Are nails a valuable non-invasive alternative for estimating human exposure to phthalate esters?

Exploring noninvasive matrices for assessing long-term exposure to phthalates: a scoping review

The phthalic acid esters (PAEs) are one class of the most abundant and frequently studied pseudo-persistent organic pollutants. Noninvasive urine is an effective substrate for evaluating PAE exposure, but repeated sampling is needed to overcome this bias. This adds much work to on-site collection and the cost of detection increases exponentially. Therefore, the aim of this study was to conduct a scope review to describe the detection methods and validity of the use of other noninvasive matrices, such as nails and hair, for assessing long-term exposure to PAEs. The PubMed, Web of Science and China National Knowledge Infrastructure (CNKI), electronic databases were searched from 1 January 2000 to 3 April 2024, and 12 studies were included. Nine and three studies used hair and nails, respectively, as noninvasive matrices for detecting PAE exposure. Five articles compared the results of nail or hair and urine tests for validity of the assessment of PAE exposure. The preprocessing and detection methods for these noninvasive samples are also described. The results of this review suggest that, compared with nails, hair may be more suitable as a noninvasive alternative matrix for assessing long-term exposure to PAEs. However, sample handling procedures such as the extraction and purification of compounds from hair are not uniform in various studies; therefore, further exploration and optimization of this process, and additional research evidence to evaluate its effectiveness, are needed to provide a scientific basis for the promotion and application of hair detection methods for assessing long-term PAE exposure levels.

Distribution of phthalate metabolites, benzophenone-type ultraviolet filters, parabens, triclosan and triclocarban in paired human hair, nail and urine samples

In this study, the distribution of nineteen ingredients of personal care product (PCPs), including seven metabolites of phthalates (mPAEs), five benzophenone-type ultraviolet filters (BPs), and seven antimicrobial agents (AAs), were investigated in paired human hair, nail and urine samples. The median concentrations of ΣmPAEs, ΣBPs and ΣAAs were 135, 2.76 and 179 ng/g in hair, 37.3, 2.95 and 297 ng/g in nails, and 345, 4.03 and 50.1 ng/mL in urine, respectively. Mono-methyl phthalate (49%), 2,4-dihydroxybenzophenone (45%) and triclosan (71%) were the most abundant mPAE, BP and AA in hair samples, respectively, and had similar abundance in nail samples. In contrast, mono-n-butyl phthalate (45%), 4-hydroxy benzophenone (29%) and methyl paraben (54%) were the predominant mPAE, BP and AA in urine samples, respectively. Significant differences in the concentrations of some target compounds were observed between male and female but inconsistent across different matrices. Moreover, most compounds with significant correlations had quite different correlation coefficients in each matrix. No significant correlations were found between hair, nail and urine samples for most of the target analytes. These results suggest these analytes have matrix-specific distribution, and it is necessary to use multiple matrices to comprehensively assess the risk of ingredients of PCPs to human health.

Human nails as a valuable noninvasive alternative for estimating exposure to parabens

Exposure of human to parabens (commonly used preservatives) is inevitable due to their extensively applied in numerous consumer products. Thus, a reliable noninvasive matrix reflecting long-term exposure to parabens is essential for human biomonitoring study. Human nails are potentially a valuable alternative for measuring intergrated exposure to parabens. In this work, we collected 100 paired nail and urine samples from university students in Nanjing, China, and measured simultaneously for six parent parabens and four metabolites. Methylparaben (MeP), ethylparaben (EtP), and propylparaben (PrP) were three predominant paraben analogue in both matrices, with the median concentrations being 12.9, 0.753, and 3.42 ng/mL in urine, and 1540, 154, and 961 ng/g in nail, respectively, while 4-hydroxybenzoic acid (4-HB) and 3,4-dihydroxybenzoic acid (3,4-DHB) were the most abundant metabolites (median values of 143 and 35.9 ng/mL, respectively) in urine. Gender-related analysis suggested that females exposed to more higher parabens than males. Significantly positive correlations were found between levels of MeP, PrP, EtP, and OH-MeP (r = 0.54-0.62, p < 0.01) in paired urine and nail samples. Our result here suggests that human nails, as an emerging biospecimen, are a potentially valuable biological matrix to evaluate human long-term exposure to parabens.

