Phthalate metabolites in urine from China, and implications for human exposures

Simultaneous determination of multiple endocrine disrupting chemicals in human amniotic fluid samples by solid phase extraction coupled with liquid chromatography tandem mass spectrometry (LC-MS/MS)

Prenatal exposure to endocrine-disrupting chemicals (EDCs) may lead to immediate and long-term adverse health effects in the offspring. The occurrence levels of EDCs in amniotic fluid (AF) have significant influence on fetus prior to birth. In this study, an analytical method for simultaneous determination of a total of 59 widely concerned EDCs, including 11 bisphenols (BPs), 4 parabens, 11 phthalate metabolites (mPAEs), 7 organophosphate metabolites (mOPEs), 8 polycyclic aromatic hydrocarbons metabolites (OH-PAHs) and 18 perfluorinated compounds (PFASs), in human AF samples was developed employing solid phase extraction (SPE) coupled with liquid chromatography tandem mass spectrometry (LC-MS/MS). Key parameters of SPE procedures were carefully investigated. The developed method enabled the determination of 59 EDCs in a low sample volume (500 μL) with LOD and LOQ values in the range of 0.02-0.2 ng/mL and 0.07-0.66 ng/mL, respectively. The recoveries (60.95 %-144.74 %) and precisions (<44 %) were obtained. To further verify the method, AF samples from Tianjin of China were collected and analyzed. The detected concentrations of BPs, parabens, mPAEs, mOsPEs, and PFASs ranged from < LOD-60.48 ng/mL, indicating satisfying performance for field samples. Furthermore, the results of AGREEprep, ComplexGAPI and BAGI exhibited good environmental friendliness and applicability of the developed method.

A narrative review of phthalates: From environmental release to kidney injury

Plastic products play an indispensable role in human daily lives, largely due to their low cost and unrivaled convenience. Phthalates (PAEs) are the most significant plastic additives due to their distinctive properties and are extensively utilized and produced in large quantities. Nevertheless, given their inability to form covalent bonds with plastics, these compounds are prone to leaching from plastic surfaces. As a result, the use of plastics in various industries has become a major source of PAEs in the environment, leading to increased risks to humans. The kidneys, which play a central role in the excretion of PAEs, are considered one of the primary target organs for PAEs accumulation and toxicity. A growing body of evidence supports an association between exposure to PAEs and adverse effects on the kidney. In environments, PAEs are often exposed simultaneously with other contaminants that may directly or indirectly modify the toxic effects of PAEs. This review focuses on the adverse effects of PAEs exposure on the kidney and their mechanisms of action, as well as the interactions between PAEs and other contaminants on the kidney. This review underscores the necessity for future toxicological studies to prioritize the mechanisms of renal injury caused by co-exposure to PAEs and other pollutants. The employment of advanced technologies, including network toxicology and molecular docking techniques, is imperative to enhance comprehension of the potential toxicity associated with co-exposures.

Dynamic assessment of phthalate exposure: Linking internal and external monitoring in diverse indoor environments

Phthalates (PAEs), as prevalent endocrine disruptors, are widely distributed in indoor environments and enter the human body through dermal contact, respiratory inhalation, and ingestion, subsequently participating in metabolic processes across various organs and tissues. Existing studies primarily focus on predicting regional exposure scenarios to assess internal or external exposures risks; however, limited studies have systematically examined the correlation and discrepancies between internal and external exposures. This study collected PAEs samples from three phases (gas, particle, and dust phases) across three representative indoor environments and conducted urinary biomonitoring of phthalate metabolites (mPAEs) among exposed populations. Results showed that PAEs concentrations in the gas phase (21.67 μg·m-3) and particle phase (2.38 μg·m-3) were significantly higher in laboratories than in dormitories and offices, whereas office desktops exhibited the highest dust phase concentration (312 μg·g-1). Urinary analysis revealed distinct metabolic profiles across populations: MBP was the dominant metabolite in office and dormitory groups (median: 19.3 ng·mL-1 and 10.4 ng·mL-1, respectively), while MMP prevailed in laboratory populations (median: 18.3 ng·mL-1). Seasonal variation analysis indicated that urinary mPAEs concentrations were 4.28 times higher in summer than in winter. Demographic analysis showed that mPAEs levels were higher in males, individuals with obesity, and those with frequent plastic use compared to females, individuals with normal BMI, and those with infrequent plastic use. Furthermore, external exposure estimated from ambient PAEs concentrations exceeded internal exposure derived from urinary mPAEs concentrations by 17.3 %. These findings provide critical insights into exposure pathway differentiation and risk assessment optimization for indoor PAEs contamination.

Analysis of Phthalate Monoesters and Bisphenols in Human Prostate Cancer Tissue and Urine

A growing concern has been raised about human exposure to phthalates and bisphenols, while data is limited regarding the accumulation of these endocrine disrupting chemicals at the target tissue. In this study, a novel, simple, and sensitive method was successfully developed for the simultaneous determination of nine phthalate monoesters and nine bisphenols in human prostate tissue samples. A solid-liquid extraction procedure was applied following ultra-high performance liquid chromatography tandem mass spectrometry analysis. The detection and quantification limits were in the range of 4.12 × 10-3 to 0.370 ng/g and 1.38 × 10-3 to 1.23 ng/g, respectively. The average spiked recoveries varied from 71.4% to 102%, with relative standard deviations ≤ 10%. Finally, this method was applied to 76 human prostate tissue samples. Four phthalate monoesters (mono-ethyl phthalate, mono-iso-butyl phthalate, mono-n-butyl phthalate, and mono-benzyl phthalate) were detected with the highest frequency of 98.68%, followed by other five phthalate monoesters (71.05% ∼ 94.74%), bisphenol S (72.37%), and bisphenol A (57.89%). Five bisphenols were not detected in any tissue sample. The concentrations of detected phthalate monoesters and bisphenols ranged from 1.12 × 10-3 to 1.86 × 102 ng/g and 6.08 × 10-3 to 39.0 ng/g, respectively, with standard errors ranging from 3.25×10-3 to 4.64 ng/g. Besides, a positive correlation for the concentration of seven phthalate monoesters and bisphenol A could be observed between tissue and urine, which indicates that these metabolites in urine can serve as noninvasive biomarkers to evaluate the true exposure level of prostate tissue. This study provides data and information on exposure to phthalate monoesters and bisphenols in human prostate tissue and the association with their urinary metabolites, supporting further studies of pollutant exposure and prostate disease.

Urinary concentrations of phthalate metabolites and the survival of high-grade serous ovarian cancer with advanced stage

Phthalates have been reported to increase the risk of various hormone-dependent cancers. However, there is still a lack of evidence regarding the association between phthalates and overall survival (OS) in advanced high-grade serous ovarian cancer (HGSOC). This study investigated the relationship between urinary phthalate metabolites and OS in patients with HGSOC using a nested case-control study within the Ovarian Cancer Follow-Up Study. We matched 159 deceased patients with HGSOC to 159 survivors by age at diagnosis, body mass index, and sampling date. Spot urine samples were analyzed for ten phthalate metabolites and five classes of phthalate molar sums via mass spectrometry. Conditional logistic regression models were employed to calculate odds ratios (ORs) and 95% confidence intervals (CIs), comparing the highest tertile with the lowest. We found that the highest tertiles of mono-2-ethyl-5-oxohexyl phthalates and monoethyl phthalates were associated with poorer OS, with ORs (95%CIs) being 4.24 (1.46, 12.32) and 3.28 (1.16, 9.22), respectively. Additionally, the highest tertiles of the sum of di(2-ethylhexyl) phthalate metabolites, the sum of high-molar-weight phthalate metabolites, and the sum of 10 phthalate metabolites, were associated with worse OS, with ORs (95%CIs) were 18.4 (4.14, 81.87), 9.28 (2.87, 30.08), and 5.94 (2.00, 17.64), respectively. Our study suggests that exposure to high levels of phthalates may be associated with poorer OS in patients with advanced HGSOC, particularly exposure to di(2-ethylhexyl) phthalates. Since it is widely used in personal care products, avoiding the use of these products may improve the OS of patients with HGSOC.

Co-exposure to multiple endocrine-disrupting chemicals and oxidative stress: Epidemiological evidence of nonmonotonic dose response curves

This study aimed to investigate the effect of multiple exposure to eight classes (parabens, bisphenols, glycidyl ethers, antimicrobials, benzophenones, phthalates, tri and dichlorophenols) of endocrine disrupting chemicals (EDCs) on oxidative stress levels of 8-hydroxy-2'-deoxyguanosine (8-OHdG). A cross-sectional study was conducted with 300 healthy Brazilian children and adolescents. Urinary levels of 65 EDCs, creatinine and 8-OHdG were analyzed by Liquid Chromatography-Tandem Mass Spectrometry. Elastic net was used to estimate the associations between the levels of EDCs and 8-OHdG. The optimal hyperparameters were estimated using ten-fold cross-validation. Bayesian Kernel machine regression (BKMR) was used to investigate potential interactions and 8-OHdG level response as a function of the co-exposure to EDCs. The elastic net analysis showed that 2,4-DCP (0.149; CI 95 %:-0.033, 0.335, p = 0.02) and BPA (0.21; CI 95 %: 0.08; 0.356, p < 0.005) were associated with urinary levels of 8-OHdG. The BKMR model indicated a positive nonlinear and nonmonotonic relationship between EDCs mixture and 8-OHdG with an inverted U-shaped dose-response curve. This study suggests the first epidemiological evidence of a complex, nonmonotonic relationship between urinary levels of EDCs and 8-OHdG. However, the lack of established reference ranges for 8-OHdG limited a deeper discussion of our findings' clinical significance. Therefore, further studies should focus on validating our results across diverse populations, particularly those affected by oxidative stress-related diseases, and investigate potential mechanisms for supporting this association.

