentation, and phytoremediation, for PAE degradation were also presented, compared, and discussed. Composting combined with these technologies significantly enhanced removal efficiency; yet, the properties and roles of each bacterial strain in the degradation, upscaling, and economic feasibility should be clarified in future research.

Phthalates in dormitory dust and human urine: A study of exposure characteristics and risk assessments of university students

Phthalate diesters (PAEs) are prevalent and potentially toxic to human health. The university dormitory represents a typical and relatively uniform indoor environment. This study evaluated the concentrations of phthalate monoesters (mPAEs) in urine samples from 101 residents of university status, and the concentrations of PAEs in dust collected from 36 corresponding dormitories. Di-(2-ethylhexyl) phthalate (DEHP, median: 68.0 μg/g) was the major PAE in dust, and mono-ethyl phthalate (47.9 %) was the most abundant mPAE in urine. The levels of both PAEs in dormitory dust and mPAEs in urine were higher in females than in males, indicating higher PAE exposure in females. Differences in lifestyles (dormitory time and plastic product use frequency) may also affect human exposure to PAEs. Moreover, there were significant positive correlations between the estimated daily intakes of PAEs calculated by using concentrations of PAEs in dust (EDI_D) and mPAEs in urine (EDI_U), suggesting that PAEs in dust could be a significant source of human exposure to PAEs. The value of EDI_D/EDI_U for low molecular weight PAEs (3-6 carbon atoms in their backbone) was lower than that of high molecular weight PAEs. The contribution rate of various pathways to PAE exposure illustrated that non-dietary ingestion (87.8 %) was the major pathway of human exposure to PAEs in dust. Approximately 4.95 % of university students' hazard quotients of DEHP were >1, indicating that there may be some health risks associated with DEHP exposure among PAEs. Furthermore, it is recommended that some measures be taken to reduce the production and application of DEHP.

Catalytic ozonation with vanadium oxide-doped TiO2 nanoparticles for the removal of di-2-ethylhexyl phthalate

Among various plastic additives, di-2-ethylhexyl phthalate (DEHP) has been a great concern due to its high leaching potential and harmful effects on both human and the ecosystem. For the effective oxidation and mineralization of DEHP by ozone in the existing TiO₂ catalytic processes, the heterogeneous catalyst, vanadium oxide (V₂O₅)-incorporated TiO₂ (V₂O₅/TiO₂), was synthesized. The generation of hydroxyl radicals was promoted by cyclic redox reactions of vanadium atoms in V₂O₅/TiO₂ via the increase of surface oxygen vacancies by the replacement of V⁵⁺ species in the lattice of TiO₂. The catalytic ozonation in the presence of V₂O₅/TiO₂ exhibited the significantly higher degradation of DEHP with the pseudo-second-order kinetic constant of 1.7 × 10⁵ mM^-1min^-1 and the removal efficiency of 58.7% after 60 s in 2 mg/L of ozone. The degradation of DEHP was initiated by the shortening of the alkyl-side chain followed by the opening of esterified benzene moieties.

Micro-contaminant, but immense impact: Source and influence of diethyl phthalate plasticizer on bottom-dwelling fishes

Sustainable plastic-waste management is becoming increasingly challenging as enormous loads of plastic debris regularly accumulate in susceptible ecosystems. The microplastic (MP) particles generated from these plastic wastes are imposing additional threats to these ecosystems due to their small size as well as their ability to adsorb and carry toxic chemicals. The current investigation deals with one such MP-originated toxicant, diethyl phthalate (DEP), and its impact on two species of freshwater loaches from the Western Ghats of India, Lepidocephalichthys thermalis and Indoreonectes evezardi. The MP samples were collected from the sediments of the Mula River and characterized using spectroscopic methods and scanning electron microscopy. Polymers, such as polyvinyl chloride and polypropylene, were identified in the collected MPs. GC-MS analysis of the MP extracts revealed the presence of DEP, confirming the MP waste as a potential source of DEP pollution. Further, to evaluate the effect of DEP on survival of selected loaches, L. thermalis and I. evezardi were exposed to DEP concentrations (18.75-300 mg L^-1) and the lethal DEP dose (LC₅₀) was estimated to be 44.53 mg L^-1 for L. thermalis and 34.64 mg L^-1 for I. evezardi. Fishes were further exposed to sub-lethal DEP concentration for one day (Short term exposure: STE) or eight days (Long term exposure: LTE) to analyze the histological condition and oxidative status of the liver in response to DEP treatment. Histology revealed congestion of sinusoids and vacuolization after the LTE. Higher lipid peroxidation levels were also measured in the livers of both species treated with DEP, which indicated DEP-mediated oxidative damage. The antioxidant enzymes including superoxide dismutase, catalase, peroxidase and glutathione-S-transferase displayed elevated activities in response to STE and LTE of DEP. Collectively, the results demonstrate that MPs in the Mula River are a potential source of DEP. The findings also show that DEP exposure can be fatal to freshwater fishes such as loaches, possibly by causing increased oxidative damage to the hepatic system.

Environmental Pollution with Bisphenol A and Phthalates-A Serious Risk to Human and Animal Health

Pollution of the natural environment is constantly increasing due to industrial development and progressive urbanization [...].

Occurrence and Risk Assessment of Personal PM2.5-Bound Phthalates Exposure for Adults in Hong Kong

We performed personal PM_2.5 monitoring involving 56 adult residents in Hong Kong. Additionally, paired personal and residential indoor fine particle (PM_2.5) samples were collected from 26 homes and from 3 fixed monitoring locations (i.e., outdoor samples). Six PM_2.5-bound phthalate esters (PAEs)-including dimethyl phthalate (DMP), diethyl phthalate (DEP), di-n-butyl phthalate (DnBP), butyl benzyl phthalate (BBP), di(2-ethylhexyl) phthalate (DEHP), and di-n-octyl phthalate (DnOP)-were measured using a thermal desorption-gas chromatography/mass spectrometer method. Average ∑₆PAEs (i.e., summation of six PAE congeners) concentrations in personal PM_2.5 exposure (699.4 ng/m³) were comparable with those in residential indoors (646.9 ng/m³), and both were slightly lower than the outdoor levels. DEHP was the most abundant PAE congener (80.3%-85.0%) and found at the highest levels in different exposure categories, followed by BBP, DnBP, and DnOP. Strong correlations were observed between DEHP with DnBP (r_s: 0.81-0.90; p < 0.01), BBP (r_s: 0.81-0.90; p < 0.01), and DnOP (r_s: 0.87-0.93; p < 0.01) in each exposure category. However, no apparent intercorrelations were shown for PAE congeners. Higher indoor concentrations and a stronger correlation between DMP and DEP were found compared with outdoor concentrations. Principal component analysis affirmed heterogeneous distribution and notable variations in PAE sources across different exposure categories. The average daily intakes of ∑₆PAEs and DEHP via inhalation were 0.14-0.17 and 0.12-0.16 μg/kg-day for adults in Hong Kong. A time-weighted model was used to estimate PAE exposures incorporating residential indoor and outdoor exposure and time activities. The inhalation cancer risks attributable to measured and estimated personal exposure to DEHP exceeded the U.S. EPA's benchmark (1 × 10^-6). The results provide critical information for mitigation strategies, suggesting that PAEs from both ambient and indoor sources should be considered when exploring the inhalation health risks of PAEs exposure.