Phthalate metabolites: Characterization, toxicities, global distribution, and exposure assessment

Phthalates are plasticizers in various products and regarded as endocrine disruptors due to their anti-androgen effects. Environmental occurrence and toxicities of parent phthalates have been widely reported, while the current state of knowledge on their metabolites is rarely summarized. Based on the available literature, the present review mainly aims to 1) characterize the potential metabolites of phthalates (mPAEs) using the pharmacokinetics evidences acquired via animal or human models; 2) examine the molecular and cellular mechanism involved in toxicity for mPAEs; 3) investigate the exposure levels of mPAEs in different human specimens (e.g., urine, blood, seminal fluid, breast milk, amniotic fluid and others) across the globe; 4) discuss the models and related parameters for phthalate exposure assessment. We suggest there is subtle difference in toxic mechanisms for mPAEs compared to their parent phthalates due to their alternative chemical structures. Human monitoring studies performed in Asia, America and Europe have provided the population exposure baseline levels for typical phthalates in different regions. Urine is the preferred matrix than other specimens for phthalate exposure study. Among ten urinary mPAEs, the largest proportions of di-(2-ethylhexyl) phthalate (DEHP) metabolites (40%), monoethyl phthalate (mEP) (43%) and DEHP metabolites/mEP (both 29%) were observed in Asia, America and Europe respectively, and mono-5-carboxy-2-ethypentyl phthalate was the most abundant compounds among DEHP metabolites. Daily intakes of phthalates can be accurately calculated via urinary mPAEs if the proper exposure parameters were determined. Further work should focus on combining epidemiological and biological evidences to establish links between phthalates exposure and biological phenotypes. More accurate molar fractions (F_UE) of the urinary excreted monoester related to the ingested diesters should be collected in epidemiological or pharmacokinetic studies for different population.

Hair and nails as noninvasive bioindicators of human exposure to chlorinated paraffins: Contamination patterns and potential influencing factors

Most of the studies on short- and medium-chain chlorinated paraffins (SCCPs and MCCPs) in human tissues have focused on human milk and blood. However, little is known about the occurrence of CPs in human hair and nails. In this study, SCCPs and MCCPs were analyzed in 62 pairs of human hair and nails from North China. Median concentrations (range) of SCCPs and MCCPs in human hair were 239 (19.2-877) and 325 (16.9-893) ng/g dw, respectively, all of which were significantly higher than 154 (57.7-355) and 233 (61.0-476) ng/g dw, respectively, in nail samples (p < 0.05). The homologue profiles of CPs in human hair were similar to those in nails, where SCCPs and MCCPs were dominated by C₁₀Cl_6-7 and C₁₄Cl_7-8, respectively. A significant positive relationship was observed between CP levels and age of people for hair, whereas negative linear correlations were observed for nails. The redundancy analysis indicated that age of people might be the main influencing factor on the accumulation of CPs in hair and nails. The present study performed comprehensive evaluation of CP exposure levels in human hair and nail and highlights the need for more data on relationship between internal and external exposure to CPs.

Web-based behavioral intervention to reduce exposure to phthalate metabolites, bisphenol A, triclosan, and parabens in mothers with young children: A randomized controlled trial

In this study, a web-based behavioral intervention was designed, which aimed to reduce exposure to phthalate metabolites, bisphenol A, triclosan, and parabens in mothers with young children. A randomized controlled design with two groups was used to verify the effects of the intervention pre- and post-test. In total, 51 mothers participated in the study, categorizing 26 and 25 in the intervention and control groups, respectively. The web-based behavioral intervention focused on changes in diet, personal care products, and health behavior and reinforced behavior through encouragement. This program included an educational video, a game for locating endocrine disruptors at home, a method for locating facilities potentially emitting endocrine disruptors, resources, and a questions and answers mode. Data were collected from May 18 to June 30, 2020. Participants allocated to the intervention group were provided access to the behavioral intervention website via a computer or smartphone. Participants allocated to the control group were sent written information about endocrine disruptors via mail. For both the intervention and control groups, questionnaire results and maternal urine samples were assessed at baseline, during the intervention, and after one month. After the intervention, the urinary concentrations of mono (2-ethylhexyl) phthalate (MEHP), mono (2-ethyl-5-oxohexyl) phthalate (MEOHP), bisphenol A (BPA), methylparaben (MP), ethylparaben (EP), and propylparaben (PP) were found to be significantly decreased in the intervention group. Compared with the control group, the intervention group showed significantly decreased urinary geometric mean values of MEHP, MEOHP, BPA, MP, and PP after one month compared with those during the intervention (3.8%, 16.3%, 28.4%, 9.2%, and 24.4%, respectively). Hence, the web-based behavioral intervention was effective at reducing the exposure to endocrine disruptors in mothers with young children.

