From: Role of epidemiology in risk assessment: a case study of five ortho-phthalates
Population sampled | Significant endpoint | Significant outcome | Parent phthalate | Estimated phthalate intake a | Lower concentration statistically significant | Reference |
---|---|---|---|---|---|---|
Women | Number of ovarian antral follicles | Decreased | DEHP | 0.03–0.25b | 1.63 μg/L-13.5 μg/L | [39] |
Decreased | DIBP | 0.13–0.19c | 10.21 μg/L | |||
Decreased | DBP | 0.24–0.42 | 12.79 μg/L | |||
Glucose levels | Decreased | DIBP | 0.20 | 10.7 μg/L | [38] | |
Thyroid hormone T4 | Decreased | DBP | 0.20 | 9.6 μg/g CRE | [55] | |
Free thyroid hormone T4 | Decreased | DEHP | 0.53–1.80 | 1.69 μg/L-13.4 μg/L | [56] | |
Thyroid hormone T4 and free T4 | Decreased | DBP | 2.86 | 9.6 μg/g CRE | [49] | |
Total number of oocytes, fertilized oocytes, mature oocytes, top quality embryos | Decreased | DEHP | 0.23–1.39 | 0.02 uM-0.12 uM | [57] | |
Total number of fertilized oocytes, mature oocytes, top quality embryos | Decreased | DBP | 0.24 | 12.7 uM | ||
Trophoblast differentiation genes | Decreased | DiBP | 0.27 | 14.2 μg/L | [58] | |
Decreased | DBP | 0.71 | 38 μg/L | |||
Decreased | DEHP | 4.21 | 221.2 μg/L | |||
Body mass index and waist circumference | Increased | DBP | 0.30 | 12.26 μg/g | [59] | |
Body mass index | Increased | DEHP | 0.56 | 1.49 μg/g CRE | ||
Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) | Increased | DEHP | 1.56 | 12.51 μg/L | [60] | |
Serum inhibin | Decreased | DEHP | 2.04 | 5.44 μg/g CRE | [61] | |
Gestational age | Shorter | DEHP | 2.46 | 18.36 μg/L | [62] | |
Longer | DEHP | 2.56–4.20 | 1.1 μg/L-5.1 μg/L | [63] | ||
C-section | Increased likelihood | DEHP | 2.56–4.20 | 1.1 μg/L-5.1 μg/L | [63] | |
Mothers (3 T) | Serum steroid hormone binding globulin | Increased | BBP | 0.06 | 3.16 μg/L | [50] |
Increased | DBP | 0.63 | 33.4 μg/L | |||
Serum dehydroepiandrosterone sulfate | Decreased | DBP | 0.63 | 33.4 μg/L | ||
Social problems | Increased | BBP | 0.07–0.23 | 3.2 μg/g | [64] | |
Delinquent and externalizing behavior | Increased | DEHP | 2.36 | 0.17 µmol/g CRE (sum DEHP) | ||
Internalizing and externalizing problems | Increased | DEHP | 6.27 | 16.7 μg/g CRE | ||
Motor development | Delayed | DIBP | 0.17 | 9.3 μg/L | [65] | |
Psychomotor development index | Decreased | DIBP | 0.17 | 9.3 μg/L | ||
Clinically withdrawn behavior and internalizing behavior | Increased | BBP | 0.36 | 19 μg/L | ||
Psychomotor and mental development index | Decreased | DBP | 0.71 | 38 μg/L | ||
Clinically withdrawn behavior | Increased | DBP | 0.71 | 38 μg/L | ||
Full scale IQ, perceptual reasoning, processing speed, verbal comprehension and working memory | Decreased | DIBP | 0.36 | 19 μg/L | [36] | |
Decreased | DBP | 1.5 | 79.8 μg/L | |||
Perceptual reasoning | Decreased | BBP | 0.56 | 30 μg/L | ||
Mental and psychomotor development indices | Decreased in boys | DBP | 0.38 | 16.9 μg/g CRE | [66] | |
Psychomotor development index | Decreased in boys | DEHP | 2.7 | 13.2 μg/g CRE | ||
Body mass index z-score | Decreased in girls | DEHP | 1.77 | 0.128µM | [67] | |
Mothers (2 T) | Masculine play behavior | Decrease | DIBP | 0.08 | 4 μg/L | [52] |
Decrease | DEHP | 0.38–0.88 | 1.4–4.7 μg/L | |||
Internalizing behavior | Increased | BBP | 0.26 | 12.8 μg/L | [68] | |