Fetal exposure to phthalates and bisphenols and DNA methylation at birth: the Generation R Study

BACKGROUND

Phthalates and bisphenols are non-persistent endocrine disrupting chemicals that are ubiquitously present in our environment and may have long-lasting health effects following fetal exposure. A potential mechanism underlying these exposure-outcome relationships is differential DNA methylation. Our objective was to examine the associations of maternal phthalate and bisphenol concentrations during pregnancy with DNA methylation in cord blood using a chemical mixtures approach.

METHODS

This study was embedded in a prospective birth cohort study in the Netherlands and included 306 participants. We measured urine phthalates and bisphenols concentrations in the first, second and third trimester. Cord blood DNA methylation in their children was processed using the Illumina Infinium HumanMethylation450 BeadChip using an epigenome-wide association approach. Using quantile g-computation, we examined the association of increasing all mixture components by one quartile with cord blood DNA methylation.

RESULTS

We did not find evidence for statistically significant associations of a maternal mixture of phthalates and bisphenols during any of the trimesters of pregnancy with DNA methylation in cord blood (all p values > 4.01 * 10^-8). However, we identified one suggestive association (p value < 1.0 * 10^-6) of the first trimester maternal mixture of phthalates and bisphenols and three suggestive associations of the second trimester maternal mixture of phthalates and bisphenols with DNA methylation in cord blood.

CONCLUSIONS

Although we did not identify genome-wide significant results, we identified some suggestive associations of exposure to a maternal mixture of phthalates and bisphenols in the first and second trimester with DNA methylation in cord blood that need further exploration in larger study samples.

Characterization and quantification of endocrine disruptors in female menstrual blood samples

Selected endocrine disrupting chemicals (EDCs) were measured in adult female menstrual blood for the first time in Ghana, Africa, taking into account the importance of non-invasive means of matrices sampling in vulnerable groups, such as pregnant women, the elderly or chronically ill people. The menstrual blood samples of twenty (20) female adults between the ages of 25-45 years were sampled. The Quick, Easy, Cheap, Effective, Rugged and Safe (QuEChERS) method was applied for the extraction and clean up, while gas chromatography-mass spectrometry (GC-MS) was used to measure the selected EDCs in adult female menstrual blood, taking into account the composition of menstrual discharge. Diethyl phthalate (DEP), Dibutyl phthalate (DBP) and Bis (2-ethylhexyl) phthalate (DEHP) were detected in all samples, whereas bisphenol A (BPA) was found in 13 participants. Dimethyl phthalate (DMP) was detected in 7 participants, Di-n-octyl phthalate (DNOP) was detected in 3 participants, Bis (2-ethylhexyl) adipate (DEHA) and pyrimidine were detected in 2 participants, while benzyl butyl phthalate (BBP) was detected in only 1 participant. The maximum concentration of DEP measured was 115.6 µg.L^-1and the minimum was 439 µg.L^-1. DEHP was the next most abundant phthalate with a maximum measured concentration of 982 µg.L^-1 and minimum of 95 µg.L^-1. The presence of parent phthalates (rather than metabolites) in menstrual blood of all participants studied suggests that bioaccumulation of selected phthalate compounds such as DEHP, DEP and DBP may be occurring with appreciable human toxicity though the carcinogenic exposure risks of DEHP via various routes were much lower than 1 × 10^-6 considered to be very low.

Personal care product use and lifestyle affect phthalate and DINCH metabolite levels in teenagers and young adults

Humans are widely exposed to phthalates and their novel substitutes, and considering the negative health effects associated with some phthalates, it is crucial to understand population levels and exposure determinants. This study is focused on 300 urine samples from teenagers (aged 12-17) and 300 from young adults (aged 18-37) living in Czechia collected in 2019 and 2020 to assess 17 plasticizer metabolites as biomarkers of exposure. We identified widespread phthalate exposure in the study population. The diethyl phthalate metabolite monoethyl phthalate (MEP) and three di (2-ethylhexyl) phthalate metabolites were detected in the urine of >99% of study participants. The highest median concentrations were found for metabolites of low-molecular-weight (LMW) phthalates: mono-n-butyl phthalate (MnBP), monoisobutyl phthalate (MiBP) and MEP (60.7; 52.6 and 17.6 μg/L in young adults). 1,2-cyclohexanedicarboxylic acid diisononyl ester (DINCH) metabolites were present in 68.2% of the samples with a median of 1.24 μg/L for both cohorts. Concentrations of MnBP and MiBP were similar to other European populations, but 5-6 times higher than in populations in North America. We also observed large variability in phthalate exposures within the study population, with 2-3 orders of magnitude differences in urinary metabolites between high and low exposed individuals. The concentrations varied with season, gender, age, and lifestyle factors. A relationship was found between high levels of MEP and high overall use of personal care products (PCPs). Cluster analysis suggested that phthalate exposures depend on season and multiple lifestyle factors, like time spent indoors and use of PCPs, which combine to lead to the observed widespread presence of phthalate metabolites in both study populations. Participants who spent more time indoors, particularly noticeably during colder months, had higher levels of high-molecular weight phthalate metabolites, whereas participants with higher PCP use, particularly women, tended to have higher concentration of LMW phthalate metabolites.

The independent and interactive effects of phthalates exposure and hypertension on the indicators of early renal injury in US adults: Evidence from NHANES 2001-2004

The association between phthalates and early renal injury is largely unknown in adults. We aim to explore the associations of phthalates and hypertension with early renal injury, and the interactive effects of phthalate and hypertension on the early renal injury. This study enrolled 3283 U.S. adults from NHANES 2001-2004. We detected nine phthalate metabolites in spot urine. We also measured the multiple indicators of early renal injury, including albumin-to-creatinine (Cr) ratio (ACR), β2-microglobulin (B2M), cystatin C (CYST), and calculated the estimated glomerular filtration rate (eGFR), including Cr-based eGFR, CYST-based eGFR, and Cr-CYST-based eGFR. Multiple linear regression and multivariable logistic regression were used to explore the associations among urinary phthalate metabolites, hypertension, and the indicators of early renal injury. The results showed that monobenzyl phthalate (MBzP), mono (3-carboxypropyl) phthalate (MCPP), and mono (2-ethylhexyl) phthalate (MEHP) were positively associated with ACR, B2M, CYST and negatively associated with three eGFR. Mono(2-ethyl-5-oxohexyl) phthalate (MEOHP) was positively associated with ACR, with a β value of 0.099 (95% CI: 0.046, 0.152). Meanwhile, MEHP was associated with a higher risk of ACR abnormality, with an OR value of 1.258 (95% CI: 1.067, 1.482). MBzP, MCPP, and MEOHP increased the risks of ACR, B2M, CYST, and eGFR abnormality. Hypertension was positively associated with ACR, with a β value of 0.460 (95% CI: 0.360, 0.561). We also found interactive effects of monoethyl phthalate (MEP), MCPP, MBzP, monobutyl phthalate (MnBP), and hypertension on B2M, CYST, and three kinds of eGFR. Our results indicated that certain phthalate metabolites might contribute to increased risks of early renal injury. The hypertension population may be more sensitive to the early renal injury caused by phthalates exposure than the non-hypertension population.

