Phthalate Exposure and Allergy in the U.S. Population: Results from NHANES 2005–2006

Abstract

Background: Environmental exposures to phthalates, particularly high-molecular-weight (HMW) phthalates, are suspected to contribute to allergy.Objective: We assessed whether phthalate metabolites are associated with allergic symptoms and sensitization in a large nationally representative sample.Methods: We used data on urinary phthalate metabolites and allergic symptoms (hay fever, rhinitis, allergy, wheeze, asthma) and sensitization from participants ≥ 6 years of age in the National Health and Nutrition Examination Survey (NHANES) 2005–2006. Allergen sensitization was defined as a positive response to at least one of 19 specific IgE antigens (≥ 0.35 kU/L). Odds ratios (ORs) per one log10 unit change in phthalate concentration were estimated using logistic regression adjusting for age, race, body mass index, gender, creatinine, and cotinine. Separate analyses were conducted for children (6–17 years of age) and adults.Results: The HMW phthalate metabolite monobenzyl phthalate (MBzP) was the only metabolite positively associated with current allergic symptoms in adults (wheeze, asthma, hay fever, and rhinitis). Mono-(3-carboxypropyl) phthalate and the sum of diethylhexyl phthalate metabolites (both representing HMW phthalate exposures) were positively associated with allergic sensitization in adults. Conversely, in children, HMW phthalate metabolites were inversely associated with asthma and hay fever. Of the low-molecular-weight phthalate metabolites, monoethyl phthalate was inversely associated with allergic sensitization in adults (OR = 0.79; 95% CI: 0.70, 0.90).Conclusion: In this cross-sectional analysis of a nationally representative sample, HMW phthalate metabolites, particularly MBzP, were positively associated with allergic symptoms and sensitization in adults, but there was no strong evidence for associations between phthalates and allergy in children 6–17 years of age.Citation: Hoppin JA, Jaramillo R, London SJ, Bertelsen RJ, Salo PM, Sandler DP, Zeldin DC. 2013. Phthalate exposure and allergy in the U.S. population: results from NHANES 2005–2006. Environ Health Perspect 121:1129–1134; http://dx.doi.org/10.1289/ehp.1206211 [Online 25 June 2013].

Phthalate exposure through different pathways and allergic sensitization in preschool children with asthma, allergic rhinoconjunctivitis and atopic dermatitis

“…Gascon et al (in press) did not find an association between prenatal phthalate exposure and a positive IgE response to three common allergens at age four. In recent work by Hoppin et al (2013), the sum of DEHP metabolites was associated with allergic sensitization in adults. Furthermore, subjects with both symptoms and allergic sensitization had higher odds of BBzP exposure, as measured by urinary MBzP levels, than subjects without sensitization or with symptoms alone.…”

Benzylbutylphthalat [MAK Value Documentation in German language, 2018]

“…Bei Kindern und Jugendlichen zwischen sechs und 17 Jahren (n = 779) war der Gehalt an MBeP im Urin nicht oder eher invers mit der Häu-figkeit der genannten Symptome korreliert und nicht mit einem erhöhten OR für den Nachweis von spezifischem Immunglobulin E assoziiert (Hoppin et al 2013). Eine Verzehnfachung des Urin-Gehalts an MBeP war in einer weiteren Auswertung der Daten von 274 oder 313 Kindern mittels dreier Modelle mit einem Anstieg des Stickstoffmonoxidgehalts in der Ausatemluft um etwa 6,8 bis 8,7 % assoziiert (Just et al 2012 b).…”

“…In einer Untersuchung mit 623 norwegischen Kindern im Alter von zehn Jahren fand sich keine Assoziation für die MBeP-Konzentration im Urin mit einem erhöh-ten Asthma-Risiko (Bertelsen et al 2013).…”

Effects of Endocrine Disrupters on Immune Function and Inflammation

“…Also, the metabolite level when stratified by quartiles was positively correlated with atopic dermatitis. In the National Health and Nutrition Examination Survey (NHANES) for 2005-2006, Hoppin et al [79] reported a positive association of phthalate metabolites with allergic symptoms and sensitization in adults, but not in children (6-17 years of age). In mice, exposure to dibutyl phthalate was shown to alter the activity of macrophages, which affected their antigen presentation capacity [80].…”