A critical review on human internal exposure of phthalate metabolites and the associated health risks

Phthalates (PAEs) are popular synthetic chemicals used as plasticizers and solvents for various products, such as polyvinyl chloride or personal care products. Human exposure to PAEs is associated with various diseases, resulting in PAE biomonitoring in humans. Inhalation, dietary ingestion, and dermal absorption are the major human exposure routes. However, estimating the actual exposure dose of PAEs via an external route is difficult. As a result, estimation by internal exposure has become the popular analytical methods to determine the concentrations of phthalate metabolites (mPAEs) in human matrices (such as urine, serum, breast milk, hair, and nails). The various exposure sources and patterns result in different composition profiles of PAEs in biomatrices, which vary from country to country. Nevertheless, the mPAEs of diethyl phthalate (DEP), di-n-butyl phthalate (DnBP), di-iso-butyl phthalate (DiBP), and di-(2-ethylhexyl) phthalate (DEHP) are predominant in the urine. These mPAEs have greater potential health risks for humans. Children have been observed to exhibit higher exposure risks to several mPAEs than adults. Besides age, other influencing factors for phthalate exposure are gender, jobs, and residential areas. Although many studies have reported biological monitoring of PAEs, only a few reviews that adequately summarized the reports are available. The current review appraised available studies on mPAE quantitation in human biomatrices and estimated the dose and health risks of phthalate exposure. While some countries lack biomonitoring data, some countries' data do not reflect the current PAE exposure. Thence, future studies should involve frequent PAE biomonitoring to accurately estimate human exposure to PAEs, which will contribute to health risk assessments of human exposure to PAEs. Such would aid the formulation of corresponding regulations and restrictions by the government.

Association between prenatal phthalate exposure and gestational metabolic syndrome parameters: a systematic review of epidemiological studies

The relationship of intrauterine phthalate exposure with gestational metabolic syndrome (GMS) parameters is inconsistently reported. We performed a systematic review to evaluate the association between prenatal phthalate exposure and GMS parameters. A literature search was performed in three databases. According to the defined PECOS statement, eligible studies were identified. The method and result for each study was qualitatively summarized with great emphasis on study design and exposure assessment. Fourteen studies were included in the present systematic review. Two studies used one-spot serum sample for evaluation of phthalate exposure, while others used 1-4 urine samples. Concentrations of phthalate metabolites varied substantially, and the levels in serum were greatly lower than those in urine. These studies observed no interstudy or intrastudy consistency for association between phthalates and GMS in pregnant women cross-sectionally or longitudinally, regardless of phthalates species or GMS indicator. Most reported associations were not significantly different from null result. Besides, positive and negative relationships also existed. The current epidemiological data do not support the hypothesis that prenatal exposure to phthalates increases GMS risk.

Novel and legacy flame retardants in paired human fingernails and indoor dust samples

In this study, the occurrence of 8 polybrominated diphenyl ethers (PBDEs), 5 alternative flame retardants (AFRs), and 7 organophosphate flame retardants (OPFRs) was determined in 50 pairs of human fingernail and indoor dust samples. The concentrations in fingernail were 9.79-242 ng/g, 17.7-926 ng/g, and 58.0-590 ng/g for PBDEs, AFRs, and OPFRs. Male fingernail showed significantly (p < 0.05) higher Σ₈PBDE concentrations than female fingernails, while no significant gender differences were observed for AFRs and OPFRs. Lower ratios of BDE209 to Σ₈PBDE and DBDPE to Σ₅AFRs were found in fingernails than in dust. Due to their relatively rapid in vivo debromination, BDE 209 and DBDPE in fingernails were most likely from external sources rather than internal exposure (such as through blood circulation). Similar composition profiles between fingernail and dust were observed for PBDEs (excluding BDE209), AFRs (excluding DBDPE), and OPFRs, indicating that indoor dust may be a significant source for these FRs in human fingernails. Significant correlations between fingernail and dust were observed for BDE 47 (p < 0.01; r = 0.50), TBPH (p < 0.01; r = 0.37) and TBOEP (p < 0.01; r = 0.53). Results in this study provided information about contamination levels and exposure sources of FRs, which is important for long-term biomonitoring and health risk assessment of FRs.