Di(2-ethylhexyl) phthalate disturbs cholesterol metabolism through oxidative stress in rat liver

Di(2-ethylhexyl) phthalate (DEHP) is widely used and has been implicated in hepatotoxicity, although the mechanism is unclear. Here, we investigated the effect of DEHP on hepatic cholesterol metabolism in SD rats exposed to 0 and 300 mg/kg/day DEHP for 12 weeks. An RNA-Seq analysis was performed to describe the hepatic responses to long-term DEHP exposure in combination with serological and oxidative stress parameter measurements. DEHP increased the serum levels of total cholesterol (TC), high-density lipoprotein (HDL), and alanine transaminase (ALT). Moreover, DEHP increased the content of malondialdehyde (MDA) and decreased antioxidant enzyme activities in the liver. Transcriptomic results revealed that DEHP dramatically changed the cholesterol metabolism pathway and oxidation-reduction process and depressed gene expression involved in cholesterol efflux and monooxygenase activity. Total antioxidant capacity (T-AOC) positively correlated with Abcg5 and Abcg8. Overall, this study showed the mechanisms underlying hepatotoxicity caused by DEHP, providing new insights into understanding DEHP poisoning.

Effects of a phthalate metabolite mixture on both normal and tumoral human prostate cells

Phthalates represent a group of substances used in industry that have antiandrogenic activity and are found in different concentrations in human urine and plasma. More than 8 million tons of phthalates are used each year, predominantly as plasticizers in polyvinyl chloride (PVC) products. Phthalates are widely used in everyday consumer products and improperly discarded into the environment. Furthermore, in vivo studies carried out in our laboratory showed that a mixture of phthalates, equivalent to the mixture used in this study, deregulated the expression of genes and miRNAs associated with prostatic carcinogenic pathways. Thus, this study was designed to establish an in vitro model to assess pathways related to cell survival, proliferation, apoptosis, and biosynthesis of miRNAs, using both normal and tumoral prostatic epithelial cells exposed to an environmentally relevant mixture of phthalate metabolites. Tumor (LNCaP) and normal (PNT-2) prostatic epithelial cell lines were exposed for 24 and 72 h to vehicle control or the phthalate mixture. The selected metabolite mixture (1000 μmol/L) consisted of 36.7% monoethyl phthalate (MEP), 19.4% mono(2-ethylhexyl) phthalate (MEHP), 15.3% monobutyl phthalate (MBP), 10.2% monoisobutyl phthalate (MiBP), 10.2% monoisononyl phthalate (MiNP), and 8.2% monobenzyl phthalate (MBzP). Gene expression was performed by qRT-PCR and cell migratory potential was measured using cell migration assays. Our results showed that the mixture of phthalates increased cell turnover, oxidative stress, biosynthesis, and expression of miRNAs in LNCaP cells; thus, increasing their cellular expansive and migratory potential and modulating tumor behavior, making them possibly more aggressive. However, these effects were less pronounced in benign cells, demonstrating that, in the short term, benign cells are able to develop effective mechanisms or more resistance against the insult.

Cumulative risk assessment of dietary exposure to phthalates in pregnant women in Beijing, China

Diet is an important exposure route for phthalates, such as di-iso-butyl phthalate (DiBP), dibutyl phthalate (DBP), bis(2-ethylhexyl) phthalate (DEHP), and benzyl butyl phthalate (BBP). In this study, we aimed to estimate phthalate exposure in the diet of pregnant women and assess the health risk. A total of 517 pregnant women in the first trimester were recruited, and food frequency questionnaires were collected. A simple distribution assessment method was used to estimate daily exposure, and the hazard index (HI) method was used to assess cumulative risk. The maximum daily dietary exposure to DEHP, DBP, DiBP, and BBP was 5.25, 3.17, 2.59, and 0.58 μg/kg bw/day, respectively, and did not exceed the safety limit values. Cereals and vegetables were the main sources of the estimated daily intake (EDI) of phthalates in the diet. The cumulative risk assessment, based on the European Food Safety Authority tolerable daily intake (TDI) and the US Environmental Protection Agency reference dose (RfD), did not exceed the threshold of 1. DiBP, DBP, and DEHP had higher hazard quotient (HQ) values for cumulative health risk than BBP. In conclusion, a low health risk was posed by the cumulative dietary exposure to phthalates for pregnant women in Beijing.

Dibutyl phthalate promotes angiogenesis in EA.hy926 cells through estrogen receptor-dependent activation of ERK1/2, PI3K-Akt, and NO signaling pathways

Dibutyl phthalate (DBP) is an endocrine disruptor that has been widely used in various products of human use. DBP exposure has been associated with reproductive and cardiovascular diseases and metabolic disorders. Although dysfunction of the vascular endothelium is responsible for many cardiovascular and metabolic diseases, little is known about the effects of DBP on human endothelium. In this study, we investigated the effect of three concentrations of DBP (10^-6, 10^-5, and 10^-4 M) on angiogenesis in human endothelial cell (EC) line EA.hy926 after acute exposure. Tube formation assay was used to investigate in vitro angiogenesis, whereas qRT-PCR was employed to measure mRNA expression. The effect of DBP on extracellular signal-regulated kinase 1/2 (ERK1/2), phosphatidylinositol 3-kinase (PI3K)-protein kinase B (Akt), and endothelial nitric oxide (NO) synthase (eNOS) activation was examined using Western blotting, whereas the Griess method was used to assess NO production. Results show that the 24-h-long exposure to 10^-4 M DBP increased endothelial tube formation, which was prevented by addition of U0126 (ERK1/2 inhibitor), wortmannin (PI3K-Akt inhibitor), and l-NAME (NOS inhibitor). Short exposure to 10^-4 M DBP (from 15 to 120 min) phosphorylated ERK1/2, Akt, and eNOS in different time points and increased NO production after 24 and 48 h of exposure. Application of nuclear estrogen receptor (ER) and G protein-coupled ER (GPER) inhibitors ICI 182,780 and G-15, respectively, abolished the DBP-mediated ERK1/2, Akt, and eNOS phosphorylation and increase in NO production. In this study, we report for the first time that DBP exerts a pro-angiogenic effect on human vascular ECs and describe the molecular mechanism involving ER- and GPER-dependent activation of ERK1/2, PI3K-Akt, and NO signaling pathways.

Concurrent Assessment of Phthalates/HEXAMOLL® DINCH Exposure and Wechsler Intelligence Scale for Children Performance in Three European Cohorts of the HBM4EU Aligned Studies

Information about the effects of phthalates and non-phthalate substitute cyclohexane-1,2-dicarboxylic acid diisononyl ester (HEXAMOLL^® DINCH) on children's neurodevelopment is limited. The aim of the present research is to evaluate the association between phthalate/HEXAMOLL^® DINCH exposure and child neurodevelopment in three European cohorts involved in HBM4EU Aligned Studies. Participating subjects were school-aged children belonging to the Northern Adriatic cohort II (NAC-II), Italy, Odense Child Cohort (OCC), Denmark, and PCB cohort, Slovakia. In each cohort, children's neurodevelopment was assessed through the Full-Scale Intelligence Quotient score (FSIQ) of the Wechsler Intelligence Scale of Children test using three different editions. The children's urine samples, collected for one point in time concurrently with the neurodevelopmental evaluation, were analyzed for several phthalates/HEXAMOLL^® DINCH biomarkers. The relation between phthalates/HEXAMOLL^® DINCH and FSIQ was explored by applying separate multiple linear regressions in each cohort. The means and standard deviations of FSIQ were 109 ± 11 (NAC-II), 98 ± 12 (OCC), and 81 ± 15 (PCB cohort). In NAC-II, direct associations between FSIQ and DEHP's biomarkers were found: 5OH-MEHP+5oxo-MEHP (β = 2.56; 95% CI 0.58-4.55; N = 270), 5OH-MEHP+5cx-MEPP (β = 2.48; 95% CI 0.47-4.49; N = 270) and 5OH-MEHP (β = 2.58; 95% CI 0.65-4.51; N = 270). On the contrary, in the OCC the relation between DEHP's biomarkers and FSIQ tended to be inverse but imprecise (p-value ≥ 0.10). No associations were found in the PCB cohort. FSIQ was not associated with HEXAMOLL^® DINCH in any cohort. In conclusion, these results do not provide evidence of an association between concurrent phthalate/DINCHHEXAMOLLR DINCH exposure and IQ in children.

