Ubiquitous exposure to phthalates, found in everything from food packaging to personal care products, is putting children’s brain development at risk, according to Project TENDR (Targeting Environmental Neuro-Development Risks), a collaboration of scientists, health professionals and advocates for children and the environment.1
The group formed in 2015 due to concerns that toxic environmental chemicals were playing a role in neurodevelopmental disorders including autism, attention deficits, hyperactivity, intellectual disability and learning disorders.
Recently, they’ve honed in on phthalates, finding that enough evidence exists to call for immediate action to protect children’s brains from exposure to this harmful class of chemicals.2
Several Behavioral Disorders Linked to Phthalates
Phthalates are high-production volume chemicals used frequently as plasticizers in polyvinyl chloride (PVC) and other plastics.
An estimated 8.4 million metric tons of plasticizers, including phthalates, are used worldwide each year,3 with phthalate production amounting to about 4.9 million metric tons annually.4 The Norwegian Institute of Public Health found that 90% of those tested from 2016 to 2017 had eight different plasticizers in their urine.5
In a peer-reviewed article published in the American Journal of Public Health, members of Project TENDR came to the conclusion that exposure to ortho-phthalates can impair brain development, increasing children’s risk of learning, attention and behavioral disorders.
They cite data from longitudinal birth cohort studies that show associations between exposure to phthalates in utero and the following health conditions:6
Other behavioral problems
Adverse cognitive development
Poorer psychomotor development
Impaired social communication
According to the report, more than 30 published studies from 11 different countries have measured prenatal phthalate exposure with the children being followed for alterations in neonatal behavior, cognitive development, executive function, social behavior and more.
“The most consistent pattern across multiple studies is associations with behaviors commonly associated with ADHD (including hyperactivity, aggression/defiance and emotional reactivity), deficits in executive function or ADHD clinical diagnosis,” the researchers noted.7
In one example, children born to mothers that were in the highest quintile of urinary phthalate levels (specifically, DEHP metabolites) during the second trimester of pregnancy were nearly three times more likely to be diagnosed with ADHD compared to children born to mothers in the lowest quintile.8
Prenatal exposure to phthalates, especially metabolites of DBP and DEHP, has also been linked to a range of additional problem behaviors such as an increased likelihood of delinquent behaviors and more aggressive behaviors,9 along with reductions in child perceptual reasoning, lowered IQ by seven points, anxiety and poorer working memory.10
Prenatal Exposures Through Puberty Particularly Problematic
There are several sensitive windows of exposure to phthalates, including prenatally and postnatally into adolescence and potentially adulthood. The ongoing development of the brain, including the prefrontal cortex, hippocampus and cerebellum, during these periods make it especially vulnerable to exposures to phthalates toxicities.
The mechanisms behind phthalates’ harms are varied, but the chemicals are known to disrupt organization and function of the hypothalamic-pituitary-gonadal axis, the system responsible for the management of stress and involved in the regulation of immune function and metabolic homeostasis. They may also inhibit fetal testosterone production and may also have antiestrogenic effects,11 which could have repercussions for brain plasticity.12
“The hippocampus and, consequently, aspects of neural plasticity, cognitive flexibility, anxiety-like behavior, learning and memory, are thought to be particularly vulnerable to phthalates,” the team noted,13 adding that phthalates may also cause harm by disrupting thyroid hormone pathways and altering lipid metabolism and ion homeostasis, including calcium signaling and peroxisome proliferator-activated receptors activation. They noted:14
“Given the widespread exposures to phthalates, including among women and children, and the limited existing US regulations, none of which focus on pregnant women, health-protective regulatory actions are required to eliminate these potentially harmful exposures.”
How Are You Exposed to Phthalates?
While the U.S. put restrictions on the use of eight phthalates in children’s toys and other child care items, this is being legally challenged by the National Association of Manufacturers, the American Chemistry Council and other industry groups.15
Further federal regulation of the chemicals remains lax and, in fact, the U.S. Food and Drug Administration approved the use of 28 phthalates for use as food additives in food contact products, such as cellophane, paper and paperboard, coating agents and binders.
Environmental and public health organizations submitted petitions asking the FDA to eliminate its approval of the 28 phthalates as food additives but the FDA did not meet the statutory deadline for final decision.16
As a result, diet continues to be a significant route of exposure to phthalates, since the chemicals can leach into food not only from food packaging commonly used by fast food and take-out restaurants but also from plastic equipment used in food production, such as commercial dairy, conveyor belts and food preparation gloves.17
Another common route of exposure is from building supplies, including vinyl flooring and wall coverings, which allow phthalates to migrate into household dust and indoor air. They’re also widely used in personal care products and cosmetics, including nail polish, fragrance, lotion and hair products.
“Overall, women have higher exposure to phthalates found in personal care products than men,” the report noted, which is especially problematic since “[p]hthalates are readily transferred from mother to fetus during pregnancy.”18
All Phthalates Should Be Regulated, Eliminated
Because people are exposed to multiple phthalates simultaneously, the report called for regulation of the chemicals as a class and policy reforms to eliminate the chemicals from products that lead to exposure in pregnant women, women of reproductive age, infants and children.
