Uses and occurrences of five major alternative plasticizers, and their exposure and related endocrine outcomes in humans: A systematic review

Abstract

Background and purpose

Non-phthalate plasticizers are being increasingly used in commercial and consumer products, to replace phthalates. Among major non-phthalate plasticizer groups, we chose five alternative plasticizers of DEHA, DINCH, DEHTP, ATBC, and TOTM, and conducted a systematic literature review for current knowledge on their use and occurrences in major sources, and their exposure and endocrine outcomes in humans.

Methods

Relevant articles published between January 2000 and December 2022 were identified from PubMed and Scopus search and analyzed.

Results

For occurrence, biomonitoring, and endocrine-related outcomes, 79, 73, and 14 studies were finally identified, respectively. The alternative plasticizers were widely used in food packaging, children’s products, hygiene products, medical devices, and construction materials, and frequently detected in indoor dust. Food packaging materials and children’s products were major sources of direct exposure to humans. Human exposure to alternative plasticizers is reported mostly via biomonitoring of urine. Urinary levels of DEHTP and DINCH metabolites were higher among infants, children, and pregnant women than in general adults. In humans, DEHTP, DINCH, or ATBC exposure were associated with sex hormone disruption and reproductive outcomes, but these associations varied by sex and age.

Conclusions

This review showed that the use of and exposure to these alternative plasticizers have increased over time. Their potential health implications, especially among susceptible humans, warrant greater attention and further investigation.

Graphical Abstract

Keywords:

• Non-phthalate
• occurrence
• exposure
• biomonitoring
• epidemiology
• reviews

HANDLING EDITORS:

• Peng Gao and Scott Bradford

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research was supported by a grant (21162MFDS074) from Ministry of Food and Drug Safety in 2023. This work was supported by Korea Environmental Industry & Technology Institute (KEITI) through “Core Technology Development Project for Environmental Diseases Prevention and Management,” funded by Korea Ministry of Environment (MOE) (2022003310006).