The Association between Asthma and Allergic Symptoms in Children and Phthalates in House Dust: A Nested Case–Control Study

Abstract

Global phthalate ester production has increased from very low levels at the end of World War II to approximately 3.5 million metric tons/year. The aim of the present study was to investigate potential associations between persistent allergic symptoms in children, which have increased markedly in developed countries over the past three decades, and the concentration of phthalates in dust collected from their homes. This investigation is a case–control study nested within a cohort of 10,852 children. From the cohort, we selected 198 cases with persistent allergic symptoms and 202 controls without allergic symptoms. A clinical and a technical team investigated each child and her or his environment. We found higher median concentrations of butyl benzyl phthalate (BBzP) in dust among cases than among controls (0.15 vs. 0.12 mg/g dust). Analyzing the case group by symptoms showed that BBzP was associated with rhinitis (p = 0.001) and eczema (p = 0.001), whereas di(2-ethylhexyl) phthalate (DEHP) was associated with asthma (p = 0.022). Furthermore, dose–response relationships for these associations are supported by trend analyses. This study shows that phthalates, within the range of what is normally found in indoor environments, are associated with allergic symptoms in children. We believe that the different associations of symptoms for the three major phthalates—BBzP, DEHP, and di-n-butyl phthalate—can be explained by a combination of chemical physical properties and toxicologic potential. Given the phthalate exposures of children worldwide, the results from this study of Swedish children have global implications.

Prenatal and early life home environment exposure in relation to preschool children’s asthma, allergic rhinitis and eczema in Taiyuan, China

“…In seven out of 9 cities the average TVOC level was higher than the Chinese Indoor Air Quality Standard (GB/T 18883-2002) [25] of 0.6 mg/m 3 as an 8-hour average. Finally, modern chemicals including phthalates [12], and glycol ethers [13] emitted by indoor decorations and furniture have shown a strong association with asthma and allergies. In this study, 28.7% of families reported new decoration before children's birth and 31.6% new furniture, with more than 60% (64.6%) of children living in the current place since children's birth.…”

“…Prenatal exposure and early life factors have been less thoroughly studied [6]. Till now, studies have reported that prenatal exposure to tobacco smoke [7,8], presence of home mold odor [9], early life presence of particle-board furniture [10], pollen or spores [11], and new chemicals [12,13] were associated with respiratory symptoms, including asthma and allergic rhinitis, in children later in life.…”

Estimated daily intake of phthalates in occupationally exposed groups

“…Sources of phthalate exposure include the workplace, diet, off-the-job activities, personal care products, and other home or environmental sources. Phthalates have been evaluated as possible reproductive and developmental toxicants in animals and humans (Hauser and Calafat, 2005;Latini, 2005;Heudorf et al, 2007;Matsumoto et al, 2008) and may also have a function in respiratory disease (Bornehag et al, 2004;Hoppin et al, 2004;Jaakkola and Knight, 2008;Kolarik et al, 2008).…”

Response to ‘Dr Raymond David, BASF Corporation’

“…Median house dust concentrations of BBzP were higher in the bedrooms of cases than controls. The risk of allergic rhinitis and eczema was related to the house dust BBzP concentrations, whereas the risk of asthma was related to concentration of DEHP (Bornehag et al 2004). Jaakkola and colleagues (2006) conducted a population-based incident casecontrol study to assess the relations between different types of interior surface materials and recent renovations at home and at work and the risk of asthma in adults.…”