Human urinary occurrence of thiourea vulcanization accelerators and their human exposure

Thiourea vulcanization accelerators (TVAs) have been detected in various household dust samples, indicating their widespread human exposure. Until now, the occurrence of TVAs in human urine, a suitable matrix for assessing human exposure, has remained unknown. The present study comprehensively examined eight kinds of TVAs in urine samples (n = 277) from participants living in Taizhou, China. A total of eight TVAs were found in these human urine samples, exhibiting the detection frequencies ranging from 13% to 91%, highlighting widespread exposure among the general population. N, N'-ethylenethiourea (ETU; 1.7 ng mL-1, min-max range, < limits of detection (LOD)-13 ng mL-1) exhibited the highest mean human urinary concentration, followed by N, N'-diethylthiourea (DETU; 0.51 ng mL-1, < LOD-3.1 ng mL-1) and N, N'-diphenylthiourea (DPTU; 0.37 ng mL-1, < LOD-0.69 ng mL-1). Gender-specific analysis demonstrated no significant (p > 0.05) distinctions in urinary concentrations of ETU, DETU, and DPTU between males and females. Additionally, a significantly (p < 0.05) negative correlation was observed between urinary ETU levels and age, with younger individuals showing relatively higher urinary concentrations. Human daily exposure (DE) values of ETU, DETU, and DPTU were estimated, primarily using their determined urinary concentrations and the fraction of these TVAs that were excreted in human urine. The mean DE values of ETU, DETU, and DPTU were 99 ng/kg bw/day, 46 ng/kg bw/day, and 19 ng/kg bw/day, respectively. To our knowledge, the present study comprehensively characterized the human urinary occurrence of TVAs for the first time. These obtained data are important for advancing the knowledge on human exposure to these TVAs.

2-Mercaptobenzothiazole-derived vulcanization accelerators in urine samples from Chinese adults

Studies have discovered wide presence of 2-mercaptobenzothiazole (2-MBT) and 2-MBT-derived vulcanization accelerators (MVAs) in household dust samples, suggesting that these chemicals may have been pervasive in the environment. However, despite the potential for human exposure, the presence of MVAs in human urine, a common matrix used for assessing exposure to environmental chemicals, has not been thoroughly investigated. The current study comprehensively analyzed 11 kinds of MVAs in urine samples from the recruited general population (n = 197) living in Taizhou city, China. Five kinds of MVAs were detectable in >50 % of human urine samples. This indicates the widespread exposure to these vulcanization accelerators among the general population. The predominant target analytes in human urine were 2-MBT and 2,2'-dithiobisbenzothiazole (MBTS), with the mean urinary concentrations of 2.7 ng/mL (range Collapse

Key Words

• 2-MBT
• Human exposuren
• MBTS
• Urinary concentration
• Vulcanization accelerators

Collapse

MESH Headings

• Humans
• Benzothiazoles/urine
• China
• Adult
• Male
• Female
• Middle Aged
• Environmental Exposure/analysis
• Environmental Monitoring
• Environmental Pollutants/urine
• East Asian People

Collapse

Grants Collapse

Affiliation(s)

Xiaoyu Wu Taizhou Central Hospital (Taizhou University Hospital), School of Medicine, Taizhou University, Taizhou, Zhejiang 318000, PR China
Yingying Zhu School of Life Sciences, Taizhou University, Taizhou, Zhejiang 318000, PR China
Ruyue Guo Key Laboratory of Microbial Technology for Industrial Pollution Control of Zhejiang Province, College of Environment, Zhejiang University of Technology, Hangzhou, Zhejiang 310032, PR China
Juxiu Huang Taizhou Central Hospital (Taizhou University Hospital), School of Medicine, Taizhou University, Taizhou, Zhejiang 318000, PR China
Hangbiao Jin Key Laboratory of Microbial Technology for Industrial Pollution Control of Zhejiang Province, College of Environment, Zhejiang University of Technology, Hangzhou, Zhejiang 310032, PR China
Lisha Zhou Taizhou Central Hospital (Taizhou University Hospital), School of Medicine, Taizhou University, Taizhou, Zhejiang 318000, PR China.

Collapse

Collaborators Collapse

Distribution characteristics and relationship of microplastics, phthalate esters, and bisphenol A in the Beiyun River basin of Beijing

Urban rivers are closely related to human life, and due to the widespread use of plastic products, rivers have become important carriers of pollutants such as microplastics (MP), phthalate esters (PAEs), and bisphenol A (BPA). However, our understanding of the distribution characteristics and relationships of MP, PAEs, and BPA in rivers is limited. In this study, MP, six PAEs and BPA were detected in the water and sediments of the Beiyun River basin. Polyvinyl chloride (PVC) was the most abundant type of microplastic, while di(2-ethylhexyl) phthalate (DEHP) and dibutyl phthalate (DBP) were the most abundant PAEs. MP, PAEs, and BPA in both water and sediment showed positive correlations, with stronger correlations and higher pollution levels in sediment than in water. The tendency for PAE congeners to partition into sediments increased with a higher octanol-water partition coefficient (Kow). There was a significant positive correlation between the distribution tendency of ∑6PAEs and TOC in sediments with a pearson correlation coefficient of 0.717. Rivers with more frequent human activities and higher levels of urbanization in the vicinity had a higher abundance of various pollutants and a greater diversity of MP types.

Comparison of urinary exposure profiles to phthalates and bisphenol analogues in kindergartens in Korea: Impact of environmental choices on children's health

Phthalates and bisphenols (BPs) are well-known endocrine disrupting chemicals (EDCs) that are widely used in diverse consumer and personal care products. Despite their vulnerability, children are frequently exposed to phthalates and BPs in their surrounding environments. Although pre-school children spend most of their time in kindergarten, no comprehensive assessment of children' exposure to EDCs has been conducted according to the type of kindergarten. In this study, the urinary concentrations of phthalate metabolites and BPs were determined in Korean children attending conventional and eco-friendly kindergartens. The exposure levels and contaminant profiles were investigated according to kindergarten type and their association with oxidative stress was assessed. Di-(2-ethylhexyl) phthalate (DEHP) metabolites, such as mono-(2-ethyl-5-carboxypentyl) phthalate (median: 47.1 ng/mL) and mono-[(2-carboxymethyl)hexyl] phthalate (8.45 ng/mL) had the highest levels, indicating that they were the primary contaminants to which the children were exposed. Urinary concentrations of phthalate metabolites and bisphenol A (BPA) were higher in children from conventional kindergarten than an eco-friendly kindergarten. Conversely, bisphenol S (BPS) concentrations were significantly higher in children from the eco-friendly kindergarten than in those from conventional kindergartens, implying that eco-friendly plastic products might contain BPS as a replacement for BPA. The estimated daily intakes of BPA for all children exceeded the new tolerable daily intake proposed by the European Food Safety Authority. Malondialdehyde levels were significantly associated with the urinary concentrations of certain phthalate metabolites, indicating potential adverse health outcomes from phthalate exposure in children. The study highlights the need for targeted interventions to reduce EDC exposure in children, especially in settings where alternative chemicals may still pose health risks.

Examining the Impact of Environmental Non-Persistent Compounds: Phthalates, BPA, and Benzophenone on Endometriosis

Endometriosis is a debilitating condition characterized by the growth of endometrial-like tissue outside the uterus, leading to chronic pain and inflammation. While its etiology remains complex, emerging evidence implicates environmental contaminants as potential contributors. This review explores the roles of endocrine-disrupting chemicals such as phthalates, bisphenol A (BPA), and benzophenone-like ultraviolet (UV) filters in the development and progression of endometriosis. These chemicals, commonly found in everyday products such as plastics, personal care items, and sunscreen, can mimic or interfere with hormonal functions, disrupting the hormonal balance essential for reproductive health. This review included 18 peer-reviewed studies on phthalates, BPA, and UV filters from 2003 to 2023. Evidence for UV filters was inconclusive, with only two studies available. BPA was positively associated with endometriosis in four out of seven studies. Phthalates were associated with a greater odds of endometriosis in five studies, and with a reduced odds in one study, while three studies found no association with endometriosis. This underscores the need for further research with improved timing of exposure measurement. Understanding the role of phthalates, BPA, and UV filters on endometriosis is crucial for developing effective prevention strategies, potentially reducing the burden of endometriosis.

Prenatal exposure to dibutyl phthalate contributes to erectile dysfunction in offspring male rats by activating the RhoA/ROCK signalling pathway

Prenatal exposure to dibutyl phthalate (DBP) has been reported to cause erectile dysfunction (ED) in adult offspring rats. However, its underlying mechanisms are not fully understood. Previously, we found that DBP activates the RhoA/ROCK pathway in the male reproductive system. This study investigated how prenatal exposure to DBP activates the RhoA/ROCK signalling pathway, leading to ED in male rat offspring. Pregnant rats were stratified into DBP-exposed and NC groups, with the exposed group receiving 750 milligrams per kilogram per day (mg/kg/day) of DBP through gavage from days 14-18 of gestation. DBP exposure activated the RhoA/ROCK pathway in the penile corpus cavernosum (CC) of descendants, causing smooth muscle cell contraction, fibrosis, and apoptosis, all of which contribute to ED. In vitro experiments confirmed that DBP induces apoptosis and RhoA/ROCK pathway activation in CC smooth muscle cells. Treatment of DBP-exposed offspring with the ROCK inhibitor Y-27632 for 8 weeks significantly improved smooth muscle cell condition, erectile function, and reduced fibrosis. Thus, prenatal DBP exposure induces ED in offspring through RhoA/ROCK pathway activation, and the ROCK inhibitor Y-27632 shows potential as an effective treatment for DBP-induced ED.

