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Effects of Phthalate Exposure on Children

Phthalate is a high volume synthetic semivolatile chemical compound with the ability to make plastics soft and flexible. Since founded in the 1920s, this material is used in a variety of industrial products, including polyvinyl chloride (PVC) floors, food packaging, daily care products, medical equipment, and children's toys.

Phthalate is not covalently bound, so it can dissolve into the surrounding environment, exposed orally, dermally, and inhalation. Phthalate metabolites can be found in air, dust, food, and water. Global biomonitoring data shows that phthalate metabolites can be found in urine, blood, breast milk, and amniotic fluid. This material can cross the placental barrier and be exposed to humans from the womb.

There is scientific evidence that adults who use several daily products such as perfume, cologne, face creams, lotions, and cosmetics have increased metabolite diethyl phthalate (DEP) and dibutyl phthalate (DBP).

The study of Sathyanarayana et al. reported increased levels of several phthalate metabolites in infants exposed to baby lotions, powder, and shampoo in the last 24 hours.

High molecular weight phthalates are found in adhesives glues, wrappers and food containers, raincoats, and other vinyl products. There is evidence that vinyl flooring is a source of oral and inhalation exposure to di-2-Ethylhexyl phthalate (DEHP) and benzyl butyl phthalate (BzBP).

Phthalate can also be found in some drugs. Users of theophylline, omeprazole, mesalamine, and didanosine have high levels of DEP and DBP in their urine. Likewise, in medical devices, metabolites containing DEHP are found in endotracheal tubes, umbilical catheters, intravenous tubes, intravenous fluid pouches, parenteral nutrition bags and tubes, and urine catheters.



Effects of Phthalate on the Health of Infants and Children

In infants, toddlers, children, and adolescents, the route and source of phthalate exposure are related to the stages of development, such as the activity of putting hands in the mouth, the walking process, daily hygiene and care, food, and health status during the child's development.

The effects of phthalate on infants and children have been studied for nearly 40 years. Many studies have stated that phthalate affects the growth, development, and endocrine system of children.

A systematic review from Ejaredar et al. found that high levels of phthalate metabolites during the prenatal period were associated with low cognitive abilities and behavior in children aged 0-12 years due to the endocrine system disruption.

In 2018, a cohort of 1,333 mother-child pairs was published. The study showed results that exposure to DBP and BzBP during pregnancy was significantly related to speech delay in preschool children.

The prevalence of speech delay in this study was 10% and higher in boys than girls. The analysis found that increasing the exposure to phthalate 2-fold will increase the risk of speech delay by 25-40%.

Another study in the same year conducted in Hokkaido tried to assess the effects of exposure to bisphenol A and phthalate metabolites to behavioral disorders. This study involved 458 subjects. The analysis showed an increased risk of behavioral problems and increased exposure to the metabolism of phthalate mono-2-ethyl-5-carboxymethyl phthalate (MECPP).

This relationship was not found related to other phthalate metabolites studied, namely mono-n-butyl phthalate (MnBP), mono-isobutyl phthalate (MiBP), mono-2-Ethylhexyl phthalate (MEHP), mono-benzyl phthalate (MBzP), mono-2-ethyl-5-hydroxyphenyl phthalate (MEHHP).



Ways to reduce exposure

In recent years the public have paid attention to the health risks associated with phthalate. In 2008, the use of BBzP, DEHP, and DBP in the manufacture of children's toys and the baby equipment were banned.

To minimize exposure, especially in children, things that can be done are environmental modification such as:

  • avoiding the use of vinyl flooring, 
  • avoiding polluted dust by removing footwear in front of the door, 
  • keeping windows clean, 
  • doing floor cleaning routinely, 
  • avoiding processed foods and foods that are wrapped in plastic, 
  • and using cooking utensils and a place to store food that is not made from plastic.



Conclusion
Phthalate is a high-volume semivolatile synthetic chemical that is loved for its ability to make plastics soft and flexible. Phthalate can be found in everyday use products such as polyvinyl chloride (PVC) floors, food packaging, perfume, lotion, children's shampoo, medical equipment, and children's toys.

Many studies link phthalate exposure to growth and development disorders, including cognitive disorders, behavioral disorders, and speech delay. Reducing phthalate exposure can be done with environmental modification, such as maintaining house cleanliness, avoiding the use of food packaging and plastic storage, and avoiding the use of PVC vinyl flooring.

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