Phthalates and Their Impacts on Human Health
2. Phthalates Applications and Exposure Routes
3. Bio-Metabolism of Phthalates in Human Body
4. Phthalates Toxicology and Risk Assessment
5. Impacts of Phthalates on Children
6. Restrictions on Phthalates
7. Strategic Recommendations
- Reassess and apply the restrictions where appropriate on high-risk products. DEHP, DBP, BBP, DiNP, DiDP, DnOP, and DiBP are now limited in certain products in many countries, which could contribute to reducing phthalates exposure. Less exposure will be observed if similar restrictions are applied in those countries that do not currently apply phthalates restrictions. Products with high phthalates exposure risk need to be strictly limited, such as food packaging, PCPs, medical devices, products likely to be sucked or ingested by infants, children, and adolescents. Pregnant women and lactating women have also been identified as vulnerable groups, and it is, therefore, necessary to impose stricter standards on the products that contact such specific groups of people.
- Phthalate alternatives (PA) with less toxicity and leakage should also be considered, especially in the health care industry. The leaching of DEHP in the environment is uncontrollable but can be avoided by using DEHP-free alternatives . The concentration of phthalates needs to be limited in the products that are most frequently used but people are not aware of the toxic exposure. In the medical industry, trioctyl trimellitate (TOTM) and diisononylester (DINCH) are found to be promising DEHP alternatives (Thomas, et al., 2021). Besides, epoxidised soybean oil (ESBO), di-(2-ethylhexyl) terephthalate (DEHT), and acetyl tributyl citrate (ATBC) are popular PAs in the plasticizer market. In Europe, PVC-free medical and DEHP-free devices are available, by using polyethylene, polypropylene, polyurethane, and other polyolefins, silicone, ethylene-vinyl acetate, and multi-layerlaminate plastics as alternatives . The alternative softeners are citrates, benzoates, trimellitates, and adipates, with much lower toxic levels than DEHP (Ruzickova, et al., 2004). Where practicable, using glass containers instead of plastic packaging, avoiding heating food in plastic containers, avoiding using fragrance that may contain phthalates, and reading the label of PCPs can easily reduce the exposure to phthalates in daily life . Also, testing drinking water routinely for phthalates can keep residents at safe levels of exposure. When processing food, it is advisable to use phthalate-free gloves, utensils, and packaging to reduce exposure in food. The most recent exposure assessment found decreased phthalates and increased PA in humans . Few adolescent participants were detected to have higher estimated daily intakes than health-based guidance values.
- To protect children, soft vinyl toys, old plastic toys, and teething rings should be avoided. Children should be kept away from waste sites of factories, especially plastic manufacturers, which can help to avoid dermal and airborne intake. A recent study at a kindergarten in China found that there were relatively high phthalates exposures in indoor air and dust, compared to the outdoor environment . In the community, it is also necessary to limit and measure the level of phthalates in kindergarten, schools, hospitals, and shopping malls. Even though PA use may reduce the phthalates levels, PA exposure cannot be ignored as well, especially from tap water and air particles . Public awareness needs to be improved to educate vulnerable members of the community to avoid using plastics voluntarily, especially plastics containing phthalates.
Conflicts of Interest
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|Compounds||Abbreviation||Where It Can Be Found||Also Named As|
|Diethylhexyl phthalate||DEHP||Plasticizer||Di-2-ethylhexyl phthalate; |
|Dibutyl phthalate||DBP||Nail polishers; plasticizer; an additive to |
adhesives or printing inks;
|Di-n-butyl phthalate, DnBP, DNBP|
|Diethyl phthalate||DEP||Toothbrushes; automobile parts; tools; toys; food packaging; cosmetics; |
|Ethyl phthalate; Di-n-ethyl phthalate|
|Di-isononyl phthalate||DiNP||Plasticizer||Bis(7-methyloctyl) phthalate; DINP|
|Di-iso-decyl phthalate||DiDP||Plasticizer||Di(i-decyl) phthalate; diisodecyl |
|Butyl benzyl phthalate||BBP||Plasticizer||Benzyl n-butyl phthalate; n-Butyl |
|Mono-(2- ethylhexyl) phthalate||MEHP||Vinyl tiles; food conveyor belts; carpet tile; |
|tert-Butyldimethylsilyl 2-ethylhexyl phthalate|
|Di-isobutyl phthalate||DiBP||Plasticizer; adhesive||Di(i-butyl)phthalate; Isobutyl phthalate; |
di-l-butyl phthalate; DIBP
|Dioctyl phthalate||DnOP||Household items and building products; |
|Di-n-octyl phthalate; DNOP|
|Endocrine systems||Weight (overweight and obesity) and height|
|Type II diabetes and insulin resistance|
|Thyroid function and increased risk of thyroid cancer|
|Higher systolic blood pressure|
|Males: genital development, semen quality|
|Females: pregnancy outcome (pregnancy loss and preterm birth, low birth weight), reproductive hormones (including lueinizing hormone, sex hormone-binding globulin, earlier menopause)|
|Others||Respiratory system: allergy and asthma|
Nervous system: delayed neurodevelopment, social impairment
|Japan ||DiNP and DEHP are banned in toys; DEHP is banned in food-handling gloves|
|Europe [42,43]||DEHP, DBP, DiBP, and BBP are banned in all PVC and plasticized toys and childcare articles; DiNP, DiDP, and DnOP are banned for products that can be placed in children’s mouth|
|The United States ||Products containing DEHP, DBP, and BBP at levels >0.1% by weight shall be banned, especially children’s toys, and childcare articles; children’s products that can be placed in a child’s mouth or childcare articles containing more than 0.1% of DiNP, DiDP, and DnOP are banned|
|Australia ||Children’s plastic products containing, or have a component containing more than 1% by weight DEHP |
|China (National Standard of the People’s Republic of China)||16 phthalates are restricted in food and food containers, including DNP, DnOP, DEHP, DiNP, DiBP, BBP, etc; dissolved DEHP in transfusion (infusion) equipment is restricted to less than 10 mg/mL; the total amount of DEHP, BBP, DBP in childcare articles should not be more than 0.1%.|
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Wang, Y.; Qian, H. Phthalates and Their Impacts on Human Health. Healthcare 2021, 9, 603. https://doi.org/10.3390/healthcare9050603
Wang Y, Qian H. Phthalates and Their Impacts on Human Health. Healthcare. 2021; 9(5):603. https://doi.org/10.3390/healthcare9050603Chicago/Turabian Style
Wang, Yufei, and Haifeng Qian. 2021. "Phthalates and Their Impacts on Human Health" Healthcare 9, no. 5: 603. https://doi.org/10.3390/healthcare9050603