Relationship of individual and mixed prenatal phthalate exposure with placental structure and efficiency in the prospective Ma'anshan Birth Cohort Study

BACKGROUND

Few studies have investigated the associations between prenatal phthalate exposure and placental structure and function with inconsistent conclusions.

METHODS

Nested on the Ma'anshan Birth Cohort study, 2723 women provided spot urine samples during the first, second and third trimesters of pregnancy to analyze six phthalate metabolites. The outcomes of interest were placental weight, efficiency (birth weight/placental weight), chorionic disc area and disc eccentricity. The relationships of prenatal exposure to a single phthalate with placental measures were analyzed. The associations between prenatal phthalate mixture exposure and placental measures were also evaluated.

RESULTS

Most phthalate metabolites were significantly associated with placental weight, efficiency and chorionic disc area during the whole gestation and in each trimester of pregnancy, with different directions of relationships. Sensitivity analyses revealed similar findings, indicating the robustness of the statistical results. Furthermore, inverted U-shaped nonlinear relationships of prenatal exposure to some phthalate metabolites with placental weight, efficiency and chorionic plate area were observed. However, quantile g-computation mixture models did not reveal any association between maternal combined exposure to the total phthalate metabolites and placental measures.

CONCLUSIONS

Maternal exposure to most phthalates and their metabolites was associated with placental weight, efficiency and chorionic plate area in both a linear manner and an inverted U-shaped nonlinear manner. However, the mixture of multiple phthalate metabolites was not observed to be associated with any placental measure.

Association between phthalate exposure and accelerated bone maturation in Chinese girls with early puberty onset: a propensity score-matched case-control analysis

Estrogen can promote the acceleration of bone maturation and phthalate esters (PAEs) have estrogen-mimicking effects. We investigated whether PAEs are associated with the acceleration of bone age (BA) in girls with early onset of puberty (EOP). This case–control study enrolled 254 girls with EOP from the Endocrinology Department at Shenzhen Children’s Hospital between December 2018 and August 2019. Ultra-performance liquid chromatography and tandem mass spectrometry were used to analyze the 10 metabolites of PAEs (mPAEs) in urine samples. BA was measured using an artificial intelligence system. BA exceeding the chronological age (CA) by > 2 years (BA-CA ≥ 2 years) was referred to as significant BA advancement. Participants were divided into groups A (BA-CA ≥ 2 years; case group) and B (BA-CA < 2 years; control group). Propensity score matching (PSM) was performed for both groups in a 1:2 ratio with a caliper of 0.25. To identify potential dose–response relationships between PAEs exposure and BA advancement, we grouped the participants after PSM according to the tertiles of the mPAE concentrations. After PSM, 31 and 62 girls in groups A and B were selected. The concentration of Mono-ethyl phthalate (MEP) in group A was significantly higher than in group B (11.83 μg/g vs. 7.11 μg/g, P < 0.05); there was no significant difference in the levels of other mPAEs between the groups. The degree of BA advancement and proportion of significantly advanced BA in the lowest, middle, and highest tertiles of the MEP sequentially increased, as well as in the lowest, middle, and highest tertiles of Mono-(2-ethyl-5-carboxypentyl) phthalate; however, these were only statistically different between the highest and lowest MEP tertiles (both P < 0.05). For the remaining mPAEs, differences in the degree of BA advancement among the lowest, middle, and highest tertiles, as well as differences in the proportion of significantly advanced BA among the lowest, middle, and highest tertiles, were not significant (all P > 0.05). Our findings suggested that MEP was positively associated with BA advancement in girls with EOP. Exposure to PAEs may promote accelerated bone maturation.

Determinants of phthalate exposures in pregnant women in New York City

Previous studies have provided data on determinants of phthalates in pregnant women, but results were disparate across regions. We aimed to identify the food groups and demographic factors that predict phthalate exposure in an urban contemporary pregnancy cohort in the US. The study included 450 pregnant women from the New York University Children's Health and Environment Study in New York City. Urinary concentrations of 22 phthalate metabolites, including metabolites of di-2-ethylhexylphthalate (DEHP), were determined at three time points across pregnancy by liquid chromatography coupled with tandem mass spectrometry. The Diet History Questionnaire II was completed by pregnant women at mid-pregnancy to assess dietary information. Linear mixed models were fitted to examine determinants of urinary phthalate metabolite concentrations. Using partial-linear single-index (PLSI) models, we assessed the major contributors, among ten food groups, to phthalate exposure. Metabolites of DEHP and its ortho-phthalate replacement, diisononyl phthalate (DiNP), were found in >90% of the samples. The sum of creatinine-adjusted DiNP metabolite concentrations was higher in older and single women and in samples collected in summer. Hispanic and non-Hispanic Black women had lower urinary concentrations of summed metabolites of di-n-octyl phthalate (DnOP), but higher concentrations of low molecular weight phthalates compared with non-Hispanic White women. Each doubling of grain products consumed was associated with a 20.9% increase in ∑DiNP concentrations (95%CI: 4.5, 39.9). PLSI models revealed that intake of dried beans and peas was the main dietary factor contributing to urinary ∑DEHP, ∑DiNP, and ∑DnOP levels, with contribution proportions of 76.3%, 35.8%, and 27.4%, respectively. Urinary metabolite levels of phthalates in pregnant women in NYC varied by age, marital status, seasonality, race/ethnicity, and diet. These results lend insight into the major determinants of phthalates levels, and may be used to identify exposure sources and guide interventions to reduce exposures in susceptible populations.

Dietary microplastics: Occurrence, exposure and health implications

The increasing use of plastic materials generates an enormous amount of waste. In the aquatic environment, a significant part of this waste is present in the form of microplastics (MPs)- particles with a diameter of between 0.1 μm and 5 mm. The arrival of these small plastics in the food chain has been recently documented. MPs have been reported in fishery products, drinking water and sea salt among other foods. Their intestinal absorption is considered limited due to their size, however, they contain a mixture of chemicals intentionally added during their manufacture, which could cross the intestinal barrier. Currently there are not enough data to allow an accurate assessment of the risk associated with dietary exposure to MPs. The lack of robust methodologies is undoubtedly one of the main problems. There is limited information on occurrence in dietary sources (drinking water and food), human intake, toxicokinetics and long term toxicity of these contaminants. The present review describes the studies published so far and points to the need for improved knowledge in order to have a more accurate view of the problems posed by MPs.

Phthalate biomarkers and associations with respiratory symptoms and healthcare utilization among low-income urban children with asthma

BACKGROUND

Phthalates are synthetic chemicals present in building materials, personal care products and other consumer goods. Limited studies link phthalates to pediatric asthma incidence; however, their effects on respiratory-related outcomes among those with pre-existing asthma remains unclear.

