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Prenatal phthalate exposure and early childhood wheeze in the SELMA study
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).ORCID iD: 0000-0001-6322-9556
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).ORCID iD: 0000-0001-9414-3018
Lund University, Sweden.
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Icahn School of Medicine at Mount Sinai, USA.ORCID iD: 0000-0003-0417-1686
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2022 (English)In: Journal of Exposure Science and Environmental Epidemiology, ISSN 1559-0631, E-ISSN 1559-064X, Vol. 32, no 2, p. 303-311Article in journal (Refereed) Published
Abstract [en]

Background Prenatal maternal phthalate exposure has been associated with wheeze and asthma in children, but results are inconclusive. Previous studies typically assessed exposure in late pregnancy, included only a small number of old phthalates, and assessed outcomes in children aged 5 years or older. Objective We explored associations between 1st trimester prenatal maternal exposure to a wider range of phthalates and wheeze in early childhood. Methods First trimester concentrations of 14 metabolites from 8 phthalates and one alternative plasticizer were quantified in first-morning void urine from 1148 mothers in the Swedish SELMA study. Associations between log-transformed metabolite concentrations and parental reported ever wheeze among 24-month-old children were investigated with logistic regression models adjusted for parental asthma/rhinitis, sex of child, maternal education, smoking, and creatinine. Results Metabolites of replacement phthalates di-iso-decyl phthalate (DiDP) and di-2-propylheptyl phthalate (DPHP) were associated with increased risk for wheeze (aOR 1.47, 95% CI 1.08-2.01 and aOR 1.49, 95% CI 1.04-2.15, respectively). The associations with DiDP and DPHP were stronger among children whose parents did not have asthma or rhinitis. In this group, wheeze was also associated with metabolites of butyl-benzyl phthalate (BBzP) and di-iso-nonyl phthalate (DiNP). Significance Maternal phthalate exposure during early pregnancy may be a risk factor for wheeze in early childhood, especially among children whose parents do not have asthma or rhinitis symptoms.

Place, publisher, year, edition, pages
Springer Nature, 2022. Vol. 32, no 2, p. 303-311
Keywords [en]
Respiratory, Pregnancy, Children's health, Plasticizer, Endocrine disruption
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public Health Science
Identifiers
URN: urn:nbn:se:kau:diva-85996DOI: 10.1038/s41370-021-00382-wISI: 000692096800002PubMedID: 34475495Scopus ID: 2-s2.0-85114619396OAI: oai:DiVA.org:kau-85996DiVA, id: diva2:1596309
Available from: 2021-09-22 Created: 2021-09-22 Last updated: 2024-07-26Bibliographically approved
In thesis
1. Phthalates: A Full Chain Story: Connecting phthalate sources, indoor dust, human intake, and airway symptoms in children
Open this publication in new window or tab >>Phthalates: A Full Chain Story: Connecting phthalate sources, indoor dust, human intake, and airway symptoms in children
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Ftalater: En kedjemodell : Samband mellan ftalatkällor, inomhusdamm, humanintag och luftvägssymtom hos barn
Abstract [en]

Phthalates are widely used in a large number of consumer goods and building materials from which they can leach and contaminate the environment such as indoor dust and air. It is unclear how phthalate sources in our homes and indoor dust contribute to human intake and airway symptoms in children. 

This thesis aims to contribute to the understanding of phthalate exposure by exploring connections between phthalate sources in home environments, indoor exposure, human intake, and childrens’ airway symptoms. It utilizes data in the Swedish SELMA study, including measurements of indoor dust phthalate levels and corresponding metabolites in prenatal maternal urine, and information on health outcomes and cofactors from self-administered questionnaires. 

The results show higher levels of three phthalates (DnBP, BBzP and DEHP) in dust from homes with PVC flooring. Four phthalates in dust (DEP, DnBP, DiBP, and BBzP) were positively correlated with corresponding maternal urinary metabolites. The dust was estimated to explain a 1-28% (median) contribution to the total daily intake of the analysed phthalates among pregnant women. Living in homes with PVC flooring was linked to a higher intake of BBzP and DEHP. Further, associations were found between prenatal phthalate exposure (BBzP, DiNP, DiDP and DPHP) and wheeze, and phthalates in dust (DEP, BBzP and DEHP) and croup in children before 2-years-of-age.

This thesis connects a full chain of factors relevant for human phthalate exposure. Sources in our homes were linked to higher levels in dust and to human intake. Also, both regulated and non-regulated phthalates were associated with human intake and airway symptoms. Combined with other research results, this implies that using new phthalates as replacements might not be optimal, and we could consider regulating phthalates as a group. Any links to effects in older children is unknown, still, limiting indoor phthalate sources could reduce intake and benefit overall public health.

Abstract [en]

The indoor environment is important for our health; still, a mix of phthalates, that are either non-regulated or classed as hazardous, can be detected in dust in our homes. The phthalates have leached from various products and building materials such as plastics, electronics, perfume, and interiors. Should this make us concerned?

This thesis has followed indoor phthalate exposure from vinyl (PVC) flooring materials to dust, to phthalate intake among pregnant women, and finally to investigated if airway symptoms in young children are linked to either phthalate exposure of the fetus or phthalates in bedroom dust.

The results show that phthalates from vinyl floorings can be followed through this full exposure chain. Both regulated and non-regulated replacement phthalates were associated with human intake and airway symptoms in children. Combined with other research results, this implies that using new phthalates as replacements might not be optimal, and we could consider regulating phthalates as a group. Although the risk is relatively low for the individual, reducing phthalate sources and exposure during early human development may have benefits on a public health level and contribute to more sustainable use of resources.

Place, publisher, year, edition, pages
Karlstad, Sweden: Karlstads universitet, 2021. p. 68
Series
Karlstad University Studies, ISSN 1403-8099 ; 2021:29
Keywords
children's health, endocrine disruption, exposure pathways, full chain model, human exposure, plasticizers, pregnancy, PVC, respiratory, SELMA study
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public Health Science
Identifiers
urn:nbn:se:kau:diva-86337 (URN)978-91-7867-234-9 (ISBN)978-91-7867-245-5 (ISBN)
Public defence
2021-12-10, Fryxell 1B 306, Universitetsgatan 2, Karlstad, 15:00 (English)
Opponent
Supervisors
Note

Article 1 part of thesis as manuscript, now published.

Available from: 2021-11-19 Created: 2021-10-29 Last updated: 2022-06-14Bibliographically approved

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Preece, Anna-SofiaKnutz, MalinBornehag, Carl-GustavShu, Huan

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