Exposure to phthalates: Reproductive outcome and children health. A review of epidemiological studies |
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Authors: | Joanna Jurewicz Wojciech Hanke |
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Institution: | (1) Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA;(2) Center for Global Health, University of Michigan, Ann Arbor, Michigan, USA;(3) Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA;(4) National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA;(5) Tanta Cancer Center and the Gharbiah Cancer Society, Gharbiah, Egypt |
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Abstract: | Phthalates are a family of industrial chemicals that have been used for a variety of purposes. As the potential consequences
of human exposure to phthalates have raised concerns in the general population, they have been studied in susceptible subjects
such as pregnant women, infants and children. This article aims at evaluating the impact of exposure to phthalates on reproductive
outcomes and children health by reviewing most recent published literature. Epidemiological studies focusing on exposure to
phthalates and pregnancy outcome, genital development, semen quality, precocious puberty, thyroid function, respiratory symptoms
and neurodevelopment in children for the last ten years were identified by a search of the PubMed, Medline, Ebsco, Agricola
and Toxnet literature bases. The results from the presented studies suggest that there are strong and rather consistent indications
that phthalates increase the risk of allergy and asthma and have an adverse impact on children’s neurodevelopment reflected
by quality of alertness among girls, decreased (less masculine) composite score in boys and attention deficit hyperactivity
disorder. Results of few studies demonstrate negative associations between phthalate levels commonly experienced by the public
and impaired sperm quality (concentration, morphology, motility). Phthalates negatively impact also on gestational age and
head circumference; however, the results of the studies were not consistent. In all the reviewed studies, exposure to phthalates
adversely affected the level of reproductive hormones (luteinizing hormone, free testosterone, sex hormone-binding globulin),
anogenital distance and thyroid function. The urinary le vels of phthalates were significantly higher in the pubertal gynecomastia
group, in serum in girls with premature thelarche and in girls with precocious puberty. Epidemiological studies, in spite
of their limitations, suggest that phthalates may affect reproductive outcome and children health. Considering the suggested
health effects, more epidemiologic data is urgently needed and, in the meantime, precautionary policies must be implemented. |
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