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Synthetic chemicals called phthalates, found in consumer products such as food storage containers, shampoo, makeup, perfume and children’s toys, may have contributed to more than 10% of all global mortality from heart disease in 2018 among men and women ages 55 through 64, a new study found.
“Phthalates contribute to inflammation and systemic inflammation in the coronary arteries, which can accelerate existing disease and lead to acute events including mortality,” said senior author Dr. Leonardo Trasande, a professor of pediatrics and population health at New York University’s Grossman School of Medicine. He also is director of NYU Langone’s Division of Environmental Pediatrics and Center for the Investigation of Environmental Hazards.
“Phthalates are known to disrupt testosterone,” Trasande said, adding that in men, “low testosterone is a predictor of adult cardiovascular disease.”
Phthalates have been linked in earlier studies with reproductive problems, such as genital malformations and undescended testes in baby boys and lower sperm counts and testosterone levels in adult males. Studies have also linked phthalates to asthma, childhood obesity and cancer.
“The new study underscores the potentially enormous health and economic burden of DEHP exposure, which aligns with existing concerns about its risks,” said David Andrews, acting chief science officer at the Environmental Working Group, a consumer organization that monitors exposure to phthalates and other chemicals in plastics, in an email. He was not involved with the study.
The American Chemistry Council, which represents industry, declined to comment on the study but told CNN via email that the organization’s High Phthalates Panel is dedicated to promoting the benefits of high phthalates such as DINP and DIDP.
Phthalates exposure and risk
Often called “everywhere chemicals” because they are so common, phthalates are added to consumer products such as PVC plumbing pipes, vinyl flooring, rain- and stain-resistant products, medical tubing, garden hoses and some children’s toys to make the plastic more flexible and harder to break.
Other common exposures come from the use of phthalates in food packaging, detergents, clothing, furniture and automotive plastics. Phthalates are also added to personal care items such as shampoo, soap, hair spray and cosmetics to make fragrances last longer.
People are exposed when they breathe contaminated air or eat or drink foods that come into contact with the plastic, according to the US Centers for Disease Control and Prevention.
A global study
The new study, published Tuesday in the journal eBiomedicine, examined the impact of one phthalate — Di(2-ethylhexyl)phthalate, or DEHP — on global deaths across 200 countries and territories.
Researchers analyzed health and environmental data from dozens of population surveys, which included urine samples containing chemical breakdown products left by DEHP, which is known to be connected to cardiovascular disease, Trasande said.
Di(2-ethylhexyl)phthalate has also been linked to birth defects, cancer and reproductive harm for men, according to California’s Proposition 65, a law that requires companies to place warning labels on products notifying consumers about chemicals’ possible health effects.
Researchers compared the exposure with death statistics collected by the Institute for Health Metrics and Evaluation, a US research group that gathers global medical information.
The analysis found exposure to DEHP contributed to 368,764 deaths in 2018 among men and women ages 55 through 64 globally. Africa accounted for 30% of the deaths from heart disease linked to DEHP, while East Asia and the Middle East accounted for 25% of the mortality, the study found.
The research is believed to be the first global estimate of any health outcome from exposure to the DEHP, said lead study author Sara Hyman, an associate research scientist at NYU Grossman School of Medicine.
“By highlighting the connection between phthalates and a leading cause of death across the world, our findings add to the vast body of evidence that these chemicals present a tremendous danger to human health,” Hyman said in a statement.
A limitation of the research, however, stems from the use of hazard ratios the US to estimate population-attributable deaths in other countries, EWG’s Andrews said.
“While the authors acknowledge this limitation, it assumes that the relationship between DEHP exposure and cardiovascular disease is consistent globally,” he said in an email. “This may not hold true given significant differences in both exposure levels and access to CVD detection and treatment across countries.”
An earlier phthalates study analyzed US data
Previous research by Trasande and his team measured the urine concentration of phthalates in more than 5,000 adults in the United States and compared those levels with the risk of early death over an average of 10 years.
In that study, the researchers found phthalates may contribute to some 91,000 to 107,000 premature deaths a year among Americans ages 55 to 64. People with the highest levels of phthalates had a greater risk of death from any cause, especially cardiovascular mortality, according to the study.
The results held even after researchers controlled for preexisting heart disease, diabetes, cancer and other common conditions, poor eating habits, physical activity and body mass, and levels of other known hormone disruptors such as bisphenol A or BPA.
Researchers estimated those deaths could cost the United States about $40 billion to $47 billion each year in lost economic productivity.
Pack your food in metal, ceramic or glass containers, experts suggest, and never microwave food in plastic. – Westend61/Getty Images
How to limit your exposure
It is possible to minimize your exposure to phthalates and other endocrine disruptors, experts say.
“Avoid plastics as much as you can. Reducing your use of ultraprocessed foods can reduce the levels of the chemical exposures you come in contact with,” Trasande said. “Never put plastic containers in the microwave or dishwasher, where the heat can break down the linings so they might be absorbed more readily.”
Here are other tips to reduce exposure:
· Use unscented lotions and laundry detergents.
· Use cleaning supplies without scents.
· Use glass, stainless steel, ceramic or wood to hold and store foods.
· Buy fresh or frozen fruits and vegetables instead of canned and processed versions.
· Encourage frequent handwashing to remove chemicals from hands.
· Avoid air fresheners and all plastics labeled as No. 3, No. 6 and No. 7.
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