Multi-class chemical exposure in rural Peru using silicone wristbands

Exposure monitoring with personal silicone wristband samplers was demonstrated in Peru in four agriculture and urban communities where logistic and practical constraints hinder use of more traditional approaches. Wristbands and associated methods enabled quantitation of 63 pesticides and screening for 1397 chemicals including environmental contaminants and personal care products. Sixty-eight wristbands were worn for approximately one month by volunteers from four communities of Alto Mayo, Peru. We identified 106 chemicals from eight chemical classes among all wristbands. Agricultural communities were characterized by pesticides and PAHs, while the urban communities had more personal care products present. Multiple linear regressions explained up to 40% of variance in wristbands from chlorpyrifos, cypermethrin, and DDT and its metabolites (DDx) (r²=0.39, 0.30, 0.40, respectively). All three pesticides were significantly different between communities, and cypermethrin and DDx were associated with participant age. The calculated relative age of DDT suggested some communities had more recent exposure than others. This work aids health research in the Alto Mayo and beyond by identifying typical mixtures and potential sources of exposure to organic chemicals in the personal environment. Silicone wristband sampling with chemical screening is a candidate for widespread use in exposure monitoring in remote areas.

Case Study on Screening Emerging Pollutants in Urine and Nails

Alternative plasticizers and flame retardants (FRs) have been introduced as replacements for banned or restricted chemicals, but much is still unknown about their metabolism and occurrence in humans. We identified the metabolites formed in vitro for four alternative plasticizers (acetyltributyl citrate (ATBC), bis(2-propylheptyl) phthalate (DPHP), bis(2-ethylhexyl) terephthalate (DEHTP), bis(2-ethylhexyl) adipate (DEHA)), and one FR (2,2-bis (chloromethyl)-propane-1,3-diyltetrakis(2-chloroethyl) bisphosphate (V6)). Further, these compounds and their metabolites were investigated by LC/ESI-Orbitrap-MS in urine and finger nails collected from a Norwegian cohort. Primary and secondary ATBC metabolites had detection frequencies (% DF) in finger nails ranging from 46 to 95%. V6 was identified for the first time in finger nails, suggesting that this matrix may also indicate past exposure to FRs as well as alternative plasticizers. Two isomeric forms of DEHTP primary metabolite were highly detected in urine (97% DF) and identified in finger nails, while no DPHP metabolites were detected in vivo. Primary and secondary DEHA metabolites were identified in both matrices, and the relative proportion of the secondary metabolites was higher in urine than in finger nails; the opposite was observed for the primary metabolites. As many of the metabolites present in in vitro extracts were further identified in vivo in urine and finger nail samples, this suggests that in vitro assays can reliably mimic the in vivo processes. Finger nails may be a useful noninvasive matrix for human biomonitoring of specific organic contaminants, but further validation is needed.

Estimating uptake of phthalate ester metabolites into the human nail plate using pharmacokinetic modelling

There is a lack of knowledge regarding uptake of phthalate esters (PEs) and other chemicals into the human nail plate and thus, clarity concerning the suitability of human nails as a valid alternative matrix for monitoring long-term exposure. In particular, the relative importance of internal uptake of phthalate metabolites (from e.g. blood) compared to external uptake pathways is unknown. This study provides first insights into the partitioning of phthalate-metabolites between blood and nail using pharmacokinetic (PK) modelling and biomonitoring data from a Norwegian cohort. A previously published PK model (Lorber PK model) was used in combination with measured urine data to predict serum concentrations of DEHP and DnBP/DiBP metabolites at steady state. Then, partitioning between blood and nail was assessed assuming equilibrium conditions and treating the nail plate as a tissue, assuming a fixed lipid and water content. Although calculated as a worst-case scenario at equilibrium, the predicted nail concentrations of metabolites were lower than the biomonitoring data by factors of 44 to 1300 depending on the metabolite. It is therefore concluded that internal uptake of phthalate metabolites from blood into nail is a negligible pathway and does not explain the observed nail concentrations. Instead, external uptake pathways are more likely to dominate, possibly through deposition of phthalates onto the skin/nail and subsequent metabolism. Modelling gaseous diffusive uptake of PEs from air to nail revealed that this pathway is unlikely to be important. Experimental quantification of internal and external uptake pathways of phthalates and their metabolites into the human nail plate is needed to verify these modelling results. However, based on this model, human nails are not a good indicator of internal human exposure for the phthalate esters studied.

