Phthalate Exposure Linked To Increased Risk of Heart-Related Deaths, Researchers Warn

Consistent or prolonged exposure to pthalates, which are a commonly used chemical in plastic, may increase the overall risk of heart complications and death, according to the findings of new research.

In a study published in the academic journal Environmental Pollution on October 12, researchers found an association between phthalate exposure and increased mortality rates, which may cost the U.S. health system more than $39 billion per year.

Phthalates are a group of chemicals used to help make plastic flexible or more durable. They are commonly part of the packaging, preparation, storage and processing of food products, but are also found in a wide range of other items including toys, PVC tubing, medical devices, pill coatings and cosmetics such as shampoo and conditioners.

Several prior studies have highlighted potential side effects of phthalates, finding that the chemicals are potent endocrine disruptors, which affect the function of hormones, including thyroid hormones, increase the risk of miscarriage, and reduce male fertility, even for generations after initial exposure.

In this latest study, researchers funded by the National Institute of Health reviewed data from the U.S. National Health and Nutrition Examination Survey 2001-2010, which included 5,303 adults 20 years or older who provided urine samples for phthalate metabolite measurements. The survey data was then linked with mortality data in 2015, and analysis was conducted in July 2020.

According to the findings, those with continuous exposure to high-molecular weight phthalates had a 14% higher risk of all-cause mortality. Specifically, those exposed to di-2-ethylhexylphthalate (DEHP), which is phthalate commonly used in industrial food processing and medical devices, were linked with a 10% higher risk of mortality in adults ages 55 to 64.

Of the phthalates recorded in urine samples, those with the greatest levels of mono-(2-ethyl-5- oxohexyl) phthalates were linked to a 74% increased risk of cardiovascular-related mortality.

Researchers noted mortality rates with phthalate exposure appeared dose-dependent, stating the highest levels of exposure had a 48% higher risk of death when compared to the lowest levels of exposure. Such dose-dependent findings are often considered strong evidence of a causal factor.

“In a nationally representative sample, phthalate exposures were associated with all-cause and cardiovascular mortality, with societal costs approximating $39 billion/year or more,” the researchers concluded. “While further studies are needed to corroborate observations and identify mechanisms, regulatory action is urgently needed.”

While the researchers called for larger scale studies to verify the findings, they also encouraged regulatory officials to require safer alternatives be used in cosmetic, personal care products and good packaging to mitigate exposing consumers to harmful chemicals.

In September 2020, the Journal of the American Medical Association published a study finding the use of personal care products containing phthalates increased the risk of ADHD by as much as 25%. Other research has linked exposure to endocrine disruptors, such as phthalates, during pregnancy to the risk of brain development disorders among children. Another study indicated endocrine disruptors found in common household chemicals and other products can interfere with thyroid hormones during pregnancy leading to impaired fetal brain development.

On August 6, Senators Dianne Feinstein, of California, and Kristen Gillibrand, of New York, introduced legislation in the U.S. Senate, “Preventing Harmful Exposure to Phthalates Act” (PDF), which they say will prevent phthalates from infiltrating the food supply. A companion bill is being introduced in the U.S. House by Representatives Ted Lieu and Katie Porter of California.

If passed into law, the bill would ban the use of phthalates in any material that comes in physical contact with food, and would require any materials replacing phthalates currently in use be proven safe. The bill would also look at whether communities of color are being disproportionately exposed and what the health consequences might be.