Phthalate exposure as a hidden risk factor for uterine leiomyoma in adult women: Accumulated evidence from observational studies

BACKGROUND

There is evidence that exposure to phthalate in women may increase the risk of uterine leiomyomas. Whereas, the association between exposure to phthalate and the incidence of uterine leiomyoma remained inconclusive.

METHODS

A meta-analysis was performed to evaluate their relationship. Literature eligible for inclusion was found in PubMed, EMBASE, Web of Science, and WanFang Medical Database. Pooled odds ratio (OR) with 95 % confidence interval (CI) was calculated to assess the risk for effect estimate for each phthalate.

RESULTS

A total of fourteen observational studies with 5777 subjects of adult women were included in this study. In the pooled analysis, we found an elevated risk of uterine leiomyoma among women who were exposed to higher levels of di-2-ethylhexyl phthalate (DEHP) (OR 1.61, 95 % CI: 1.18-2.20), as estimated indirectly from the molar summation of its urinary metabolite concentrations. In addition, a positive association was observed between the occurrence of uterine leiomyoma and exposure to low molecular weight phthalate mixture (OR 1.08, 95 % CI: 1.00-1.15), as well as high molecular weight phthalate mixture (OR 1.08, 95 % CI: 1.01-1.15), as quantified by integrating the effect estimates of individual metabolite from each study. Urinary levels of DEHP metabolites, monobenzyl phthalate, mono-(3-carboxypropyl) phthalate, mono-isobutyl phthalate, mono-n-butyl phthalate, monoethyl phthalate, and monomethyl phthalate were not appreciably correlated with the risk of uterine leiomyoma.

CONCLUSION

Our results indicated that exposure to DEHP, and co-exposure to high or low molecular weight phthalate mixture might be potential risk factors for uterine leiomyoma in adult women. Owing to the indirect estimation of association, when interpreting these findings, cautions should be taken.

Current Phthalate Exposure Risks of Rural Population in the Northwest China: Evidence from an Internal Exposure Study

Phthalates (PAEs) are synthetic chemicals widely used in industrial and personal consumer products as adhesives or plasticizers. PAEs have been demonstrated to have toxic effects on the human body. However, biological monitoring data for the internal PAE exposure levels of Chinese rural residents are still limited. The present study investigated the exposure levels of ten phthalate metabolites (mPAEs) of rural residents in Northwest China. The results showed that mPAEs were wildly prevalent in urine and the geometric mean concentration of Σ10mPAEs was 957.02 ng mL-1 (adjusted by specific gravity). Mono-n-butyl phthalate (MBP) and metabolites of di(2-ethylhexyl)-phthalate (DEHP) were the most dominant mPAEs in urine, with specific gravity adjusted median concentrations of 174.67 and 156.30 ng mL-1, respectively. Urinary concentrations of mPAEs were significantly associated with age, body mass index and economic level (p < 0.05). By calculating the percentage and relative conversion rate of DEHP metabolites, it was found that the degree of oxidative metabolism of DEHP in children was significantly higher than that in adults (p < 0.05), indicating that the pathway and degree of DEHP oxidation were age-related. The risk assessment showed that 59.12% of rural residents may have a noncancer risk from PAE exposure. This study provides important basis for assessing the occurrence and exposure of urinary phthalate metabolites among rural residents in China.

Exploring the relationships between exposure levels of bisphenols and phthalates and prostate cancer occurrence

We established an ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method for simultaneously analyzing the metabolites of bisphenols and phthalates in urine to identify the associations between these exposure levels and prostate cancer (PCa) based on a case-control study. After purifying urine samples with SPE, 18 metabolites were separated on a C18 column, and MS detection was performed. The UPLC-MS/MS method has been proven effective at evaluating bisphenol and phthalate exposure (0.020-0.20 μg/L of the limits of detection, 71.8 %∼119.4 % of recoveries, 0.4 %∼8.2 % of precision). Logistic regression explored the association between exposure level and PCa in 187 PCa cases and 151 controls. The detection rates of bisphenol A (BPA) and most phthalate metabolites were 100 % ranging from 0.06-46.74 and 0.12-899.92 μg/g creatinine, respectively, while the detection rates of other bisphenols and mono-benzyl phthalate (MBzP) are low, ranging from 0 % to 21.85 %. Correlation analysis of the metabolite levels indicated that the exposure sources of BPA, di-ethyl phthalate (DEP), and di(2-ethylhexyl) phthalate (DEHP) were different, and that the exposure sources of di-n-butyl phthalate (DnBP) and di-isobutyl phthalate (DiBP) may differ between two groups. Logistic regression analysis revealed that BPA (OR<0.45 vs ≥1.43 =10.02) and DEHP exposure (OR<21.75 vs ≥45.42 =48.26) increased the risk of PCa.

Phthalate Acid Esters (PAEs) in Indoor Dust from Decoration Material Stores: Occurrence, Sources, and Health Risks

Phthalate acid esters (PAEs) are one of the most widely used plasticizers globally, extensively employed in various decoration materials. However, studies on the impact of these materials on indoor environmental PAE pollution and their effects on human health are limited. In this study, forty dust samples were collected from four types of stores specializing in decoration materials (flooring, furniture boards, wall coverings, and household articles). The levels, sources, exposure doses, and potential health risks of PAEs in dust from decoration material stores were assessed. The total concentrations of Σ9PAE (the sum of nine PAEs) in dust from all decoration-material stores ranged from 46,100 ng/g to 695,000 ng/g, with a median concentration of 146,000 ng/g. DMP, DEP, DBP, and DEHP were identified as the predominant components. Among all stores, furniture board stores exhibited the highest Σ9PAE (159,000 ng/g, median value), while flooring stores exhibited the lowest (95,300 ng/g). Principal component analysis (PCA) showed that decoration materials are important sources of PAEs in the indoor environment. The estimated daily intakes of PAEs through non-dietary dust ingestion and dermal-absorption pathways among staff in various decoration-material stores were 60.0 and 0.470 ng/kg-bw/day (flooring stores), 113 and 0.780 ng/kg-bw/day (furniture board stores), 102 and 0.510 ng/kg-bw/day (wall covering stores), and 114 and 0.710 ng/kg-bw/day (household article stores). Particularly, staff in wall-covering and furniture-board stores exhibited relatively higher exposure doses of DEHP. Risk assessment indicated that although certain PAEs posed potential health risks, the exposure levels for staff in decoration material stores were within acceptable limits. However, staff in wall covering stores exhibited relatively higher risks, necessitating targeted risk-management strategies. This study provides new insights into understanding the risk associated with PAEs in indoor environments.

Estimated daily intake and cumulative risk assessment of organophosphate esters and associations with DNA damage among e-waste workers in Hong Kong

Organophosphate esters (OPEs) are extensively used as additives in various products, including electronic equipment, which becomes e-waste when obsolete. Nevertheless, no study has evaluated OPEs exposure levels and the related health risks among e-waste workers in Hong Kong. Therefore, 201 first-spot morning urine samples were collected from 101 e-waste workers and 100 office workers to compare eight urinary OPE metabolites (mOPEs) levels in these groups. The concentrations of six mOPEs were similar in e-waste workers and office workers, except for significantly higher levels of diphenyl phosphate (DPHP) in e-waste workers and bis(1-chloro-2propyl) phosphate (BCIPP) in office workers. Spearman correlation analysis showed that most non-chlorinated mOPEs were correlated with each other in e-waste workers (i.e., nine out of ten pairs, including di-p-cresyl phosphate (DpCP) and di-o-cresyl phosphate (DoCP), DpCP and bis(2-butoxyethyl) phosphate (BBOEP), DpCP and DPHP, DpCP and dibutyl phosphate (DBP), DoCP and BBOEP, DoCP and DPHP, DoCP and DBP, BBOEP and DPHP, DPHP and DBP), indicating that handling e-waste could be the exposure source of specific OPEs. The median values of estimated daily intake (EDI) and hazard quotient (HQ) suggested that the health risks from OPEs exposures were under the recommended thresholds. However, linear regression models, Quantile g-computation, and Bayesian kernel machine regression found that urinary mOPEs elevated 8-hydroxy-2-deoxyguanosine (8-OhdG) levels individually or as a mixture, in which DPHP contributed prominently. In conclusion, although e-waste might not elevate the internal OPEs levels among the participating Hong Kong e-waste workers, attention should be paid to the potential DNA damage stimulated by OPEs under the currently recommended thresholds.

Phthalate esters in clothing: A review

Phthalate esters (PAEs) are widely used as plasticizers to enhance the flexibility and durability of different consumer products, including clothing. However, concerns have been raised about the potential adverse health effects associated with the presence of phthalates in textiles, such as endocrine disruption, reproductive toxicity and potential carcinogenicity. Based on examination of more than 120 published articles, this paper presents a comprehensive review of studies concerning the phthalate content in clothing and other textile products, with special emphasis on those conducted in the last decade (2014-2023). The types and role of PAEs as plasticizers, the relevant legislation in different countries (emphasizing the importance of monitoring PAE levels in clothing to protect consumer health) and the analytical methods used for PAE determination are critically evaluated. The review also discusses the models used to evaluate exposure to PAEs and the associated health risks. Finally, the study limitations and challenges related to determining the phthalate contents of textile products are considered.