Evaluation of exposure to phthalate esters and DINCH in urine and nails from a Norwegian study population

Phthalate esters (PEs) and 1,2-cyclohexane dicarboxylic acid diisononyl ester (DINCH) used as additives in numerous consumer products are continuously released into the environment, leading to subsequent human exposure which might cause adverse health effects. The human biomonitoring approach allows the detection of PEs and DINCH in specific populations, by taking into account all possible routes of exposure (e.g. inhalation, transdermal and oral) and all relevant sources (e.g. air, dust, personal care products, diet). We have investigated the presence of nine PE and two DINCH metabolites and their exposure determinants in 61 adult residents of the Oslo area (Norway). Three urine spots and fingernails were collected from each participant according to established sampling protocols. Metabolite analysis was performed by LC-MS/MS. Metabolite levels in urine were used to back-calculate the total exposure to their corresponding parent compound. The primary monoesters, such as monomethyl phthalate (MMP, geometric mean 89.7ng/g), monoethyl phthalate (MEP, 104.8ng/g) and mono-n-butyl phthalate (MnBP, 89.3ng/g) were observed in higher levels in nails, whereas the secondary bis(2-ethylhexyl) phthalate (DEHP) and DINCH oxidative metabolites were more abundant in urine (detection frequency 84-100%). The estimated daily intakes of PEs and DINCH for this Norwegian population did not exceed the established tolerable daily intake and reference doses, and the cumulative risk assessment for combined exposure to plasticizers with similar toxic endpoints indicated no health concerns for the selected population. We found a moderate positive correlation between MEP levels in 3 urine spots and nails (range: 0.56-0.68). Higher frequency of personal care products use was associated with greater MEP concentrations in both urine and nail samples. Increased age, smoking, wearing plastic gloves during house cleaning, consuming food with plastic packaging and eating with hands were associated with higher levels in urine and nails for some of the metabolites. In contrast, frequent hair and hand washing was associated with lower urinary levels of monoisobutyl phthalate (MiBP) and mono(2-ethyl-5-hydroxyhexyl) phthalate (5-OH-MEHP), respectively.

Long-term exposure assessment to phthalates: How do nail analyses compare to commonly used measurements in urine

Phthalate esters (PEs) are easily metabolized and commonly excreted via urine within 24h, therefore their bioaccumulation potential is thought to be rather low. In the present study, we developed a sample preparation combined with a new microextraction method to measure seven PE metabolites in nails. The use of whole nails did not result in significantly different levels compared to powdered nails, which makes the method very fast and user friendly. The method was validated using whole nails showing good accuracy, satisfactory precision and low limits of quantification (2-14ng/g). Although method development was the primary aim of the study, the method was also applied to real samples. PEs were measured in nails of 9 individuals collected at 2 distinct time points (15 days apart) and compared to levels in the respective urine samples (daily morning sample for 15 days). Additionally two volunteers have collected two more urine spots (afternoon and evening) per day. Major metabolites in nails were mono (ethyl hexyl) phthalate (MEHP), monoethyl phthalate (MEP) and sum of mono-n-butyl and mono-isobutyl phthalate (Σ(MnBP, MiBP)) while MEP and Σ(MnBP, MiBP) were the major ones identified in urine. In urine, first void morning urine reflected higher total excretion (sum of PEs of 7.0μg/g creatinine) for all individuals than the afternoon/evening voids. Participants also filled a questionnaire regarding their life-style. The use of hand care products and consumption of pre-packed food was associated with di-(2-ethylhexyl) phthalate (DEHP) oxidative metabolites, while the use of medical devices with butylbenzyl phthalate (BBzP) exposure. Although the metabolism (rate) and other factors that influence the transfer of the analytes from blood or other body compartments into nails needs further investigation, nails can be used to assess exposure to PEs. From our knowledge, urine reflects the excretion of PEs on 'daily basis' while nails show less fluctuation and more stable levels.