OBJECTIVE

We examined associations between phthalates and asthma symptoms, healthcare use, lung function, and lung inflammation among children with asthma.

METHODS

We collected repeated measures of urinary biomarkers for select phthalates and phthalate replacements (MBzP, MCINP, MCIOP, MCPP, MECPTP, MEHHTP, molar sum of DEHP biomarkers [MECPP, MEHHP, MEHP, MEOHP], MEP, MiBP, MnBP) and asthma symptoms, healthcare utilization, lung function, and inflammation among 148 predominantly low-income Black children (5-17 years) with persistent asthma every 3 months for one year. We used generalized estimating equations to assess associations between biomarker concentrations and asthma-related measures adjusting for age, sex, race/ethnicity, caregiver's education level, presence of smokers in the home, and season. We also considered co-exposures to other contaminants previously associated with asthma morbidity.

RESULTS

We observed consistent positive associations with individual DEHP biomarkers, the molar sum of DEHP, and BBzP with increased odds of asthma symptoms and with healthcare utilization (adjusted Odds Ratio for general asthma symptoms: ΣDEHP:1.49,95% Confidence Interval, CI:1.08-2.07; BBzP:1.34, CI:1.04-1.73). We observed similar associations between the DEHP phthalate replacement biomarker MEHHTP and most asthma symptoms evaluated; and with select low molecular weight phthalates (DiBP, DBP) and healthcare utilization. Results were similar when controlling for other environmental exposures (e.g., PM_2.5, BPA). No associations were observed with lung function or inflammation, and overall, we did not observe consistent evidence of sexually dimorphic effects.

CONCLUSION

In the present study, we found evidence to suggest that exposure to select phthalates may be associated with asthma symptoms and healthcare utilization. These findings warrant confirmation given the high asthma burden and widespread and disparate phthalate exposures reported among select populations of color.

Exposure to phthalates, phenols, and parabens mixture and alterations in sex steroid hormones among adolescents

Exposure to phthalates (PAEs), phenols, and parabens has been linked with sex hormone imbalance; however, previous studies were predominantly limited to adults and failed to examine the combined effects of these chemicals mixture among adolescents. Thus, we used the data from the National Health and Nutrition Examination Survey (2013-2016) to explore the associations of urinary PAEs, phenols, and parabens biomarkers with sex hormones among participants aged 12-19 years old (n = 613). Latent class analysis (LCA) and quantile-based g-computation (QGC) were applied to assess the associations of the latent exposure profiles and chemicals mixture with sex hormone indicators, including steroid hormones and sex hormone binding globulin (SHBG), in adolescents and by sex. Using LCA, four latent classes were identified among all participants. Compared with the class characterized by "Low exposure", the class represented by "High PAEs" [mono (2-ethyl-5-carboxypentyl) phthalate (MECPP), mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), and monobenzyl phthalate (MBZP)] had lower level of estradiol (E₂) [β = -0.249, 95% confidence interval (CI): -0.419, -0.08], free androgen index (FAI) (β = -0.258, 95%CI: -0.512, -0.005) and free testosterone (FT) (β = -0.248, 95%CI: -0.496, -0.001) among male adolescents. These results were echoed by the results in QGC analyses, where PAEs mixture was negatively associated with E₂ (β = -0.137, 95% CI: -0.263, -0.011), FAI (β = -0.198, 95%CI: -0.387, -0.008) and FT (β = -0.189, 95%CI: -0.375, -0.002) among male adolescents. By contrast, the associations of the identified latent classes or chemicals mixture with sex hormone indicators were generally nonsignificant among female counterparts, except for a positive association between PAEs mixture and SHBG (β = 0.121, 95%CI: 0.012, 0.23). Our study demonstrated that exposure to PAEs, particularly MECPP, MEHHP, and MBZP, would be a threat to the sex hormone homeostasis of male adolescents.

Levels and health risks of urinary phthalate metabolites and the association between phthalate exposure and unexplained recurrent spontaneous abortion: a large case-control study from China

Phthalate acid esters (PAEs) are environmental endocrine disruptors that can interfere with endocrine processes and cause adverse reproductive outcomes. The link between PAE exposure and unexplained recurrent spontaneous abortion (URSA) remains unknown. In this study, nine urinary metabolites of PAEs (mPAEs) were measured in 594 URSA cases and 569 healthy controls. The measured mPAEs were ubiquitously detected and present at higher levels (median: 203 ng/mL) in the URSA cases than in the controls (median: 161 ng/mL). Multiple logistic regression analysis showed that URSA was associated with higher concentrations of mono (2-ethyl-5-hydroxyhexyl) phthalate (mEHHP), mono (2-ethylhexyl) phthalate (mEHP), and mono-ethyl phthalate (mEP) and lower concentrations of mono-isobutyl phthalate (miBP). Moreover, a quantile-based g-computation (QGC) model revealed a positive association between mPAEs mixture and URSA. The URSA cases showed significantly higher concentrations of di-(2-ethylhexyl) phthalate (DEHP) than the controls. This was consistent with the health risk assessment, which suggested that DEHP is the main contributors to potential non-carcinogenic risk. DEHP accounted for over 80% of total risk. The large case-control study results suggest that PAE exposure may increase the risk of URSA, and that policy-makers and public health experts should pay more attention to DEHP exposure.

Phthalate levels in prenatal and postnatal bedroom dust in the SELMA study

Phthalates are common in polyvinyl chloride (PVC) plastics and numerous consumer goods in our homes from which they can migrate and adhere to indoor dust particles. It is known that indoor dust exposure contribute to human phthalate intake; however, there is a lack of large studies with a repeated-measure design investigating how phthalate levels in indoor dust may vary over time in people's homes. This study investigated levels of seven phthalates and one alternative plasticiser di-iso-nonyl-cyclohexane-di-carboxylate (DiNCH) in bedroom dust collected prenatally around week 25 during pregnancy and postnatally at six months after birth, from 496 Swedish homes. Prenatal and postnatal phthalate levels were compared using correlation and season-adjusted general linear regression models. Over the nine-month period, levels of six out of seven phthalates were associated as indicated by a positive Pearson correlation (0.18 < r < 0.50, P < .001) and Lin's concordance correlation between matched prenatal and postnatal dust samples. Compared to prenatal levels, the season-adjusted postnatal levels decreased for five phthalates, whilst di-ethyl-hexyl phthalate (DEHP), di-2-propylheptyl phthalate (DPHP) and DiNCH increased. The results suggest that families with higher phthalate levels in bedroom dust during pregnancy are likely to remain among those with higher levels in the infancy period. However, all average phthalate levels changed over this specific nine-month period suggesting that available phthalate sources or their use were altered between the dust collections. Changes in home characteristics, family lifestyle, and phthalate replacement trends may contribute to explain the differences.

Associations Between Prenatal Urinary Biomarkers of Phthalate Exposure and Preterm Birth: A Pooled Study of 16 US Cohorts

Importance

Phthalate exposure is widespread among pregnant women and may be a risk factor for preterm birth.

Objective

To investigate the prospective association between urinary biomarkers of phthalates in pregnancy and preterm birth among individuals living in the US.

Design, Setting, and Participants

Individual-level data were pooled from 16 preconception and pregnancy studies conducted in the US. Pregnant individuals who delivered between 1983 and 2018 and provided 1 or more urine samples during pregnancy were included.