Biomonitoring and health risk assessment of exposure to phthalate esters in waste management workers

Humans are at risk of exposure to phthalates due to the widespread use of plasticized plastics, and one of the major concerns is occupational exposure. The present study investigated occupational exposure to phthalates at one of the greatest solid waste management sites in the second-largest country in the Middle East. Carcinogenic and non-carcinogenic health risks were assessed by human biomonitoring (HBM). The concentration of phthalate esters was determined using gas chromatography-mass spectrometry (GC-MS), and the daily intake (DI) of phthalate was calculated based on the adjusted urinary creatinine concentrations. Moreover, carcinogenic and non-carcinogenic risks were assessed. Monte Carlo simulations were performed for uncertainty and sensitivity analysis. The highest concentration recorded was 130.80 µg/g creatinine for mono-ethyl phthalate (MEP) among the composting group, while the lowest concentration was 0.49 µg/g creatinine for Monobenzyl phthalate (MBzP) among the office group. All estimates of daily intake were below the reference concentration, and differences between the DI at site sections were statistically significant (p < 0.05). The non-carcinogenic risk level was negligible. The excess lifetime cancer risk (ELCR) values corresponding to di-(2-ethylhexyl) phthalate (DEHP) exposure were 2.07E-04 among the composting group and 2.07E-04 among the processing group, posing a definite risk. The carcinogenic risk value among the office group was in a possible risk category with ELCR values of 9.75 E-05. The on-site workers of waste management sites can be highly exposed to phthalates, and their health risk is considerable. Appropriate measures and interventions should be considered to reduce occupational exposure to phthalates.

Environmental exposure and child health in China

Chinese children are exposed to broad environmental risks ranging from well-known hazards, such as pesticides and heavy metals, to emerging threats including many new man-made chemicals. Although anecdotal evidence suggests that the exposure levels in Chinese children are substantially higher than those of children in developed countries, a systematic assessment is lacking. Further, while these exposures have been linked to a variety of childhood diseases, such as respiratory, endocrine, neurological, behavioral, and malignant disorders, the magnitude of the associations is often unclear. This review provides a current epidemiologic overview of commonly reported environmental contaminants and their potential impact on children's health in China. We found that despite a large volume of studies on various topics, there is a need for more high-quality research and better-coordinated regional and national data collection. Moreover, prevention of such diseases will depend not only on training of environmental health professionals and enhanced research programs, but also on public education, legislation, and networking.

Release kinetics and risk assessment of additives in plastic advertising banners

Plastic advertising banners (PABs) have been widely used for advertising and publicizing with large usage amount. The PABs are usually added with plenty of chemical additives for improving material performance, and the additives can be released during the lifetime of the PABs. However, limited knowledge is available on the composition and release of the additives in the PABs. In this study, benzenoids were found as the dominant additive categories in PABs. Release kinetics of benzenoid additives with high detection frequency and high abundance from the PABs under indoor and outdoor environments were investigated. During the 150-day release experiment, average release rates of the additives from the PABs under outdoor and indoor environments were 8.3 × 10-10 kg/m2·s and 6.3 × 10-10 kg/m2·s, respectively. The release rates of the additives were negatively related to the thickness of the PAB samples. Health risk assessment indicated that chemicals associated with PABs have potential carcinogenic risks to salesmen in the shopping malls. The risks of chemical exposure associated with PABs to consumers in the shopping malls were acceptable. This study unveils a considerable source of chemical exposure to humans.

Phthalate exposure aggravates periodontitis by activating NFκB pathway

BACKGROUND

Phthalates are widely used plasticizers, which were identified as risk factors in the development of many human diseases. However, the effects of phthalates in the periodontitis are unknown. We aimed to investigated the relationship of periodontitis and phthalate exposure as well as the underlying mechanisms.

MATERIALS AND METHODS

Univariate and multivariate logistic regressions were employed to evaluate the association between phthalate metabolites and periodontitis. The generalized additive model and piecewise logistic regression were conducted to investigate the dose-response relationship. Cell and animal models were used to explore the role and mechanism of DEHP in the development of periodontitis. Transcriptome sequencing, bioinformatics analysis, western blot, immunofluorescence and mice model of periodontitis were also employed.

RESULTS

MEHP (OR 1.14, 95% CI 1.05-1.24), MCPP (OR 1.08, 95% CI 1.00-1.17), MEHHP (OR 1.18, 95% CI 1.08-1.29), MEOHP (OR 1.18, 95% CI 1.07-1.29), MiBP (OR 1.15, 95% CI 1.04-1.28), and MECPP (OR 1.20, 95% CI 1.09-1.32) were independent risk factors. And MEHHP, the metabolite of DEHP, showed the relative most important effects on periodontitis with the highest weight (0.34) among all risk factors assessed. And the increase of inflammation and the activation of NFκB pathway in the periodontitis model mice and cells were observed.

CONCLUSION

Exposure to multiple phthalates was positively associated with periodontitis in US adults between 30 and 80 years old. And DEHP aggravated inflammation in periodontitis by activating NFκB pathway.

Melatonin alleviates di-butyl phthalate (DBP)-induced ferroptosis of mouse leydig cells via inhibiting Sp2/VDAC2 signals

As one of the endocrine-disrupting chemicals (EDCs), dibutyl phthalate (DBP) has been extensively used in industry. DBP has been shown to cause damage to Leydig cells, yet its underlying mechanism remains elusive. In this study, we show that DBP induces ferroptosis of mouse Leydig cells via upregulating the expression of Sp2, a transcription factor. Also, Sp2 is identified to promote the transcription of Vdac2 gene by binding to its promoter and subsequently involved in DBP-induced ferroptosis of Leydig cells. In addition, DBP is proved to induce ferroptosis via inducing oxidative stress, while inhibition of oxidative stress by melatonin alleviates DBP-induced ferroptosis and upregulation of Sp2 and VDAC2. Taken together, our findings demonstrate that melatonin can alleviate DBP-induced ferroptosis of mouse Leydig cells via inhibiting oxidative stress-triggered Sp2/VDAC2 signals.

Assessment of PAH exposure and health risks among South Korean firefighters based on urinary PAH metabolites

Polycyclic aromatic hydrocarbons (PAHs) comprise a group of compounds resulting from the incomplete combustion of organic matter. Firefighters engaged in fire suppression are highly exposed to PAHs. This study centered on evaluating the exposure levels and health risks of PAHs in South Korean firefighters involved in firefighting activities. The concentrations of 10 PAH metabolites in the urine of firefighters were measured immediately after, and two weeks post their engagement in extinguishing a large tire factory fire. The levels of OH-PAHs in urine samples immediately after fire suppression were elevated by a factor of 1.01-1.84 compared to urine samples from non-exposed period. The median concentration of total PAH metabolites (OH-PAHs) was higher in urine samples immediately after fire suppression (5910 ng/g creatinine) than in urine samples from non-exposed periods (5020 ng/g creatinine). However, the ∑OH-PAH levels in firefighters' urine were related to personal habits such as smoking. The concentrations of all individual OH-PAHs in the urine samples of nonsmokers exhibited a substantial increase, ranging from 1.37 to 2.3 times, clearly demonstrating that firefighting activities were a substantial source of PAH exposure. The calculated values associated with the health risks stemming from exposure to PAHs, including carcinogenic risk, total estimated daily intake (TEDI), and hazard quotients/index (HQs/HI), all fell within acceptable limits, indicating negligible risk. However, the HQ/HI values and TEDI for individual and total PAH exposures, except those for naphthalene, were 1.36-2.00 times higher in firefighters' samples taken after firefighting operations compared to those during regular duty. This underscores the need for more comprehensive investigations to comprehend the singular impact of firefighting activities due to the diverse sources of PAH emissions in the environment.

Pollution characteristics and affecting factors of phthalate esters in agricultural soils in mainland China

Phthalate esters (PAEs), the most commonly produced and used plasticizers, are widely used in plastic products and agroecosystems, posing risks to agricultural products and human health. However, current research on PAE pollution characteristics in agricultural soils in China is not comprehensive; affecting factors and relationships with microplastics and plasticizer organophosphate esters have not been sufficiently considered. In this study, farmland soil samples were collected with field questionnaires on a national scale across mainland China. The results showed that the detection rate of PAEs was 100% and the Σ16PAEs concentrations were 23.5 - 903 μg/kg. The level of PAEs was highest in the greenhouse, and significantly higher than that in mulched farmland (p < 0.05). The PAE concentration in northwestern China was the lowest among different physical geographic zones. PAEs in farmlands posed a low cancer risk to Chinese people. PAE pollution in farmlands was significantly (p < 0.05) affected by agronomic measures (such as disposal method), environmental factors, and socioeconomic factors. Overall, PAEs were significantly and positively correlated (p < 0.05) with organophosphate esters but not with microplastics. This study aims to provide scientific data for relevant prevention and control policies, as well as actionable recommendations for pollution reduction.

High-throughput analytical methodology of monoalkyl phthalate esters and the composite risk assessment with their parent phthalate esters in aquatic organisms and seawater

A sensitive, robust, and highly efficient analytical methodology involving solid phase extraction coupled to ultra-high performance liquid chromatography tandem mass spectrometry was successfully established to detect 13 monoalkyl phthalate esters (MPAEs) in aquatic organisms and seawater. After the organisms were preprocessed using enzymatic deconjugation with β-glucuronidase, extraction, purification, and qualitative and quantitative optimization procedures were performed. Under optimal conditions, the limits of detection varied from 0.07 to 0.88 μg/kg (wet weight) and 0.04-1.96 ng/L in organisms and seawater, respectively. Collectively, MPAEs achieved acceptable recovery values (91.0-102.7%) with relative standard deviations less than 10.4% and matrix effects ranging from 0.93 to 1.07 in the above matrix. Furthermore, MPAEs and phthalate esters were detected by the developed methodology and gas chromatography-triple quadrupole tandem mass spectrometer in practical samples, respectively. Mono-n-butyl phthalate and mono-iso-butyl phthalate were the most predominant congeners, accounting for 24.8-35.2% in aquatic organisms and seawater. Comprehensive health and ecological risks were higher after the MPAEs were incorporated than when phthalate esters were considered separately, and greater than their risk threshold. Therefore, the risks caused by substances and their metabolites in multiple media, with analogous structure-activity relationships, should be considered to ensure the safety of aquatic organisms and consumers.

