Phthalates, the Everywhere Chemical

Erika Schreder has worked for the Washington Toxics Coalition as a staff scientist since 1997. She has a Masters in resource ecology and management and a B.S. in molecular biology. She currently directs the Clean Water for Salmon campaign, which aims to end pesticide uses that pollute water and threaten salmon.

Editor’s Note: Whatcom Watch will publish most of the 64-page report “Pollution in People” released in May by the Toxic-Free Legacy Coalition. The entire report is available as a pdf file at http://www.pollutioninpeople.org.

Part 2

Pam Tazioli is the consummate Washington woman. Raised in Seattle, she grew up swimming in Puget Sound, digging clams on Northwest beaches and hiking in the Cascades. She went on to start two day care centers and help children with special needs. But Pam was forced to examine her life at age 47, when she was diagnosed with two forms of breast cancer that required extensive treatment. A double mastectomy and six rounds of chemotherapy later, Pam is now passionate about her health and diligent about getting the care she needs to keep the cancer from coming back. As the Washington state coordinator for the Breast Cancer Fund, Pam also educates women about how to reduce breast cancer by addressing environmental causes like pesticides and other toxic chemicals.

Pam has particular concerns about a class of plasticizing chemicals known as phthalates (pronounced THAL-ates), used widely in consumer products like cosmetics, vinyl flooring and shower curtains. Phthalates are nearly ubiquitous in the medical devices Pam got to know intimately during her treatment. Her fears about the chemicals were realized when she received her Pollution in People study results: Pam had some of the highest levels of phthalates in the study, with a total of 467 ppb in her urine. Since phthalates don’t build up in the body, it’s unlikely that this was a remnant of her cancer treatment. Instead, her levels indicate Pam is encountering phthalates in her daily life—from the vinyl wallpaper in her apartment, the food she eats, her follow-up medical care and the cosmetics and personal-care products she uses.

Our results show that Pam is not the only one unable to avoid phthalate exposure. We tested for seven forms of phthalates, which vary in their toxicity and use.2 Most forms were found in all participants; five participants tested positive for all seven forms. Because the CDC tests for phthalates, we were able to compare the levels in our participants with levels found in a large number of people nationwide. For most of the forms, we found levels much higher than those in the population at large.

The graph on the facing page shows our participants’ exposures to the phthalate known as DEHP, which is widely used and, among phthalates, appears to be most toxic at low levels of exposure. Median levels among our participants for the three DEHP metabolites (MEHP, MEOHP and MEHHP) were 7.7, 31.9, and 58.6 ppb; median levels in the CDC study were lower, at 4.1, 17.7, and 12.2 ppb (CDC 2005). We can’t be sure why the levels in our participants were higher, but there are two possibilities. Our samples were all taken at the first morning void, while the CDC took samples throughout the day, potentially creating a difference. Our participants or Washingtonians in general may, however, have greater exposures than others in the United States.

The Pollution in People participant at the top of the list for DEHP metabolites is an occupational and environmental nurse whose job takes her to foundries, shipyards, biotech companies and a medical supplies warehouse. The chemicals she picks up at these workplaces include heavy metals, solvents … and apparently phthalates. Karen Bowman’s career in nursing spans more than two decades, and the tools of her trade make heavy use of phthalate-containing plastics. Medical devices made of polyvinyl chloride (PVC), such as gloves, tubing and intravenous bags, contain 20 to 40 percent DEHP. Karen’s overall DEHP metabolite levels (603 ppb) were more than twice those of any other participant.

The widespread exposures among our study participants are not a surprise. Phthalates are found in an array of consumer products most of us use every day: cosmetics and personal-care products, plastic toys, and vinyl flooring, wallpaper and shower curtains. The chemicals are often an unlisted ingredient in personal-care products such as lotions, shampoo, perfume and after-shave, where they are used to carry fragrances and can thus simply be labeled “fragrance,” despite the fact that they may make up 20 percent or more of the product (ATSDR 1995). In nail polish, phthalates are included to prevent chipping (EWG 2000).

In plastic, phthalates can make up as much as 80 percent of a product. Since they’re not chemically bound to the plastic, up to 50 percent of the phthalates can leach from a product over its lifetime (DiGangi 2002). Phthalates are used most often as plasticizers, or softeners, in PVC products; in fact, such use accounts for 90 percent of all phthalate use. PVC, the second-most commonly used plastic worldwide (CHEJ 2004), is found in an incredible range of products, from pipes and building materials to packaging and toys.