Exposures

Urinary phthalate metabolites were quantified as biomarkers of phthalate exposure. Concentrations of 11 phthalate metabolites were standardized for urine dilution and mean repeated measurements across pregnancy were calculated.

Main Outcomes and Measures

Logistic regression models were used to examine the association between each phthalate metabolite with the odds of preterm birth, defined as less than 37 weeks of gestation at delivery (n = 539). Models pooled data using fixed effects and adjusted for maternal age, race and ethnicity, education, and prepregnancy body mass index. The association between the overall mixture of phthalate metabolites and preterm birth was also examined with logistic regression. G-computation, which requires certain assumptions to be considered causal, was used to estimate the association with hypothetical interventions to reduce the mixture concentrations on preterm birth.

Results

The final analytic sample included 6045 participants (mean [SD] age, 29.1 [6.1] years). Overall, 802 individuals (13.3%) were Black, 2323 (38.4%) were Hispanic/Latina, 2576 (42.6%) were White, and 328 (5.4%) had other race and ethnicity (including American Indian/Alaskan Native, Native Hawaiian, >1 racial identity, or reported as other). Most phthalate metabolites were detected in more than 96% of participants. Higher odds of preterm birth, ranging from 12% to 16%, were observed in association with an interquartile range increase in urinary concentrations of mono-n-butyl phthalate (odds ratio [OR], 1.12 [95% CI, 0.98-1.27]), mono-isobutyl phthalate (OR, 1.16 [95% CI, 1.00-1.34]), mono(2-ethyl-5-carboxypentyl) phthalate (OR, 1.16 [95% CI, 1.00-1.34]), and mono(3-carboxypropyl) phthalate (OR, 1.14 [95% CI, 1.01-1.29]). Among approximately 90 preterm births per 1000 live births in this study population, hypothetical interventions to reduce the mixture of phthalate metabolite levels by 10%, 30%, and 50% were estimated to prevent 1.8 (95% CI, 0.5-3.1), 5.9 (95% CI, 1.7-9.9), and 11.1 (95% CI, 3.6-18.3) preterm births, respectively.

Conclusions and Relevance

Results from this large US study population suggest that phthalate exposure during pregnancy may be a preventable risk factor for preterm delivery.

American oysters as bioindicators of emerging organic contaminants in Florida, United States

Per- and polyfluoroalkyl substances (PFAS) and phthalate esters (PAEs) are emerging contaminants of higher concern due to their wide industrial and commercial use, toxicity, and potential adverse health effects. In this study, we assessed PFAS and PAEs exposure in American oysters collected in three study sites in Florida, USA. Potential physiological effects of these contaminants were assessed by collecting oyster biometric data, calculating condition indices, and assessing oxidative stress levels in these individuals. Finally, a human health risk assessment was conducted based on the concentrations found in the consumable Tampa Bay (TB) oysters. All PFAS and PAEs compounds assessed in this study were detected in at least one oyster in all study sites. Among all locations, ΣPFAS concentration range was 0.611-134.78 ng·g^-1 and ΣPAEs <0.328-1021 ng·g^-1. Despite the smaller size of Biscayne Bay (BB) oysters, they displayed the highest concentrations of most of the PFAS and PAEs compounds, which is likely associated with population size, and other sources in the area. Condition index (CI) III was smaller in BB oysters, likely indicating a stressed population. Even though BB oysters were the most affected individuals, Marco Island (MI) oysters displayed the highest levels of lipid peroxidation, which can also be associated with environmental factors and decreased food availability. Conversely, TB oysters exhibited the highest levels of hydrogen peroxide, likely indicating a better defense mechanism in TB oysters compared to MI oysters. The human health risk assessment for TB oysters indicated low risk from PFAS and PAEs exposure, but there is no reference dose for other compounds and the human diet is wider than only oysters. Therefore, the risk of contaminant exposure is likely higher. This study demonstrates the value of integrating data on contaminant exposure and physiological responses of bioindicator specimens to better understand how emerging contaminants are affecting marine wildlife.

Exposure to phthalates in early pregnancy and the risk of fetal growth restriction: a nested case-control study in a Zhuang Chinese population

Phthalates (PAEs) are common endocrine disrupting chemicals (EDCs) that disrupt fetal development. The present study aimed to evaluate the effects of single and coexposure to phthalates in early pregnancy on fetal growth restriction (FGR) by a nested case-control study based on the Guangxi Zhuang Birth Cohort (GZBC). Maternal serum concentrations of seven phthalates in 97 neonates with FGR and 291 matched controls were detected through gas chromatography-mass spectrometry (GC-MS). The associations between phthalates and FGR were analyzed using multiple logistic regression, weight quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) models. We found that exposures to butyl-benzyl phthalate (BBP, OR_adj = 1.849, 95% CI: 1.080-3.177, P_adj = 0.025, P_trend = 0.046), di (2-ethyl-hexyl) phthalate (DEHP, OR_adj = 3.893, 95% CI: 1.305-11.910, P_adj = 0.015, P_trend = 0.098) and dimethyl phthalate (DMP, OR_adj = 1.722, 95% CI: 1.089-2.725, P_adj = 0.020, P_trend = 0.002) were significantly positively associated with the risk of FGR, while mono-butyl phthalate (MBP) showed a significant negative association with FGR (OR_high = 0.192, 95% CI: 0.036-0.795, P_adj = 0.033, P_trend = 0.035) only among girls. The WQS model identified that BBP, di(2-ethyl)phthalate (DEP), DMP, DEHP, di-n-butyl phthalate (DBP), and MBP were highly weighted in the association with FGR. The BKMR model supported the positive association between joint exposure to phthalates and the risk of FGR and identified no significant interaction between the seven phthalates. Overall, maternal exposure to BBP, DEHP, and DMP may cause adverse effects on FGR, especially with combined effects.

Diet quality and exposure to endocrine-disrupting chemicals among US adults

Human exposure to endocrine-disrupting chemicals (EDCs) may increase risk for chronic disease. Diet is a significant source of EDC exposure, yet healthy diets recommended for chronic disease prevention have not been thoroughly examined for associations with EDC exposure. Using data from the National Health and Nutrition Examination Survey 2013-2016, we examined associations of dietary patterns with exposure to non-persistent EDCs potentially consumed through diet. EDCs were measured in spot urine samples. Diet was assessed using 24-h recalls. Multivariable linear regression was used to examine associations of three healthy diet scores [Healthy Eating Index (HEI), relative Mediterranean Diet (rMED), and Dietary Approaches to Stop Hypertension] and fast-food consumption with EDCs. In fully adjusted models, no diet was associated with exposure to the bisphenols, phthalates, or polycyclic aromatic hydrocarbons examined. A 1-point increase in rMED (of 18 possible points) was associated with 2.7% (95% CI: 1.7%, 3.8%) greater urinary nitrate. A 10-point increase in HEI (of 100 possible points) was associated with 5.3% (95% CI: 2.8%, 7.9%) greater nitrate and 6.8% (95% CI: 4.5%, 9.2%) greater perchlorate. Because perchlorate and nitrate can disrupt thyroid hormone production, we conducted an exploratory analysis to examine whether these chemicals mediate an association between diet and thyroid hormones. A 10-point increase in HEI was associated with 0.6% reduced serum total thyroxine (95% CI: 1.7%, 0.5%) among all adults, with 57.5% of the effect explained by perchlorate. Nitrate mediated an association of rMED with modestly reduced total triiodothyronine among females. Most EDCs examined had no association with the diets evaluated, indicating that recommended healthy diets were not protective against EDC exposures. As observed with two thyroid antagonists, some recommended diets may increase EDC exposures and related adverse health outcomes. Additional work should identify effective food production and processing practices to reduce dietary exposures to potentially harmful EDCs.