Effect of prenatal exposure to phthalates on birth weight of offspring: A meta-analysis

Prenatal exposure to phthalates is common. However, its effect on birth weight has always been met with conflicting conclusions. To explore the effects of prenatal phthalate exposure on neonatal weight, we searched PubMed, Web of Science (WOS), Cochrane Library, and Embase databases for articles published up to October 24, 2023. Observational studies with 95% confidence intervals (CI) were included. Our findings indicate no significant association between either mixed exposure effects or single phthalate metabolites and offspring birth weight when monitoring maternal urine phthalate metabolites. When stratified by sex, ΣHMWPs and MMP significantly reduced the birth weight of female offspring (ΣHMWPs: Pooled β = -62.08, 95%CI: -123.11 to -1.05, P = 0.046; MMP: Pooled β = -10.77, 95%CI: -18.74 to -2.80, P = 0.008). The results of subgroup analysis showed that ΣPAEs and ΣDEHP significantly decreased birth weight in the specific gravity correction group (ΣPAEs: Pooled estimates = -29.31, 95%CI: -58.52 to -0.10, P = 0.049; ΣDEHP: Pooled estimates = -18.25, 95%CI: -33.03 to -3.47, P = 0.016), and MECPP showed a positive correlation in the creatinine correction group (MECPP: Pooled estimates = 18.45, 95%CI: 0.13 to 36.77, P = 0.048). MEP and MBzP were negatively associated with birth weight in the no adjustment for gestational age group (MEP: Pooled estimates = -7.70, 95%CI: -14.19 to -1.21, P = 0.020; MBzP: Pooled estimates = -9.55, 95%CI: -16.08 to -3.03, P = 0.004). To make the results more convincing, more high-quality studies with large samples are urgently required.

Phthalate metabolites in urine and follicular fluid in relation to menstrual cycle characteristics in women seeking fertility assistance

BACKGROUND

Phthalates have been shown to disrupt the estrous cycle in animal studies. However, epidemiological research investigating their associations with menstrual cycle characteristics is limited.

OBJECTIVE

To explore the relationships between phthalate exposure and menstrual cycle characteristics among women seeking fertility assistance.

METHODS

We determined the levels of eight phthalate metabolites in both follicular fluid (FF) and urine specimens collected from 441 women in the Tongji Reproductive and Environmental (TREE) cohort, using high-performance liquid chromatography and tandem mass spectrometry. Information about menstrual cycle parameters was obtained through a questionnaire. The impacts of individual and joint exposure to phthalates on menstrual cycle characteristics were assessed using multivariable linear regression, Poisson regression, and quantile g-computation approaches.

RESULTS

After adjusting for relevant covariates, we found that per log10-unit increase in mono(2-ethylhexyl) phthalate (MEHP) level in urine specimens was associated with a decrease of 0.20 days (95 % CI: -0.37, -0.03) in bleeding duration. We also observed that mono(2-ethyl-5-carboxypentyl) phthalate (MECPP) and the sum of di(2-ethylhexyl) phthalate (DEHP) metabolites (∑DEHP) concentrations in FF samples were inversely related to cycle length [β = -1.92 (95 % CI: -3.10, -0.75) and -1.87 (95 % CI: -3.56, -0.19), respectively]. However, we generally observed null associations between phthalate metabolites and irregular cycle, dysmenorrhea, hypomenorrhea, or cycle length variation. Furthermore, we also found that phthalate metabolite mixtures in FF and urine were generally unrelated to menstrual cycle characteristics.

CONCLUSION

Our findings suggest that some DEHP metabolites in FF and urine are inversely associated with menstrual cycle length and menstrual bleeding duration in women attending a fertility center.

Effects of butyl benzyl phthalate on zebrafish (Danio rerio) brain and the underlying molecular mechanisms revealed by transcriptome analysis

Butyl benzyl phthalate (BBP), a widely used class of plasticizers, has caused considerable concerns due to its widespread detection in various environmental media. However, the potential impact of BBP on the brain and its underlying molecular mechanisms remain poorly understood. In this study, adult zebrafish (Danio rerio) were exposed to 0, 5, 50, and 500 μg/L BBP for 28 days. Elevated levels of both reactive oxygen species and 8-hydroxydeoxyguanosine were observed, indicating the occurrence of oxidative stress and DNA damage. Furthermore, exposure to BBP resulted in neurotoxicity, apoptosis, and histopathological damage within the zebrafish brain. Transcriptome analysis further revealed that Gene Ontology terms associated with muscle contraction were specifically expressed in the brain after BBP exposure. In addition, BBP altered the transcriptome profile of the brain, with 293 genes induced and 511 genes repressed. Kyoto Encyclopedia of Genes and Genomes analysis highlighted the adverse effects of BBP on the complement and coagulation cascades and two cardiomyopathy-related pathways. Taken together, our results revealed that BBP resulted in brain oxidative stress, histological damage, and transcriptome alterations. These findings have the potential to offer novel insights into the adverse outcome pathways of key events in the brain.

Worldwide risk assessment of phthalates and bisphenol A in humans: The need for updating guidelines

Phthalates and bisphenol A (BPA) are compounds widely used as raw materials in the production of plastics, making them ubiquitous in our daily lives. This results in widespread human exposure and human health hazards. Although efforts have been conducted to evaluate the risk of these compounds in diverse regions around the world, data scattering may mask important trends that could be useful for updating current guidelines and regulations. This study offers a comprehensive global assessment of human exposure levels to these chemicals, considering dietary and nondietary ingestion, and evaluates the associated risk. Overall, the exposure daily intake (EDI) values of phthalates and BPA reported worldwide ranged from 1.11 × 10-7 to 3 700 µg kg bw-1 d-1 and from 3.00 × 10-5 to 6.56 µg kg bw-1 d-1, respectively. Nevertheless, the dose-additive effect of phthalates has been shown to increase the EDI up to 5 100 µg kg bw-1 d-1, representing a high risk in terms of noncarcinogenic (HQ) and carcinogenic (CR) effects. The worldwide HQ values of phthalates and BPA ranged from 2.25 × 10-7 to 3.66 and from 2.74 × 10-7 to 9.72 × 10-2, respectively. Meanwhile, a significant number of studies exhibit high CR values for benzyl butyl phthalate (BBP) and di(2-ethylhexyl) phthalate (DEHP). Moreover, DEHP has shown the highest maximum mean CR values for humans in numerous studies, up to 179-fold higher than BBP. Despite mounting evidence of the harmful effects of these chemicals at low-dose exposure on animals and humans, most regulations have not been updated. Thus, this article emphasizes the need for updating guidelines and public policies considering compelling evidence for the adverse effects of low-dose exposure, and it cautions against the use of alternative plasticizers as substitutes for phthalates and BPA because of the significant gaps in their safety.

A Study of the Relationship between Phthalate Exposure and the Occurrence of Adult Asthma in Taiwan

Although phthalate esters contribute to airway remodeling by increasing bronchial cells' migration and proliferation, the relationship between human exposure to phthalates and asthma is not understood. We measured phthalate exposure in the human body and evaluated its effect on asthma. Asthma (n = 123) and asthma-free (n = 139) participants were, respectively, recruited from an asthma clinic and the community in Taiwan. The urine levels of six phthalate metabolites were determined by liquid chromatography tandem mass spectrometry. Compared with the controls, male asthma patients had higher means of mono-(2-ethylhexyl) phthalate (MEHP) (116.3 nmol/g), monobutyl phthalate (MBP) (850.3 nmol/g) and monoethyl phthalate (MEP) (965.8 nmol/g), and female patients had greater MBP (2902.4 nmol/g). Each 10-fold increase in the level of these phthalate metabolites was correspondingly associated with a 5.0-, 5.8-, 4.2- and 5.3-fold risk of contracting asthma. Male asthma patients were identified to have a higher proportion of MEHP exposure (32.5%) than the controls (25.3%). In asthma patients, an increase in urine MEHP levels and the total phthalate metabolite concentration were notably linked to increased risks of emergency room visits and being hospitalized. For the occurrence and acute clinical events of adult asthma, phthalate exposures and MEHP retention may contribute to higher risks of contracting this respiratory disorder.