Scientists have shown that phthalates leach from medical devices, such as tubing and blood bags. In a 2005 study, Harvard University researchers measured phthalate levels in newborns at two Boston-area hospitals to determine whether those who received feedings, respiratory therapy and other treatments with PVC products received higher phthalate exposures than those treated with non-PVC products. The study found that the newborns in the hospital where PVC was used had higher phthalate levels than newborns in the hospital using predominantly other plastics (Green 2005). Newborns that had the most intensive treatment with phthalate-containing products had levels five times those of newborns with less-intensive treatment.

For years, evidence that exposure to phthalates may be leading to health problems has been accumulating. Animal tests have revealed a wide array of phthalate-related health effects, most of them reproductive: small or otherwise abnormal testes, hypospadias (abnormal urinary openings) and undescended testes (Gray 2000). These effects occur at exposure levels higher than those expected for people today; however, some of the most highly exposed people have phthalate levels greater than the no-effect, or safe, level in animal tests. For example, some children in neonatal intensive care have DEHP doses greater than levels considered safe by the FDA or EPA. In humans, phthalates cross the placenta to reach the growing fetus. They’re also present in breast milk.

Researchers believe that the phthalate forms that have these reproductive effects, such as DEHP and DBP, act by reducing levels of testosterone and important growth factors in young males. Damage occurs when males are exposed in utero—that is, when mothers come into contact with phthalates during pregnancy. Phthalates are not all equally toxic in this regard, but CDC testing indicates that exposure patterns are of concern. In particular, women have higher exposure to DBP, the harmful phthalate form found in nail polish and other cosmetics, than do men. These women are also exposed to other phthalates, with similar effects, creating the potential that a significant segment of the population may have total phthalate levels high enough to cause harm.

A 2005 study that looked at mothers’ phthalate exposure and reproductive organs in their baby boys provides evidence that current exposure levels may indeed be having an impact on boys’ health. University of Rochester researcher Shana Swan and colleagues found that baby boys whose mothers had greater exposure to phthalates were more likely to have altered genital development. These boys had a changed penis location and a smaller average penis size and were more likely to have undescended testicles (Swan 2005). These effects are consistent with a “phthalate syndrome” observed in male rodents with phthalate-induced feminized traits. Future studies will shed more light on the extent to which phthalates are already affecting baby boys’ reproductive development.

Phthalate exposure has also been linked to lower sperm counts, reduced sperm motility and damaged sperm in men (Duty 2003). The plasticizers may also affect women’s fertility; animal studies show that females exposed to the chemicals experience more difficulty becoming pregnant (Hauser 2005).

Other phthalate-related health concerns include liver and kidney damage as well as asthma (ATSDR 2002). Researchers have found that children in homes with greater levels of phthalates are more likely to have asthma (Bornehag 2004). In adults, phthalate exposure has been associated with reduced lung capacity, with the magnitude of effects similar to that of tobacco smoke (Hoppin 2004).

The reality of the reproductive effects caused by phthalates at today’s exposure levels highlights the urgent need to eliminate the plasticizers from products. Addressing two types of products containing phthalates—PVC and cosmetics—would have a major impact in reducing exposure.

A number of companies, hospitals and government agencies have taken steps to switch to alternative materials and phase out PVC use. Microsoft, for example, has now completely ended the use of PVC in its packaging material, and Kaiser Permanente has pledged to reduce PVC wherever possible in new construction. The health care provider has also worked with vendors to develop PVC-free carpeting and wall coverings. Evergreen Hospital in Kirkland has eliminated most PVC products from its neonatal intensive care unit, as has the special care nursery at Group Health Cooperative in Seattle. Seattle and Olympia have both passed resolutions committing them to seeking alternatives to PVC for city operations.

Based on existing evidence, the European Union passed legislation banning some phthalates in cosmetics in 2003, and has kept three phthalates out of toys since 1999. Although many uses of phthalates are essentially ungoverned in the United States, cosmetic and medical uses are regulated by the Food and Drug Administration (FDA). The FDA has not taken steps to ban phthalates. It has, however, urged medical providers to switch to alternative products that do not contain phthalates. Cosmetics companies, on the other hand, have taken action on their own: Revlon, L’Oreal and other major companies are phasing phthalates out of nail polish. Three hundred companies, including The Body Shop and Burt’s Bees, have pledged to eliminate phthalates from their products in response to requests from the Campaign for Safe Cosmetics. §

Next Month