Prenatal single and combined exposure to phthalates associated with girls' BMI trajectory in the first six years

Evidence of the influence of prenatal phthalate exposure on childhood longitudinal obesity markers is limited. Nested on the Ma'anshan birth cohort study, 990 mother-daughter pairs were included. Seven phthalate metabolites were determined in urine collected in each trimester. Each child underwent a physical examination from birth to 6 years of age twelve times. Latent class growth models were used to identify three trajectories of girls' body mass index (BMI). Logistic regression, quantile g-computation and Bayesian kernel machine regression models analyzed the relationships of prenatal exposure to individual and mixed phthalates with girls' body mass index (BMI) trajectory. Compared to the "lowest trajectory" class, prenatal average concentrations of mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP, OR_crude = 2.095, 95 % CI = 1.014-4.328) and di(2-ethylhexyl) phthalate (DEHP, OR_crude = 2.336, 95 % CI = 1.022-5.338) during pregnancy were associated with an increased probability of being in the "highest trajectory" class. The average concentration of DEHP (OR_crude = 1.879, 95 % CI = 1.002-3.522) was associated with an increased probability of being in the "moderate trajectory" class. Stratified analyses by trimester of pregnancy mainly showed that third-trimester exposure to monoethyl phthalate (MEP, OR_adjusted = 1.584, 95 % CI = 1.094-2.292), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP, OR_adjusted = 2.885, 95 % CI = 1.367-6.088), MEHHP (OR_adjusted = 2.425, 95 % CI = 1.335-4.407), DEHP (OR_adjusted = 2.632, 95 % CI = 1.334-5.193) and high molecular weight phthalate (OR_adjusted = 2.437, 95 % CI = 1.239-4.792) was associated with an increased probability of being in the "highest trajectory" class. However, the mixture of phthalates was not significantly related to the girl's BMI trajectory. In conclusion, in utero exposure to phthalates, including MEP and DEHP metabolites (MEHHP and MEOHP), was significantly associated with early childhood high BMI trajectories in girls. The third trimester of pregnancy seemed to be the window of vulnerability to phthalate exposure for girls' high BMI trajectory at periods of prenatal development. No evidence supported a significant relationship between combined exposure to phthalate metabolites and girls' high BMI trajectory.

Combined Toxicological Effects of Di (2-Ethylhexyl) Phthalate and UV-B Irradiation through Endoplasmic Reticulum Stress-Tight Junction Disruption in Human HaCaT Keratinocytes

Di (2-ethylhexyl) phthalate (DEHP) is widely used as a plasticizer, and human exposure to DEHP is widespread and frequent. However, information about the combined effect of DEHP and ultraviolet (UV)-B on the skin are still limited. We investigated the cytotoxic effects of DEHP and UV-B on HaCaT keratinocytes and evaluated the related underlying mechanisms involving endoplasmic reticulum (ER) stress signals and the disruption of junction complexes as an effective target for skin inflammation. Our results revealed that co-treatment with DEHP and UV-B irradiation alleviated the cell cytotoxicity and markedly decreased X-box binding protein 1 (XBP1), endoplasmic reticulum oxidoreductase 1 alpha (Ero1α), and C/EBP homologous protein (CHOP) whereas a single dose of 40 mJ/cm² UV-B generated mild ER stress to slightly less or similar levels as that seen with DEHP. DEHP was also shown to inhibit tight junctions (TJs) after UV-B irradiation, increased apoptosis by altering apoptotic gene Bax and stress kinases, JNK, and p38 MAPK. Furthermore, exposure of HaCaT cells to DEHP and UV-B irradiation resulted in the marked suppression of the nuclear factor kappa B (NF-κB)/p65 signaling pathway. Taken together, our data suggest that nontoxic DEHP and UV-B irradiation regulated ER stress and epidermal TJ disruption with the induction of apoptosis activation and the secretion of proinflammatory cytokines such as interleukin 1 beta (IL-1β) and IL-6 in human keratinocytes. Further investigation is needed to confirm the mechanisms implicated in its toxicity and determine the effects of exposure to DEHP and UV-B irradiation on markers involved in this study.

Mapping DEHP to the adverse outcome pathway network for human female reproductive toxicity

Adverse outcome pathways (AOPs) and AOP networks are tools for mechanistic presentation of toxicological effects across different levels of biological organization. These tools are used to better understand how chemicals impact human health. In this study, a four-step workflow was used to derive the AOP network of human female reproductive toxicity (HFRT-AOP) from five AOPs available in the AOP-Wiki and ten AOPs obtained from the literature. Standard network analysis identified key events (KEs) that are point of convergence and divergence, upstream and downstream KEs, and bottlenecks across the network. To map di-(2-ethylhexyl) phthalate (DEHP) to the HFRT-AOP network, we extracted DEHP target genes and proteins from the Comparative Toxicogenomic and the CompTox Chemicals Dashboard databases. Enriched GO terms analysis was used to identify relevant biological processes in the ovary that are DEHP targets, whereas screening of scientific literature was performed manually and automatically using AOP-helpFinder. We combined this information to map DEHP to HFRT-AOP network to provide insight on the KEs and system-level perturbations caused by this endocrine disruptor and the emergent paths. This approach can enable better understanding of the toxic mechanism of DEHP-induced human female reproductive toxicity and reveal potential novel DEHP female reproductive targets for experimental studies.

Correlates of non-persistent endocrine disrupting chemical mixtures among reproductive-aged Black women in Detroit, Michigan

Some studies indicate that Black women have higher exposure to multiple non-persistent endocrine disrupting chemicals (EDCs) than white women, but little is known about correlates of exposure to EDC mixtures. Using baseline data from a prospective cohort study of reproductive-aged Black women (N = 751), we characterized profiles of EDC mixtures and identified correlates of exposure. At baseline, we quantified biomarkers of 16 phthalates, 7 phenols, 4 parabens, and triclocarban in urine and collected covariate data through self-administered questionnaires and interviews. We used principal component (PC) analysis and k-means clustering to describe EDC mixture profiles. Associations between correlates and PCs were estimated as the mean difference (β) in PC scores, while associations between correlates and cluster membership were estimated as the odds ratio (OR) of cluster membership. Personal care product use was consistently associated with profiles of higher biomarker concentrations of non-persistent EDCs. Use of nail polish, menstrual and vaginal products (e.g., vaginal powder, vaginal deodorant), and sunscreen was associated with a mixture of phthalate and some phenol biomarkers using both methods. Current vaginal ring use, a form of hormonal contraception placed inside the vagina, was strongly associated with higher concentrations of high molecular weight phthalate biomarkers (k-means clustering: OR = 2.42, 95% CI = 1.28, 4.59; PCA: β = -0.32, 95% CI = -0.71, 0.07). Several dietary, reproductive, and demographic correlates were also associated with mixtures of EDC biomarkers. These findings suggest that personal care product use, diet, and contraceptive use may be sources of exposure to multiple non-persistent EDCs among reproductive-aged Black women. Targeted interventions to reduce exposure to multiple EDCs among Black women are warranted.

