Written by Jessica Patella, ND. Study suggests that prenatal exposure to certain phthalates including di-isobutyl phthalate (DiBP) and di-isononyl phthalate (DiNP), may contribute to the development of eczema in early childhood.

infants and childrenPhthalates are plasticizers that adds flexibility to plastics. It can be found in food wrappers, cosmetics, children’s toys, cleaning products, medical devices, pharmaceuticals, PVC flooring and building materials 1,2.  Due to the fact that phthalates are in so many products, there is growing concern over the health effects.  Recent research found a correlation between prenatal exposure to certain phthalates and eczema in boys 1.

An estimated 9.6 million children and 31.6 million adults in the United States suffer from eczema 3.  The exact cause of eczema is still unclear, but it is likely multifactorial 1.  In utero, the skin of the fetus may be exposed to phthalates from what the mother absorbs; this is supported by phthalates detected in amniotic fluid 1,4.  In childhood the exposure can come from skin products, toys and even soil and dust 1,5.  Because the data is unclear, researchers wanted to evaluate the association between maternal exposure to phthalates during the second trimester (24-28 weeks) and occurrence of eczema in male children in the first 5 years of life 1.

The research included 604 mother-son pairs.  First morning urine was collected from the mothers between 24-28 weeks of pregnancy.  The urine was then tested for metabolites of phthalates.  In the boys, eczema was assessed via a standardized questionnaire and physician at 1, 2, 3, 4 and 5 years of age at their annual exam.

Two eczema phenotypes were distinguished, early onset (first 2 years of life) or late onset (2-5 years of life).  A total of 293 boys also had total serum IgE assessed at the 5 years of age assessment, boys were classified as atopic if IgE levels were 60 IU/mL or above 1.

The following results were observed:

Prevalence of eczema:

  • early-onset 15.7%
  • late-onset 14.7%
  • 1-year of age 9.7%
  • 2-years of age 15.7%
  • 3-years of age 21.0%
  • 4-years of age 26.6%
  • 5-years of age 30.4%

– Phthalate metabolites were detected in the urine of more than 97% of mothers.

– Phthalate metabolites were associated with both early and late onset eczema (di-isobutyl phthalate (DiBP) and di-isononyl phthalate (DiNP)).

– Among the atopic boys (determined via IgE levels) phthalate metabolites (di-n-butyl phthalate (DBP) and DiBP) were statistically significant with ever having eczema (HR=1.67 (95% CI: 1.10, 2.54), p=0.01 and HR=1.87 (95% CI: 1.01, 3.48), p=0.04, respectively)

In conclusion, there was an association between prenatal urinary concentration of phthalate metabolites (DiBP and DiNP) and eczema development in early childhood for boys.  This was a larger population-based study, but still needs to be studied in greater detail to provide more evidence of the role of phthalates on eczema in children 1.

Additional information 6:

  • DiBP is used in cellulose plastic, nail polish and lacquer manufacturing.
  • DiNP is used in electric wires and cables, PVC sheeting, coated fabrics, automotive parts, building materials, plastic books, plastic balls, plastic dolls and cartoon figurines.

Source: Soomro, Munawar Hussain, Nour Baiz, Claire Philippat, Celine Vernet, Valerie Siroux, Cara Nichole Maesano, Shreosi Sanyal, Remy Slama, Carl-Gustaf Bornehag, and Isabella Annesi-Maesano. “Prenatal exposure to phthalates and the development of eczema phenotypes in male children: results from the EDEN mother–child cohort study.” Environmental health perspectives 126, no. 2 (2018): 027002.

Posted July 14, 2020.

Jessica Patella, ND, is a naturopathic physician specializing in nutrition and homeopathic medicine and offers a holistic approach to health. She earned her ND from Southwest College of Naturopathic Medicine in Tempe, AZ, and is a member of the North Carolina Association of Naturopathic Physicians. Visit her website at www.awarenesswellness.com

References:

  1. Soomro MH, Baiz N, Philippat C, et al. Prenatal Exposure to Phthalates and the Development of Eczema Phenotypes in Male Children: Results from the EDEN Mother-Child Cohort Study. Environ Health Perspect. 2018;126(2):027002.
  2. Meeker JD, Sathyanarayana S, Swan SH. Phthalates and other additives in plastics: human exposure and associated health outcomes. Philosophical transactions of the Royal Society of London Series B, Biological sciences. 2009;364(1526):2097-2113.
  3. National Eczema Association. Eczema Facts. 2020; https://nationaleczema.org/research/eczema-facts/. Accessed June 30, 2020.
  4. Jensen MS, Anand-Ivell R, Nørgaard-Pedersen B, et al. Amniotic fluid phthalate levels and male fetal gonad function. Epidemiology. 2015;26(1):91-99.
  5. Overgaard LEK, Main KM, Frederiksen H, et al. Children with atopic dermatitis and frequent emollient use have increased urinary levels of low-molecular-weight phthalate metabolites and parabens. Allergy. 2017;72(11):1768-1777.
  6. Johns LE, Cooper GS, Galizia A, Meeker JD. Exposure assessment issues in epidemiology studies of phthalates. Environ Int. 2015;85:27-39.