Effects of the in-utero dicyclohexyl phthalate and di-n-hexyl phthalate administration on the oxidative stress-induced histopathological changes in the rat liver tissue correlated with serum biochemistry and hematological parameters

Phthalates are widely used as plasticizers in the industry and are found in cosmetics, food and drink packaging, drugs, toys, households, medical devices, pesticides, personal care products, and paints. Phthalates exert endocrine disrupting and peroxisome proliferator effects in humans and wildlife associated with the pathogenesis of various diseases, including diabetes, obesity, infertility, cardiovascular diseases, metabolic syndrome, and cancer. Since phthalates are metabolized in the liver, which regulates the body's energy metabolism, long or short-term exposure to the phthalates is associated with impaired glucose, lipid, and oxidative stress metabolisms contributing to liver toxicity. However, the impact of in-utero exposure to DHP and DCHP on liver metabolism has not been studied previously. Thus, in this study, we evaluated serum biochemistry parameters, hematological markers, histopathological changes, and oxidative and pentose phosphate pathway (PPP) metabolisms in the liver following in-utero DHP and DCHP administration, respectively, in male and female rats. We found increased relative and absolute liver weights and impaired triglyceride, alanine transaminase (ALT), lactate dehydrogenase (LDH), and alkaline phosphatase (ALP) levels upon dicyclohexyl phthalate (DCHP) and di-n-hexyl phthalate (DHP). Histopathological changes, including congestion, sinusoidal dilatation, inflammatory cell infiltration, cells with a pyknotic nucleus, lysis of hepatocytes, and degeneration of hepatic parenchyma have been observed in the liver samples of DHP and DCHP dose groups. Moreover, increased glutathione s-transferase (GST), glucose 6-phosphate dehydrogenase (G6PD), and glutathione reductase (GR) activities have been found in the liver samples of DHP and DCHP-treated rats associated with impaired pentose phosphate pathway (PPP) and oxidative stress metabolism. First time in the literature, we showed that in-utero exposure to DHP and DCHP causes liver damage associated with impaired oxidative stress metabolism in male and female rats. Our data may guide researchers and governments to regulate and restrict phthalates in industrial products.

Phthalate exposure with sperm quality among healthy Chinese male adults: The role of sperm cellular function

Adverse male reproduction caused by phthalate ester (PAE) exposure has been well documented in vivo. However, existing evidence from population studies remains inadequate to demonstrate the impact of PAE exposure on spermatogenesis and underlying mechanisms. Our present study aimed to explore the potential link between PAE exposure and sperm quality and the possible mediation by sperm mitochondrial and telomere in healthy male adults recruited from the Hubei Province Human Sperm Bank, China. Nine PAEs were determined in one pooled urine sample prepared from multiple collections during the spermatogenesis period from the same participant. Sperm telomere length (TL) and mitochondrial DNA copy number (mtDNAcn) were determined in sperm samples. The sperm concentration and count per quartile increment in mixture concentrations were -4.10 million/mL (-7.12, -1.08) and -13.52% (-21.62%, -4.59%), respectively. We found one quartile increase in PAE mixture concentrations to be marginally associated with sperm mtDNAcn (β = 0.09, 95% CI: -0.01, 0.19). Mediation analysis showed that sperm mtDNAcn significantly explained 24.6% and 32.5% of the relationships of mono-2-ethylhexyl phthalate (MEHP) with sperm concentration and sperm count (β = -0.44 million/mL, 95% CI: -0.82, -0.08; β = -1.35, 95% CI: -2.54, -0.26, respectively). Our study provided a novel insight into the mixed effect of PAEs on adverse semen quality and the potential mediation role of sperm mtDNAcn.

Phthalates and phthalate metabolites in urine from Tianjin and implications for platelet mitochondrial DNA methylation

Background

Phthalates (PAEs) are important synthetic substances in plastics, attracting much attention due to their potential effects on the cardiovascular system.

Methods

In this study, urine and blood samples from 39 individuals were collected in Tianjin, China. Phthalates and phthalate metabolites (mPAEs) were analyzed using gas chromatography-mass spectrometry (GC-MS) and high-performance liquid chromatography-mass spectrometry (HPLC-MS), respectively. The polymerase chain reaction (PCR) products from bisulfite-treated mitochondrial DNA (mtDNA) samples were analyzed using pyrosequencing technology.

Results

The detection frequencies for 9 PAEs varied from 2.56 to 92.31%, and those for 10 mPAEs varied from 30.77 to 100%. The estimated daily intakes (EDIs) and cumulative risk of PAEs were calculated based on the experimental statistics of urinary PAEs and mPAEs. For PAEs, the HIRfD (hazard index corresponding to reference doses) values of 10.26% of participants and the HITDI (hazard index corresponding to tolerable daily intake) values of 30.77% of participants were estimated to exceed 1, suggesting a relatively high exposure risk. The mtDNA methylation levels in the MT-ATP8 and MT-ND5 were observed to be lower than in the MT-ATP6. Mono-ethyl phthalate (MEP) and MT-ATP8 were positively correlated with triglyceride levels (p < 0.05). Based on the association of PAEs, mtDNA methylation, and triglycerides, the mediating role of mtDNA methylation between PAEs and cardiovascular diseases (CVDs) was analyzed in this study, but no mediated effect was observed.

Conclusion

The effects of PAE exposure on cardiovascular diseases (CVDs) should be investigated further.

The cumulative risk assessment of phthalates exposure in preterm neonates

Phthalates are widely used plasticizers in various consumer products and medical devices, with some reporting as having estrogenic and anti-androgenic endocrine-disrupting effects. Premature neonates may be exposed to high levels of specific phthalates during hospitalization in the neonatal intensive care unit (NICU) because of reliance on multiple medical procedures that pose a possible health risk. The present study utilized seven urinary phthalate metabolites of dibutyl phthalate isomers [(di-n-butyl phthalate (DnBP) and diisobutyl phthalate (DiBP)], butylbenzyl phthalate (BBzP), and di(2-ethylhexyl) phthalate (DEHP) that had been previously measured in 33 preterm neonates sampled at hospital admission (N = 23) and daily during their NICU stay (N = 260). We aimed to perform: (1) cumulative risk assessment (CRA) using the volume and creatinine-adjusted models; (2) examine the temporal variability of CRA from repeated measures and (3) estimate the risk of cumulative exposure to phthalates based on their anti-androgenic and/or estrogenic properties. We multiplied the relative activity of individual phthalates exhibiting estrogenic or anti-androgenic effects by daily intake. For each preterm neonate, CRA was assessed based on the hazard index (HI) metric [the sum of hazard quotients] based on three reference doses for anti-androgenicity: the tolerable daily intake (TDI) from the European Food Safety Authority, the reference dose (RfD-AA) published in 2010 and newly revised published in 2020 (NRfD-AA). The metabolites of BBzP and DEHP were 2-23 fold higher in preterm neonates during their NICU stay. Median HIs increased in the order of HI_NRfDAA > HI_RfDAA > HI_TDI. In the creatinine-based model, 87% (92%), 87% (96%), and 100% (100%) of preterm neonates at admission (during NICU stay) showed HI_TDI, HI_RfD-AA, and HI_NRfD-AA exceeding 1, respectively with DEHP the most prevalent. The temporal reproducibility of HI (based on three reference doses) during preterm neonate stay in the NICU was high, with intra-class correlation coefficients ranging between 0.77 and 0.97, suggesting persistent exposure to phthalates. The four phthalates that preterm neonates were exposed to in the NICU exhibited estrogenic binding and anti-androgenic effects with median values (creatinine-based) of 98.7 and 56.9 μg/kg body weight/day, respectively. This was especially true for DEHP. The results indicate that preterm neonates in this NICU setting are probably at high risk of cumulative phthalate exposure with anti-androgenic properties that may have long-term adverse reproductive and developmental effects.

Time-trends in human urinary concentrations of phthalates and substitutes DEHT and DINCH in Asian and North American countries (2009-2019)

BACKGROUND

Many phthalates are environmental pollutants and toxic to humans. Following phthalate regulations, human exposure to phthalates has globally decreased with time in European countries, the US and Korea. Conversely, exposure to their substitutes DEHT and/or DINCH has increased. In other countries, including China, little is known on the time-trends in human exposure to these plasticizers.

OBJECTIVE

We aimed to estimate time-trends in the urinary concentrations of phthalates, DEHT, and DINCH metabolites, in general population from non-European countries, in the last decade.

METHODS

We compiled human biomonitoring (HBM) data from 123 studies worldwide in a database termed "PhthaLit". We analyzed time-trends in the urinary concentrations of the excreted metabolites of various phthalates as well as DEHT and DINCH per metabolite, age group, and country/region, in 2009-2019. Additionally, we compared urinary metabolites levels between continents.

RESULTS

We found solid time-trends in adults and/or children from the US, Canada, China and Taiwan. DEHP metabolites decreased in the US and Canada. Conversely in Asia, 5oxo- and 5OH-MEHP (DEHP metabolites) increased in Chinese children. For low-weight phthalates, the trends showed a mixed picture between metabolites and countries. Notably, MnBP (a DnBP metabolite) increased in China. The phthalate substitutes DEHT and DINCH markedly increased in the US.

SIGNIFICANCE

We addressed the major question of time-trends in human exposure to phthalates and their substitutes and compared the results in different countries worldwide.

IMPACT

Phthalates account for more than 50% of the plasticizer world market. Because of their toxicity, some phthalates have been regulated. In turn, the consumption of non-phthalate substitutes, such as DEHT and DINCH, is growing. Currently, phthalates and their substitutes show high detection percentages in human urine. Concerning time-trends, several studies, mainly in Europe, show a global decrease in phthalate exposure, and an increase in the exposure to phthalate substitutes in the last decade. In this study, we address the important question of time-trends in human exposure to phthalates and their substitutes and compare the results in different countries worldwide.

