Abstract
Previous studies have shown that phthalate exposure in childhood is associated with the development of respiratory problems. However, few studies have assessed the relative impact of prenatal and postnatal exposure to phthalates on the development of asthma later in childhood. Therefore, we assessed the impact of prenatal and postnatal phthalate exposure on the development of asthma and wheezing using a Taiwanese birth cohort. A total of 430 pregnant women were recruited, and 171 (39.8%) of them had their children followed when they were aged 2, 5, and 8 years. The International Study of Asthma and Allergies in Childhood questionnaire was used to assess asthma and wheezing symptoms and serum total immunoglobulin E levels were measured at 8 years of age. Urine samples were obtained from 136 women during their third trimester of pregnancy, 99 children at 2 years of age, and 110 children at 5 years. Four common phthalate monoester metabolites in maternal and children’s urine were measured using liquid chromatography-electrospray ionization-tandem mass spectrometry. Maternal urinary mono-benzyl phthalate [MBzP] concentrations were associated with an increased occurrence of wheezing in boys at 8 years of age (odds ratio [OR] = 4.95 (95% CI 1.08–22.63)), for upper quintile compared to the others) after controlling for parental allergies and family members' smoking status. Urinary mono-2-ethylhexyl phthalate [MEHP] levels over the quintile at 2-year-old were associated with increased asthma occurrence (adjusted OR = 6.14 (1.17–32.13)) in boys. Similarly, the sum of di-2-ethyl-hexyl phthalate [DEHP] metabolites at 5 years was associated with asthma in boys (adjusted OR = 4.36 (1.01–18.86)). Urinary MEHP in maternal and 5-year-old children urine were significantly associated with increased IgE in allergic children at 8 years. Prenatal and postnatal exposure to phthalate was associated with the occurrence of asthma in children, particularly for boys.
Highlights
Over the past few decades, the prevalence of childhood asthma has been increasing throughout the world [1]
It has been hypothesized that the increase in asthma is attributable to exposure to endocrine disruptors that act as adjuvants to immunoglobulin E (IgE)-dependent mechanisms and allergen-specific T helper type 2 (Th2) immune responses [2,3]
The most commonly used phthalates are di-2-ethyl-hexyl phthalate (DEHP) and benzyl butyl phthalate (BBzP), which is the most commonly found phthalate in indoor settings
Summary
Over the past few decades, the prevalence of childhood asthma has been increasing throughout the world [1]. The prevalence of asthma has increased faster in Taiwan than in most countries, possibly due to increased exposure to environmental factors [1]. It has been hypothesized that the increase in asthma is attributable to exposure to endocrine disruptors that act as adjuvants to immunoglobulin E (IgE)-dependent mechanisms and allergen-specific T helper type 2 (Th2) immune responses [2,3]. The primary route of exposure to phthalates is through contaminated food, children have a higher total phthalate intake than adults, likely as a result of mouthing plastics and ingesting indoor dust [6]. The intensive use of plastic materials may be related to the increased exposure to phthalate esters observed in Taiwan, thereby increasing the risk of adverse effects of phthalates, in pregnant women and children [7,8]
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