Increased | DBP | 0.68 | 33.1 μg/L | |||
Emotional symptom score and relationship problems | Increased | DBP | 0.68 | 33.1 μg/L | ||
Eczema | Increased | DIBP | 0.51 | 25 μg/L | [53] | |
Attention deficit hyperactivity disorder | Increased | DEHP | 2.66 | 0.21 µM | [69] | |
Mothers (1 T) | Anogenital distance | Shorter | DEHP | 0.66–0.80 | 2–6.1 μg/L | [70] |
Children (4–9 yo) | Thyroid hormone T3 and free T3 | Decreased in girls | BBP | 0.10 | 3.3 μg/L | [71] |
Decreased in girls | DBP | 1.97 | 63 μg/L | |||
Decreased in boys | DBP | 2.34 | 75 μg/L | |||
Children (12 yo) | Height standard deviation | Decreased in obese pubertal children | DEHP | 0.18 | 0.6 μg/g CRE | [72] |
Insulin sensitive index | Increased in obese pre-pubertal children | DEHP | 0.19 | 0.27 μg/g CRE | ||
Waist circumference | Decreased in obese pre-pubertal children | DEHP | 0.19–0.35 | 0.27–1.24 μg/g CRE | ||
Puberty | Delayed in obese pre-pubertal children | DEHP | 0.19–0.35 | 0.27–1.24 μg/g CRE | ||
Waist to hip ratio | Increased in obese pre-pubertal children | DEHP | 0.23 | 0.76 μg/g CRE | ||
Children (8–14 yo) | Estrogen, testosterone and free testosterone | Decreased | DIBP | 0.18 | 7.02 μg/L | [50] |
Free testosterone | Decreased | DEHP | 1.52 | 3.48 μg/L | ||
Serum steroid hormone binding globulin | Increased | DEHP | 1.52–5.09 | 3.48–29 μg/L | ||
Children (8 yo) | Puberty | Delayed in girls | BBP | 0.19 | 6.2 μg/L | [73] |
Delayed in girls | DBP | 1.56 | 50 μg/L | |||
Delayed in girls | DEHP | 4.63 | 74 μg/L | |||
Children (8–10 yo) | Obesity | Increased in boys | DBP | 0.95 | 30.4 μg/L | [74] |
Decreased in girls | DEHP | 1.72–4.31 | 3.3–32 μg/L | |||
Children (6–19 yo) | Albumin/creatinine ratio | Increased | DEHP | 1.60 | 0.1 µM | [75] |
Systolic blood pressure | Increased | DEHP | 3.20 | 0.166 µM | [76] | |
Children (12–19 yo) | Thyroid hormone T3 | Increased | DEHP | 2.2–2.89 | 5.76–10.3 μg/g CRE | [77] |
Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) | Increased | DEHP | 2.76 | 0.17 µM | [78] | |
Men | Sperm motility and concentration | Decreased | DBP | 0.19 | 10.6 μg/L | [48] |
Decreased | DBP | 0.38 | Â | [79] | ||
Sperm motility | Decreased | BBP | 0.25 | 13.4 μg/L | [79] | |
Semen quality | Decreased | DEHP | 242.55 | 20.16 μg/L | [47] | |
Testosterone, free testosterone, free androgen index | Decreased | DEHP | 0.40–2.13 | 1.3–15.9 μg/L | [80] | |
Serum steroid hormone binding globulin | Increased | DEHP | 0.41 | 1.3 μg/L | ||
Testosterone, estrogen, free androgen index | Decreased | DEHP | 0.99 | 3.18 μg/L | [81] | |
Testosterone/estrogen ratio | Increased | DEHP | 0.99 | 3.18 μg/L | ||
Thyroid hormone T3 and free thyroid hormone T4 | Decreased | DEHP | 0.99 | 3.18 μg/L | [82] | |
Thyroid stimulating hormone | Decreased | DEHP | 242.55 | 21 µM | [47] | |
Men and women | Body mass index and waist circumference | Increased | BBP | 0.58 | 30.9 μg/L | [51] |
Decreased | DEHP | 13.75 | 44 μg/L | |||
Body mass index | Increased | DBP | 0.72 | 38.4 μg/L | ||
Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) | Increased | DEHP | 3.16 | 18.51 μg/L | ||
Thyroid hormone T4 | Decreased | DEHP | 1.48–1.97 | 5.43–9.84 μg/g CRE | [77] | |
Thyroid stimulating hormone | Increased | DEHP | 1.97 | 9.84 μg/g CRE |