Risk Assessment of Phthalates and Their Metabolites in Hospitalized Patients: A Focus on Di- and Mono-(2-ethylhexyl) Phthalates Exposure from Intravenous Plastic Bags

Phthalate esters (PAEs) are plasticizers associated with multiple toxicities; however, no strict regulations have been implemented to restrict their use in medical applications in Lebanon. Our study aimed at assessing the potential risks correlated with phthalate exposure from IV bags manufactured in Lebanon. GC–MS analysis showed that di-(2-ethylhexyl) phthalate (DEHP) is the predominant phthalate found in almost all samples tested with values ranging from 32.8 to 39.7% w/w of plastic. DEHP concentrations in the IV solutions reached up to 148 µg/L, as measured by SPME-GC–MS/MS, thus resulting in hazard quotients greater than 1, specifically in neonates. The toxicity of DEHP is mainly attributed to its metabolites, most importantly mono-(2-ethylhexyl) phthalate (MEHP). The IV bag solution with the highest content in DEHP was therefore used to extrapolate the amounts of urinary MEHP. The highest concentrations were found in neonates having the lowest body weight, which is concerning, knowing the adverse effects of MEHP in infants. Our study suggests that the use of IV bags manufactured in Lebanon could pose a significant risk in hospitalized patients, especially infants in neonatal care. Therefore, Lebanon, as well as other countries, should start imposing laws that restrict the use of phthalates in medical IV bags and substitute them with less toxic plasticizers.

Association of Serum Levels of Plasticizers Compounds, Phthalates and Bisphenols, in Patients and Survivors of Breast Cancer: A Real Connection?

Phthalates and bisphenols are ubiquitous environmental pollutants with the ability to perturb different systems. Specifically, they can alter the endocrine system, and this is why they are also known as endocrine-disrupting compounds (EDCs). Interestingly, they are related to the development and progression of breast cancer (BC), but the threshold concentrations at which they trigger that are not well established. Objectives: The aim of this study was to compare the concentration measures of parent EDCs in three groups of women (without BC, with BC, and BC survivors) from two urban populations in Mexico, to establish a possible association between EDCs and this disease. We consider the measure of the parent compounds would reflect the individual’s exposure. Methods: The levels of di-ethyl-hexyl-phthalate (DEHP), butyl-benzyl-phthalate (BBP), di-n-butyl phthalate (DBP) and di-ethyl-phthalate (DEP), bisphenol A (BPA) and bisphenol S (BPS) were determined by gas chromatograph-mass spectrometry in 102 subjects, including 37 women without any pathological disease, 46 patients with BC and 19 women survivals of BC of Mexico and Toluca City. Results: All phthalates were detected in 100% of women, two of them were significantly higher in patients with different BC subtypes in Mexico City. Differential increases were observed mainly in the serum concentration of phthalates in women with BC compared to women without disease between Mexico and Toluca City. In addition, when performing an analysis of the concentrations of phthalates by molecular type of BC, DEP and BBP were found mainly in aggressive and poorly differentiated types of BC. It should be noted that female BC survivors treated with anti-hormonal therapy showed lower levels of BBP than patients with BC. BPA and BPS were found in most samples from Mexico City. However, BPS was undetectable in women from Toluca City. Discussion: The results of our study support the hypothesis of a positive association between exposure to phthalates and BC incidence.

Diethyl phthalate (DEP) perturbs nitrogen metabolism in Saccharomyces cerevisiae

Phthalates are ubiquitously used as plasticizers in various consumer care products. Diethyl phthalate (DEP), one of the main phthalates, elicits developmental and reproductive toxicities but the underlying mechanisms are not fully understood. Chemogenomic profiling of DEP in S. cerevisiae revealed that two transcription factors Stp1 and Dal81 involved in the Ssy1-Ptr5-Ssy5 (SPS) amino acid-sensing pathway provide resistance to DEP. Growth inhibition of yeast cells by DEP was stronger in poor nitrogen medium in comparison to nitrogen-rich medium. Addition of amino acids to nitrogen-poor medium suppressed DEP toxicity. Catabolism of amino acids via the Ehrlich pathway is required for suppressing DEP toxicity. Targeted metabolite analyses showed that DEP treatment alters the amino acid profile of yeast cells. We propose that DEP inhibits the growth of yeast cells by affecting nitrogen metabolism and discuss the implications of our findings on DEP-mediated toxic effects in humans.

Effects of dibutyl phthalate and di (2-ethylhexyl) phthalate on hepatic structure and function of adult male mice

The objective of the present research was to determine if dibutyl phthalate (DBP) and di-(2-ethylhexyl) phthalate (DEHP) alone and combined exposure induced pathological alterations in laboratory reared albino mice. Adult male mice were equally divided (n = 10) into Control, corn oil (CO), DBP, DEHP, and DBP+DEHP treated groups. Dibutyl phthalate (250 mg/kg), DEHP (300 mg/kg), and DBP+DEHP (250+300 mg/kg), respectively, were administered by oral gavage mixed in corn oil (0.2 mL) for 28 days. All animals were sacrificed following 28 days of treatment and blood was collected for serum lipid profiles and liver function tests. Liver samples were also collected for observation of histological changes. Microphotographs of hematoxylin and eosin-stained sections were used for computer-based micrometry. CO, DBP, DEHP, and DBP+DEHP treatment resulted in a significant increase in the mean body and liver weights as compared with the Control group. Histological examination of the livers with DBP and/or DEHP treatment showed marked alterations leading to hepatic hypertrophy. In the treated groups, a significant increase in the mean number of mononucleated, binucleated cells, and oval cells per unit area was noticed with disorganized trabecular arrangement as compared with the Control group. Treatment with DBP and/or DEHP resulted in large regeneration zones in the liver and an increased relative nucleo-cytoplasmic index of mononuclear shepatocytes when compared with the Control group. All treatments caused a significant increases in the liver enzymes and proteins as well as altered serum cholesterol, triglycerides, LDL, and VLDL levels. The histopathological and serological findings confirmed the toxic potentials to hepatic tissue of DBP and DEHP either given alone or in combination.

Phthalate metabolites in paired human serum and whole blood

Presence of phthalate metabolites (PMs) in human serum has been well documented. However, the distribution pattern of PMs in different human blood matrixes remains not well known. To investigate this, paired serum and whole blood samples were collected from 145 adults (76 males and 69 females) in Quzhou, China, and analyzed for nine PMs in this study. All PMs had high detection frequencies (> 70%) in human serum and whole blood, except mono benzyl phthalate. Total concentrations of detected PMs in serum and whole blood were 0.70-61 ng/mL (mean 12 ng/mL) and 1.6-33 ng/mL (7.5 ng/mL), respectively. Mono methyl phthalate (MMP), mono (2-ethylhexyl) phthalate, and mono butyl phthalate were consistently the predominant PMs in human serum and whole blood, with the mean concentrations of 3.4 and 2.0 ng/mL, 3.3 and 2.1 ng/mL, and 2.8 and 1.8 ng/mL, respectively. Females had higher mean serum concentrations of PMs, except MBP, than males. Youngest age group (20-30 years) consistently had the lowest mean whole blood levels of all PMs. For the first time, the distribution pattern of PMs in human blood was evaluated based on the calculated partitioning coefficient (K_p) between serum and whole blood. MMP had the highest mean K_p value (1.6; 10th-90th percentile: 1.0-2.2), while mono (2-ethyl-5-oxohexyl) phthalate had the lowest mean K_p value (0.63; 10th-90th percentile: 0.25-1.3). These results help better understand the occurrence of PMs in human blood.