Phthalates
are widely used in consumer products and are well-known
for adverse endocrine outcomes. Di-(2-ethylhexyl) phthalate (DEHP),
one of the most extensively used phthalates, has been rapidly substituted
with alternative plasticizers in many consumer products. The aim of
this study was to assess urinary phthalate and alternative plasticizer
exposure and associated risks in children of three Asian countries
with different geographical, climate, and cultural characteristics.
Children were recruited from elementary schools of Saudi Arabia (n = 109), Thailand (n = 104), and Indonesia
(n = 89) in 2017–2018, and their urine samples
were collected. Metabolites of major phthalates and alternative plasticizers
were measured in the urine samples by HPLC-MS/MS. Urinary metabolite
levels differed substantially between the three countries. Metabolite
levels of diisononyl phthalate (DiNP), diisodecyl phthalate (DiDP),
di(2-ethylhexyl) terephthalate (DEHTP), and 1,2-cyclohexane dicarboxylic
acid diisononyl ester (DINCH) were the highest in Saudi children:
Median urinary concentrations of oxo-MiNP, OH-MiDP, 5cx-MEPTP, and
OH-MINCH were 8.3, 8.4, 128.0, and 2.9 ng/mL, respectively. Urinary
DEHP metabolite concentrations were the highest in the Indonesian
children. The hazard index (HI) derived for the plasticizers with
antiandrogenicity based reference doses (RfDAA) was >1
in 86%, 80%, and 49% of the Saudi, Indonesian, and Thai children,
respectively. DEHP was identified as a common major risk driver for
the children of all three countries, followed by DnBP and DiBP depending
on the country. Among alternative plasticizers, urinary DEHTP metabolites
were detected at levels comparable to those of DEHP metabolites or
higher among the Saudi children, and about 4% of the Saudi children
exceeded the health based human biomonitoring (HBM)-I value. Priority
plasticizers that were identified among the children of three countries
warrant refined exposure assessment for source identification and
relevant exposure reduction measures.