“We’re exposed to multiple phthalates, and that mixture can come within a single product, but also across multiple products that people are exposed to in a day,” lead author Stephanie Engel told CNN. “The reality is that we need to think of phthalates as a class because that’s how people are exposed to them.”19
Reviewing the chemicals as a class would also prevent manufacturers from simply swapping one phthalate with another, similar to what occurred with bisphenol-A and bisphenol-S. Linda Birnbaum, former director of the National Institute for Environmental Health Sciences and the National Toxicology Program, told CNN:20
“This is the whole history of these chemicals, whether you call it ‘whack a mole’ or ‘chemical conveyor belt’ or ‘unfortunate substitution.’ We move from one chemical that we have concerns about to another one which we just haven’t studied yet, which often turns out to be just as problematic.
We can’t continue to test these things one at a time. I could make an argument that if one chemical can be substituted for another without changing the process, then why would you think the biology would be different?”
While industry groups have pushed back due to the “costs” associated with removing the chemicals, some retailers and manufacturers have already taken voluntary action to replace them. Home Depot introduced policy to restrict phthalates in vinyl flooring and wall-to-wall carpeting, for instance, and Apple removed the class of chemicals from nearly all of its products.21
Microplastic Pollution Is Another Human Health Crisis
In a perspective article published in the journal Science, Dick Vethaak from Vrije Universiteit Amsterdam and Juliette Legler from Utrecht University in the Netherlands suggest that ubiquitous exposure to microplastics, including plastic particles smaller than 5 millimeters and nanosized plastics smaller than 1 µm, represent another significant risk to human health.22,23
Exposure occurs via both inhalation and ingestion and is the result of the continual breakdown of plastic products such as car tires, clothing, paint coatings and more, which comes in shapes such as spheres, fragments and fibers. The plastics contain mixtures of chemicals, including additives and other environmental contaminants.
“[A] growing body of evidence suggests widespread exposure to microplastics from various foods, drinking water and air,” the researchers noted, adding that microplastics may cause physical, chemical and microbiological toxicity in humans, with the toxic effects acting cumulatively.
In addition, chemical toxicity could also occur since microplastics may act as “vectors to transfer exogenous hazardous chemicals, proteins and toxins present in or on the particles into the body.”24 They pointed out a little-known and understudied potential hazard as well — the presence of an eco- or biocornoa, which are substances on the surface of the plastic particle that could interfere with normal particle uptake:25
“Before crossing the epithelial barriers in the lung and intestine, microplastics are trapped in the mucus layer covering the cells, whereas ingested particles have to pass through acidic conditions in the stomach and intestinal lumen.
The role of the changing composition of the eco- or biocorona acquired by microparticles, from the outside to the inside of the body, across tissue barriers, and the underlying mechanisms in mediating uptake and toxicity are poorly understood and deserve more study.”
In a study at University of Newcastle, Australia, researchers quantified what microplastic exposure may mean for humans, revealing a shocking finding that the average person could be eating about 5 grams of plastic per week — about the amount found in one credit card.26
While environmental groups have called for national targets for plastic reduction, recycling and management, along with an international treaty to stop plastic pollution in the oceans, don’t underestimate the impact one person — you — can have by making simple tweaks to your daily life.
By avoiding the use of single-use plastics like straws, utensils, bags and bottles, and seeking to purchase products that are not made from or packaged in plastic, you can make a dent in the amount of plastic waste and pollution being produced.
How to Reduce Your Phthalate Exposure
You can take steps to reduce your exposure to phthalates and other plasticizers by making small changes in your everyday routine. This includes:
Avoid plastic containers and plastic wrap for food and personal care products. Store food and drinks in glass containers instead.
Avoid plastic children’s toys. Use toys made of natural substances, such as wood and organic materials.
Read labels on your cosmetics and avoid those containing phthalates.
Avoid products labeled with “fragrance,” including air fresheners, as this catch-all term may include phthalates commonly used to stabilize the scent and extend the life of the product.
Read labels looking for PVC-free products, including children’s lunch boxes, backpacks and storage containers.
Do not microwave food in plastic containers or covered in plastic wrap.
Frequently vacuum and dust rooms with vinyl blinds, wallpaper, flooring and furniture that may contain phthalates, as the chemical collects in dust and is easily ingested by children.
Ask your pharmacist if your prescription pills are coated to control when they dissolve as the coating may contain phthalates.
Eat mostly fresh, raw whole foods. Food packaging is often a source of phthalates.
Use glass baby bottles instead of plastic. Breastfeed exclusively for the first year, if you can, to avoid plastic nipples and bottles altogether.
Remove your fruit and vegetables from plastic bags immediately after coming home from the grocery store and wash before storing them; alternatively, use cloth bags to bring home your produce.
Cash register receipts are heat printed and often contain BPA. Handle the receipt as little as possible and ask the store to switch to BPA-free receipts.
Use natural cleaning products or make your own.
Replace feminine hygiene products with safer alternatives.
Avoid fabric softeners and dryer sheets; make your own to reduce static cling.
Check your home’s tap water for contaminants and filter the water if necessary.
Teach your children not to drink from the garden hose, as many hoses contain plasticizers such as phthalates.
Use reusable shopping bags for groceries.
Take your own non-plastic leftovers container to restaurants. Avoid disposable utensils and straws.
Bring your own mug for coffee and bring drinking water from home in glass water bottles instead of buying bottled water.
Consider switching to bamboo toothbrushes and brushing your teeth with coconut oil and baking soda to avoid plastic toothpaste tubes.