Reproductive and developmental effects of phthalate diesters in females

Abstract

Phthalate diesters, widely used in flexible plastics and consumer products, have become prevalent contaminants in the environment. Human exposure is ubiquitous and higher phthalate metabolite concentrations documented in patients using medications with phthalate-containing slow release capsules raises concerns for potential health effects. Furthermore, animal studies suggest that phthalate exposure can modulate circulating hormone concentrations and thus may be able to adversely affect reproductive physiology and the development of estrogen sensitive target tissues. Therefore, we conducted a systematic review of the epidemiological and experimental animal literature examining the relationship between phthalate exposure and adverse female reproductive health outcomes. The epidemiological literature is sparse for most outcomes studied and plagued by small sample size, methodological weaknesses, and thus fails to support a conclusion of an adverse effect of phthalate exposure. Despite a paucity of experimental animal studies for several phthalates, we conclude that there is sufficient evidence to suggest that phthalates are reproductive toxicants. However, we note that the concentrations needed to induce adverse health effects are high compared to the concentrations measured in contemporary human biomonitoring studies. We propose that the current patchwork of studies, potential for additive effects and evidence of adverse effects of phthalate exposure in subsequent generations and at lower concentrations than in the parental generation support the need for further study.

• Breast cancer
• developmental
• endometriosis
• fertility
• hormones
• phthalates
• pregnancy
• puberty
• reproductive

Acknowledgements

The authors gratefully acknowledge the administrative support of Ms. Margaret Talbot during the preparation of this manuscript.

Declaration of interests

Funding has been provided by Ferring Pharmaceutical to WGF for the qualification of phthalate exposure in patients prescribed medications containing phthalates in slow release capsules. No external funding support was provided for the preparation of this manuscript. The manuscript was prepared during the normal course of the authors’ employment. The authors have not participated in any legal or regulatory proceedings related to the subject matter of the manuscript. The authors have sole responsibility for the preparation of the manuscript and the views and opinions expressed in the manuscript.