The Role of Exposure to Phthalates from Polyvinyl Chloride Products in the Development of Asthma and Allergies: A Systematic Review and Meta-analysis

Abstract

BackgroundPhthalates from polyvinyl chloride (PVC) plastics may have adverse effects on airways and immunologic systems, but the evidence has not been reviewed systematically.ObjectiveWe reviewed the evidence for the role of exposure to phthalates from PVC products in the development of asthma and allergies.MethodsWe conducted a Medline database search (1950 through May 2007) for relevant studies on the respiratory and allergic effects of exposure to phthalates from PVC products.ResultsWe based this review on 27 human and 14 laboratory toxicology studies. Two mouse inhalation experiments indicated that mono-2-ethylhexyl phthalate (MEHP) has the ability to modulate the immune response to exposure to a coallergen. The data suggested a no observed effect level of 30 μg MEHP/m3, calculated to be below the estimated level of human exposure in common environments. Case reports and series (n = 9) identified and verified cases of asthma that were very likely caused by fumes emitted from PVC film. Epidemiologic studies in adults (n = 10), mostly small studies in occupational settings, showed associations between heated PVC fumes and asthma and respiratory symptoms; studies in children (n = 5) showed an association between PVC surface materials in the home and the risk of asthma [fixed-effects model: summary odds ratio (OR), 1.55; 95% confidence interval (CI), 1.18–2.05; four studies] and allergies (OR, 1.32; 95% CI, 1.09–1.60; three studies).ConclusionsHigh levels of phthalates from PVC products can modulate the murine immune response to a coallergen. Heated PVC fumes possibly contribute to development of asthma in adults. Epidemiologic studies in children show associations between indicators of phthalate exposure in the home and risk of asthma and allergies. The lack of objective exposure information limits the epidemiologic data.

Identification and Quantification of Phthalate Pollution in Holothuria atra, a Sea Cucumber from the Persian Gulf (Iran)

“…These phthalates effect the endocrine systems, such as sex hormones and thyroids (4). Previous studies also indicate that phthalates could exhibit inflammation, early puberty in girls, oxidative stress, asthma, and allergic reactions (5)(6)(7). Furthermore, induction of toxicity in the liver, lungs, kidneys and testis has been reported for these compounds (3).…”

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).…”

Facts about phthalate toxicity in humans and their occurrence in alcoholic beverages

“…Exposure to phthalates during childhood (as well as in the foetal and neonatal period) is often associated with impaired lung function, risk of bronchial obstruction, asthma and allergies in children, and asthma in adults (59,63). The lungs of newborn rats exposed to DEHP exhibited histological changes similar to those observed in the lungs of children with bronchopulmonary dysplasia, a chronic lung disease typical of preterm infants (64).…”