DBP and BaP co-exposure induces kidney injury via promoting pyroptosis of renal tubular epithelial cells in rats

Dibutyl phthalate (DBP) and benzo(a)pyrene (BaP) are widespread environmental and foodborne contaminants that have detrimental effects on human health. Although people are often simultaneously exposed to DBP and BaP via the intake of polluted food and water, the combined effects on the kidney and potential mechanisms remain unclear. Hence, we treated rats with DBP and BaP for 90 days to investigate their effects on kidney histopathology and function. We also investigated the levels of paramount proteins and genes involved in pyroptosis and TLR4/NF-κB p65 signaling in the kidney. Our research showed that combined exposure to DBP and BaP triggered more severe histopathological and renal function abnormalities than in those exposed to DBP or BaP alone. Simultaneously, combined exposure to DBP and BaP enhanced the excretion of IL-1β and IL-18, along with the release of LDH in rat renal tubular epithelial cells (RTECs). Moreover, combined exposure to DBP and BaP increased the expression of pyroptosis marker molecules, including NLRP3, ASC, cleaved-Caspase-1, and GSDMD. Meanwhile, the combination of DBP and BaP activated TLR4/NF-κB signaling in the kidney. Taken together, the combined exposure to DBP and BaP causes more severe kidney injury than that caused by DBP or BaP exposure separately. In addition, pyroptosis of RTECs regulated by TLR4/NF-κB signaling may add to the kidney damage triggered by combined exposure to DBP and BaP.

Effects of single or combined exposure to bisphenol A and mono(2-ethylhexyl)phthalate on oxidant/antioxidant status, endoplasmic reticulum stress, and apoptosis in HepG2 cell line

Endocrine disrupting chemicals (EDCs) may affect many biological processes like growth and stress response. Bisphenol A (BPA) is a plasticizer that is used to harden plastics and polycarbonates. Phthalates are used to add flexibility to polyvinyl chloride containing plastics. The main metabolite of di(2-ethylhexyl) phthalate (DEHP) is mono(2-ethylhexyl) phthalate (MEHP) and it is even more toxic than the parent compound. Humans are usually exposed to these chemicals in mixtures by different routes starting from fetal period. However, there are not many studies in literature that investigate the combined effects of these chemicals. The aim of this study is to investigate toxic effects of BPA and/or MEHP on HepG2 cell line. We have evaluated cytotoxicity, cytomorphological, apoptotic changes, oxidative stress, oxidant/antioxidant status alterations, and endoplasmic reticulum (ER) stress. Combined exposure to BPA and MEHP caused alterations in oxidant/antioxidant status and ER stress marker proteins in both cytoplasmic and nuclear cellular fractions. We can suggest that combined exposure to EDCs may cause serious toxicological outcomes and more mechanistic studies are needed to determine the combined toxic effects.

Endocrine disruptors and endometriosis

Endometriosis is a hormone-dependent inflammatory gynecological disease of reproductive-age women. It is clinically and pathologically characterized by the presence of functional endometrium as heterogeneous lesions outside the uterine cavity. The two major symptoms are chronic pelvic pain and infertility, which profoundly affect women's reproductive health and quality of life. This significant individual and public health concerns underscore the importance of understanding the pathogenesis of endometriosis. The environmental endocrine-disrupting chemicals (EDCs) are exogenous agents that interfere with the synthesis, secretion, transport, signaling, or metabolism of hormones responsible for homeostasis, reproduction, and developmental processes. Endometriosis has been potentially linked to exposure to EDCs. In this review, based on the robust literature search, we have selected four endocrine disruptors (i) polychlorinated biphenyls (PCB)s (ii) dioxins (TCDD) (iii) bisphenol A (BPA) and its analogs and (iv) phthalates to elucidate their critical role in the etiopathogenesis of endometriosis. The epidemiological and experimental data discussed in this review indicate that these four EDCs activate multiple intracellular signaling pathways associated with proinflammation, estrogen, progesterone, prostaglandins, cell survival, apoptosis, migration, invasion, and growth of endometriosis. The available information strongly indicates that environmental exposure to EDCs such as PCBs, dioxins, BPA, and phthalates individually or collectively contribute to the pathophysiology of endometriosis. Further understanding of the molecular mechanisms of how these EDCs establish endometriosis and therapeutic strategies to mitigate the effects of these EDCs in the pathogenesis of endometriosis are timely needed. Moreover, understanding the interactive roles of these EDCs in the pathogenesis of endometriosis will help regulate the exposure to these EDCs in reproductive age women.

The influence of perinatal maternal exposure to dibutyl phthalate on glucolipid metabolism in adult female offspring

BACKGROUND

Maternal exposure to dibutyl phthalate (DBP) may result in obesity in female offspring. However, the underlying mechanisms remain elusive.

MATERIALS AND METHODS

Sprague-Dawley rats were intraperitoneally injected with different doses of DBP and corn oil from gestational day 7 until the end of lactation. The weights, visceral fat percentage, serum lipid, insulin and glucose, protein levels of PI3K signal pathway in muscle were detected in F1 female offspring.

RESULTS

Although the birth weight of F1 female offspring was not different among groups, the weights were heavier in DBP groups from postnatal day 7 to adult (P < 0.001). The visceral adipose percentage in adult female offspring was increased by perinatal exposure to DBP (P < 0.001). Decreased serum level of triglyceride (P = 0.001) in F1 female offspring was found in DBP group as compared to control, especially in medium and high DBP. However, none difference was found for fasting glucose, prolactin, HOMA-IR, fasting insulin, total cholesterol, adiponectin. Different protein levels of GPR30 were observed in muscle of female offspring among four groups (P = 0.016). The protein level of AKT seemed higher in DBP group but without statistical significance (P = 0.05). None difference was observed for the protein levels of PI3K, p-AKT, pAKT/AKT, PTEN, GLUT4, InsR, IRS.

CONCLUSION

Maternal perinatal exposure to DBP might induce obesity and accumulation of visceral adipose tissue for the adult female offspring. Serum glucolipid and local signal transduction of PTEN/PI3K/AKT pathway in muscle were not adversely affected by perinatal exposure to DBP for adult female offspring.

Phthalates in dormitory dust and human urine: A study of exposure characteristics and risk assessments of university students

Phthalate diesters (PAEs) are prevalent and potentially toxic to human health. The university dormitory represents a typical and relatively uniform indoor environment. This study evaluated the concentrations of phthalate monoesters (mPAEs) in urine samples from 101 residents of university status, and the concentrations of PAEs in dust collected from 36 corresponding dormitories. Di-(2-ethylhexyl) phthalate (DEHP, median: 68.0 μg/g) was the major PAE in dust, and mono-ethyl phthalate (47.9 %) was the most abundant mPAE in urine. The levels of both PAEs in dormitory dust and mPAEs in urine were higher in females than in males, indicating higher PAE exposure in females. Differences in lifestyles (dormitory time and plastic product use frequency) may also affect human exposure to PAEs. Moreover, there were significant positive correlations between the estimated daily intakes of PAEs calculated by using concentrations of PAEs in dust (EDI_D) and mPAEs in urine (EDI_U), suggesting that PAEs in dust could be a significant source of human exposure to PAEs. The value of EDI_D/EDI_U for low molecular weight PAEs (3-6 carbon atoms in their backbone) was lower than that of high molecular weight PAEs. The contribution rate of various pathways to PAE exposure illustrated that non-dietary ingestion (87.8 %) was the major pathway of human exposure to PAEs in dust. Approximately 4.95 % of university students' hazard quotients of DEHP were >1, indicating that there may be some health risks associated with DEHP exposure among PAEs. Furthermore, it is recommended that some measures be taken to reduce the production and application of DEHP.

The independent and interactive effects of phthalates exposure and hypertension on the indicators of early renal injury in US adults: Evidence from NHANES 2001-2004

The association between phthalates and early renal injury is largely unknown in adults. We aim to explore the associations of phthalates and hypertension with early renal injury, and the interactive effects of phthalate and hypertension on the early renal injury. This study enrolled 3283 U.S. adults from NHANES 2001-2004. We detected nine phthalate metabolites in spot urine. We also measured the multiple indicators of early renal injury, including albumin-to-creatinine (Cr) ratio (ACR), β2-microglobulin (B2M), cystatin C (CYST), and calculated the estimated glomerular filtration rate (eGFR), including Cr-based eGFR, CYST-based eGFR, and Cr-CYST-based eGFR. Multiple linear regression and multivariable logistic regression were used to explore the associations among urinary phthalate metabolites, hypertension, and the indicators of early renal injury. The results showed that monobenzyl phthalate (MBzP), mono (3-carboxypropyl) phthalate (MCPP), and mono (2-ethylhexyl) phthalate (MEHP) were positively associated with ACR, B2M, CYST and negatively associated with three eGFR. Mono(2-ethyl-5-oxohexyl) phthalate (MEOHP) was positively associated with ACR, with a β value of 0.099 (95% CI: 0.046, 0.152). Meanwhile, MEHP was associated with a higher risk of ACR abnormality, with an OR value of 1.258 (95% CI: 1.067, 1.482). MBzP, MCPP, and MEOHP increased the risks of ACR, B2M, CYST, and eGFR abnormality. Hypertension was positively associated with ACR, with a β value of 0.460 (95% CI: 0.360, 0.561). We also found interactive effects of monoethyl phthalate (MEP), MCPP, MBzP, monobutyl phthalate (MnBP), and hypertension on B2M, CYST, and three kinds of eGFR. Our results indicated that certain phthalate metabolites might contribute to increased risks of early renal injury. The hypertension population may be more sensitive to the early renal injury caused by phthalates exposure than the non-hypertension population.

