Exposure to di-2-ethylhexylphthalate from plastics may have accounted for a large number of cardiovascular deaths worldwide in 2018 among adults aged 55 to 64 years, according to a recent study.
In a global burden analysis, investigators quantified cardiovascular mortality attributable to di-2-ethylhexylphthalate (DEHP), a plasticizer widely used in polyvinylchloride products. Using a disease burden model incorporating global DEHP exposure data and cardiovascular mortality statistics from the Institute for Health Metrics and Evaluation, the investigators estimated that 356,238 cardiovascular disease (CVD) deaths in 2018 among adults aged 55 to 64 years were attributable to DEHP exposure. Among these, 349,113 deaths—or 98%—were specifically linked to plastics.
The investigators, led by Sara Hyman, of the Department of Paediatrics at the New York University Grossman School of Medicine, assessed DEHP exposure using four urinary metabolites: mono (2-ethylhexyl) phthalate, mono (2-ethyl-5-hydroxyhexyl) phthalate, mono (2-ethyl-5-oxohexyl) phthalate, and mono (2-ethyl-5-carboxypentyl) phthalate. Regional exposure levels were obtained from national biomonitoring surveys in the United States, Canada, and Europe, and from meta-analytic estimates in regions without such data, including Africa and Asia. Metabolite concentrations were converted to a unified molar exposure value and scaled to monoethylhexyl phthalate equivalents. A previously established log-linear hazard ratio of 1.10 per log-unit increase above 0.05 μmol/L was applied to calculate cardiovascular risk.
The investigators estimated that 13.5% of all global CVD deaths among 55- to 64-year-old individuals in 2018 were attributable to DEHP exposure. Additionally, they calculated 10.47 million years of life lost globally as a result of DEHP. The Middle East and South Asia accounted for the largest proportion of these deaths (41.7%), followed by East Asia and the Pacific (31.4%). India experienced the highest national burden, with 103,587 DEHP-attributable deaths compared with 60,937 in China, despite having a smaller population in the target age group.
The findings highlighted significant geographic disparities and suggested that countries with high plastic production, consumption, and limited regulation face a disproportionate cardiovascular burden. The results supported the implementation of global regulatory measures to reduce phthalate exposure and mitigate its health impacts.
Full disclosures can be found in the published study.
Source: eBioMedicine
