Are phthalates threatening your health?

Phthalates hide in plain sight. They’re in countless products you use every day, yet you can’t see, taste or smell them. This family of chemicals make plastics soft, flexible and harder to break.

Phthalates can be found in hundreds of products including:

• Personal care products—cosmetics, shampoo, moisturizers, hair spray and nail polish. They’re often added to provide a smooth feel or fragrance.
• Household items like shower curtains, raincoats and hoses
• Toys
• Vinyl flooring, wall coverings and blinds
• Foods and drinks that are processed and packaged in plastic
• Some medical supplies like intravenous tubes

Although phthalates are common in many consumer products, questions remain about how safe they are for you and your family.

Exposure to phthalates

When phthalates can leach out of plastics, you may be exposed in a few ways:

• Consuming food or drinks contaminated through packaging and storage
• Breathing in air or dust contaminated with phthalates
• Touching or using products made with phthalates

Pregnant women, unborn babies and newborns are most vulnerable to these chemicals, according to the Harvard School of Public Health. Newborns in neonatal intensive units tend to have higher exposure due to the necessary use of medical tubing.

So, how do these chemicals affect your body?

Some phthalates are endocrine disrupters that mimic or interfere with the work of hormones. These chemicals don’t build up in your body. They’re broken down and pass through your urine. But since phthalates are in so many products, you’re constantly exposed to them. In fact, the National Health and Nutrition Examination Survey (NHANES), a yearly examination of American health, finds that phthalate exposure is widespread and ongoing, based on urine tests of survey participants.

How these chemicals could affect our health

Much of the research on phthalate safety comes from animal studies, which can expose subjects to massive amounts of these substances. For ethical and safety reasons, these same kinds of studies can’t be performed in people. Furthermore, animal results don’t always apply to humans.

Some studies have found associations between phthalate exposure and various health risks, measured through human urine samples, but it is difficult to prove that phthalates were the exact cause.

Pregnancy

It’s possible that high levels of a very common phthalate, diethylhexyl phthalate (DEHP), may increase the chance of miscarriage in some women. Researchers followed more than 250 women undergoing fertility treatments, collecting urine samples at the time of conception. The study, published in the journal Epidemiology in 2016, found that women with the highest concentrations of DEHP were 60 percent more likely to lose a pregnancy before 20 weeks than women with the lowest concentrations.

Childhood development

There’s evidence that a pregnant woman’s exposure to phthalates may damage the developing reproductive systems of male fetuses, says Ahmet Ergin, MD, an endocrinologist at Heart and Family Institute, affiliated with St. Lucie Medical Center in Port St. Lucie, Florida.

A 2015 study published in the journal Human Reproduction found that boys who were exposed to DHEP during the first trimester had a shorter anogenital distance than those who weren’t exposed. That distance refers to the space between the anus and genitals. A shortened distance has been linked to infertility and low sperm count, Dr. Ergin says.

Some research has also looked at exposure to phthalates in the womb and developmental problems in childhood. A 2014 study published in the journal Plos One found a connection between phthalates and lower IQ. The urine of 328 expectant moms was tested during their third trimester and their children received IQ tests at age seven. They found that children exposed to the highest levels of di-n-butyl phthalate (DnBP) and di-isobutyl phthalate (DiBP) had between a 6.7 and 7.6 decrease in IQ scores compared to those exposed to the lowest levels.

Liver damage

It’s too soon to draw any conclusions, but some preliminary evidence suggests phthalates could cause liver damage in people. A small study presented at the European Congress of Endocrinology in 2019 analyzed urine samples of people in three groups: obese people, those with type 2 diabetes and otherwise healthy people (the control group).

Researchers found that high levels of two common phthalates were linked to higher indicators of liver damage—as well as insulin resistance, increased fat circulating in the blood (triglycerides) and lower levels of “healthy” (HDL) cholesterol—in people with obesity and diabetes. More research is needed to determine the effect of phthalates on liver health.

Cancer

You might wonder if phthalates cause cancer in people. Dr. Ergin says there is no proof of that. But in rodent studies, high levels of DEHP caused liver cancer. Based on these studies, the U.S. Department of Health and Human Services has determined that DEHP may “reasonably be anticipated” to be a human carcinogen. The Environmental Protection Agency calls DEHP a “probable” human carcinogen.

Should you avoid phthalates?

It’s still tough to know the effect of phthalates and at what levels potential damage may occur. Dr. Ergin thinks products containing phthalates should include warning labels. He also believes pregnant women should consider avoiding products with the chemical in it.

Unfortunately, warning labels for phthalates do not exist right now and the research is still forthcoming. If you want to avoid phthalates, consider these tips:

Be microwave-smart

When heating and storing food, glass containers are a safe choice. If you’re storing food using plastic containers or plastic wrap, check to see if it is labeled phthalate-free. If you’re not sure about your container, transfer food to a microwave-safe plate before heating. Wash plastic containers by hand instead of putting them in the dishwasher.

Choose fresh food

Processed food, including fast food, can be packaged in containers that contain phthalates. Many fresh foods use less packaging and can be healthier for you, as well.

Go “fragrance-free”

If a cosmetic or household good, like laundry detergent, is scented, there could be greater chance that it contains phthalates. They may not even appear under listed ingredients, since manufacturers are allowed to label phthalates as just “fragrance.” If you can’t live without your favorite scent, look for products labeled “phthalate-free.”

Check labels

Personal care items sold to consumers are required to list ingredients. Steer clear of phthalate, diethyl phthalate (DEP) or dibutyl phthalate (DBP) if you see them on the label. Some manufacturers have taken these chemicals out of their products. The safest bet is to look for “phthalate-free” on the label.

Go online

If you can’t remember that alphabet soup, Dr. Ergin suggests going to the internet to check ingredient lists. Websites like the Environmental Working Group’s Skin Deep database or Campaign for Safe Cosmetics often compile lists of “safe” personal care products and brands.

Know your numbers

Plastic bottles, containers and other goods include a triangular universal recycling symbol, usually stamped into the bottom of the product. If there’s a "3" inside the triangle and a "V" or "PVC" below it, it may contain phthalates.

Be choosy with toys

Little ones explore the world with their mouths. Make sure they aren’t chewing or sucking on soft or flexible plastic toys—especially ones sold before April 2018. Since then, the government has banned many phthalates from toys and many childcare products.