Dibutyl phthalate causes MC3T3-E1 cell damage by increasing ROS to promote the PINK1/Parkin-mediated mitophagy

Dibutyl phthalate (DBP) is a plasticizer widely used in daily production, which causes serious environmental pollution, and damage to brain, liver, kidney, and lung by producing excessive reactive oxygen species (ROS) after entering the body. DBP can also cause skeletal dysplasia, but it is unclear whether ROS is involved. In addition, overproduction of ROS can activate mitophagy, which is an important mechanism for regulating mitochondrial quality and cell homeostasis. In order to investigate whether DBP can damage MC3T3-E1 cells (osteoblast cell line) and whether ROS and mitophagy are involved, DBP toxicity experiment, Parkin gene silencing experiment, and N-acetylcysteine (NAC) intervention experiment were performed on MC3T3-E1 cells in turn. First, we found that DBP caused MC3T3-E1 cell viability decline and osteogenic dysfunction, accompanied by the overproduction of ROS and the activation of mitophagy. Then, we found that silencing Parkin expression alleviated DBP-induced apoptosis and osteogenic dysfunction of MC3T3-E1 cells. In addition, NAC treatment inhibited the PINK1/Parkin-mediated mitophagy and alleviated the apoptosis and osteogenic dysfunction of MC3T3-E1 cells caused by DBP. Our research results showed that DBP could cause MC3T3-E1 cell damage by increasing ROS to promote the PINK1/Parkin-mediated mitophagy.

National-scale urinary phthalate metabolites in the general urban residents involving 26 provincial capital cities in China and the influencing factors as well as non-carcinogenic risks

Phthalates (PAEs) are widely used in daily products but can cause a variety of adverse effects in humans. Few studies have been carried out on human internal exposure levels of PAEs on a large-scale, especially in developing countries. In the present study, 1161 urine samples collected from residents of 26 provincial capitals in China were analyzed for nine phthalate metabolites (mPAEs). The chemicals were widely detected, and the median specific gravity adjusted urinary concentration of Σ₉mPAEs was 278 μg/L. Di-(2-ethylhexyl) phthalate (DEHP) and di-n-butyl phthalate (DnBP) were the main parent PAEs that the residents were exposed to. Demographic characteristics, such as age and educational level, were significantly associated with PAE exposure. Children and the elderly had higher mPAE levels. Subjects with lower educational levels were more frequently exposed to DnBP and DEHP. However, mono-ethyl phthalate showed the opposite trend, i.e., higher concentrations in subjects aged 18-59 years and with higher educational levels. Geographic differences were detected at the national scale. Residents in northeastern and western China had higher levels of mPAEs than those in central China, most likely because of different industrial usage of the chemicals and different living habits and living conditions of the residents. Health risk assessment showed that hazard indices of PAEs ranged from 0.07 to 9.34, with 20.0% of the subjects being concern for potential non-carcinogenic risk as assessed by Monte Carlo simulation. DEHP and DnBP were the primary contributors, representing 96.7% of total risk. This first large-scale study on PAE human internal exposure in China provides useful information on residents' health in a developing country, which could be used for chemical management and health protection.

Levels and health risks of urinary phthalate metabolites and the association between phthalate exposure and unexplained recurrent spontaneous abortion: a large case-control study from China

Phthalate acid esters (PAEs) are environmental endocrine disruptors that can interfere with endocrine processes and cause adverse reproductive outcomes. The link between PAE exposure and unexplained recurrent spontaneous abortion (URSA) remains unknown. In this study, nine urinary metabolites of PAEs (mPAEs) were measured in 594 URSA cases and 569 healthy controls. The measured mPAEs were ubiquitously detected and present at higher levels (median: 203 ng/mL) in the URSA cases than in the controls (median: 161 ng/mL). Multiple logistic regression analysis showed that URSA was associated with higher concentrations of mono (2-ethyl-5-hydroxyhexyl) phthalate (mEHHP), mono (2-ethylhexyl) phthalate (mEHP), and mono-ethyl phthalate (mEP) and lower concentrations of mono-isobutyl phthalate (miBP). Moreover, a quantile-based g-computation (QGC) model revealed a positive association between mPAEs mixture and URSA. The URSA cases showed significantly higher concentrations of di-(2-ethylhexyl) phthalate (DEHP) than the controls. This was consistent with the health risk assessment, which suggested that DEHP is the main contributors to potential non-carcinogenic risk. DEHP accounted for over 80% of total risk. The large case-control study results suggest that PAE exposure may increase the risk of URSA, and that policy-makers and public health experts should pay more attention to DEHP exposure.

Exposure characteristics of phthalate metabolites among the Zunyi cohort of pregnant women in Southwest China

Reported evidence has increasingly indicated that exposure to phthalates can cause adverse pregnancy outcomes. However, phthalate exposure levels among pregnant women remains unclear. We aimed to evaluate the concentrations and predictors of phthalate metabolites in urine samples of the ongoing Zunyi cohort of pregnant women from Southwest China. The urine samples were collected from 1003 pregnant women during their third trimester of pregnancy. The concentrations of nine phthalate metabolites in urine samples were then determined. Data on socio-demographic profiles of the participants, lifestyle during pregnancy, parity, and sampling season were collected using questionnaires. The detectable rate of phthalate metabolites ranged from 76 to 100%. On average, mono-butyl phthalate exhibited the highest median concentration (62.45 μg/L), while mono-benzyl phthalate exhibited the lowest median concentration (0.04 μg/L). Urine concentrations of phthalate metabolites were significantly higher in older, multiparous, higher body mass index, higher income, and passive smoking during pregnancy participants. The levels of low-molecular-weight phthalate metabolites were highest during the summer. The findings indicate the health of pregnant women and fetuses in Zunyi may be generally harmed by the high exposure of phthalate metabolites, especially by mono-n-butyl phthalate. In addition, phthalate metabolites present a demographic and seasonal differential distribution among the study population. Targeted measures to reduce phthalate exposure for high-risk pregnant women and during high-exposure seasons may have potential benefits for maternal and fetal health protection.

Maternal DBP exposure promotes synaptic formation in offspring by activating astrocytes via the AKT/NF-κB/IL-6/JAK2/STAT3 signaling pathway

It has been demonstrated that activated astrocytes in the hypothalamus could disrupt GnRH secretion in offspring after maternal di-n-butyl phthalate (DBP) exposure, indicating that the effect of DBP on astrocyte activation and crosstalk between astrocytes and neurons is still worthy of further investigation. In this study, pregnant mice were intragastrically administered DBP dissolved in corn oil from gestational days (GD) 12.5-21.5. Maternal DBP exposure resulted in hippocampal astrocyte activation, abnormal synaptic formation, and reduced autonomic and exploratory behavior in offspring on postnatal day (PND) 22. Further studies identified that mono-n-butyl phthalate (MBP) induced astrocyte activation and proliferation by activating the AKT/NF-κB/IL-6/JAK2/STAT3 signaling pathway. Moreover, upregulated thrombospondin 1 (TSP1) in activated astrocytes regulated synaptic-related protein expression. This study highlights the neurotoxicity of maternal DBP exposure to offspring, which provides new insights into identifying potential molecular targets for the treatment of diseases related to neurological development disorders in children.

Exposure to phthalate esters in Japanese females in Kyoto, Japan from 1993 to 2016: Temporal trends and associated health risks

Phthalates are used as plasticizers in many products used in daily life worldwide. Due to industrial and economic developments, exposure among general population to phthalates may vary geographically and temporally. However, studies are lacking for investigating temporal changes in phthalate exposure in the Japanese population. In the present study, the temporal trends in exposure to various phthalates were assessed among a group of Japanese adult female population over 1993-2016 and derived associated risks. For this purpose, urine samples of healthy Japanese females in Kyoto, Japan (N = 132) collected in 1993, 2000, 2003, 2009, 2011, and 2016, were employed and measured for the concentrations of 18 phthalate metabolites. Over this period, the detection rates of mono(3-carboxypropyl) phthalate (MCPP) and monoisobutyl phthalate (MiBP) decreased, and the geometric means of the urinary concentrations of mono(2-ethyl-5-carboxypentyl) phthalate (MECPP), and mono(2-ethyl-5-oxohexyl) phthalate (MEOHP) showed a significant decreasing trend. Cumulative risk due to exposure to dibutyl phthalate (DBP), diisobutyl phthalate (DiBP), butyl benzyl phthalate (BBP), and di-2-ethylhexyl phthalate (DEHP) showed a dramatic decrease only between 1993 and 2000. The maximum hazard quotient (HQ_M) was attributed to DEHP in most subjects regardless of sampling year. This study showed the temporal trend of the exposure of Japanese females to several phthalate esters over two decades. As of the late 2010's, DEHP was still the predominant component of phthalate ester exposure in the population. The HI value, however, indicates that direct risk due to phthalate exposure was unlikely among the studied population.

Risk Assessment of Phthalates and Their Metabolites in Hospitalized Patients: A Focus on Di- and Mono-(2-ethylhexyl) Phthalates Exposure from Intravenous Plastic Bags

Phthalate esters (PAEs) are plasticizers associated with multiple toxicities; however, no strict regulations have been implemented to restrict their use in medical applications in Lebanon. Our study aimed at assessing the potential risks correlated with phthalate exposure from IV bags manufactured in Lebanon. GC–MS analysis showed that di-(2-ethylhexyl) phthalate (DEHP) is the predominant phthalate found in almost all samples tested with values ranging from 32.8 to 39.7% w/w of plastic. DEHP concentrations in the IV solutions reached up to 148 µg/L, as measured by SPME-GC–MS/MS, thus resulting in hazard quotients greater than 1, specifically in neonates. The toxicity of DEHP is mainly attributed to its metabolites, most importantly mono-(2-ethylhexyl) phthalate (MEHP). The IV bag solution with the highest content in DEHP was therefore used to extrapolate the amounts of urinary MEHP. The highest concentrations were found in neonates having the lowest body weight, which is concerning, knowing the adverse effects of MEHP in infants. Our study suggests that the use of IV bags manufactured in Lebanon could pose a significant risk in hospitalized patients, especially infants in neonatal care. Therefore, Lebanon, as well as other countries, should start imposing laws that restrict the use of phthalates in medical IV bags and substitute them with less toxic plasticizers.