Background:
Diethyl phthalate (DEP) is widely used in many commercially available
products including plastics and personal care products. DEP has generally
not been found to share the antiandrogenic mode of action that is common
among other types of phthalates, but there is emerging evidence that DEP may
be associated with other types of health effects.
Objective:
To inform chemical risk assessment, we performed a systematic review
to identify and characterize outcomes within six broad hazard categories
(male reproductive, female reproductive, developmental, liver, kidney, and
cancer) following exposure of nonhuman mammalian animals to DEP or its
primary metabolite, monoethyl phthalate (MEP).
Methods:
A literature search was conducted in online scientific databases
(PubMed, Web of Science, Toxline, Toxcenter) and Toxic Substances Control
Act Submissions, augmented by review of online regulatory sources as well as
forward and backward searches. Studies were selected for inclusion using
PECO (Population, Exposure, Comparator, Outcome) criteria. Studies were
evaluated using criteria defined a priori for reporting quality, risk of
bias, and sensitivity using a domain-based approach. Evidence was
synthesized by outcome and life stage of exposure, and strength of evidence
was summarized into categories of
robust
,
moderate
,
slight
,
indeterminate
, or
compelling evidence of no
effect
, using a structured framework.
Results:
Thirty-four experimental studies in animals were included in this
analysis. Although no effects on androgen-dependent male reproductive
development were observed following gestational exposure to DEP, there was
evidence including effects on sperm following peripubertal and adult
exposures, and the overall evidence for male reproductive effects was
considered
moderate
. There was
moderate
evidence that DEP exposure can lead to developmental effects, with the major
effect being reduced postnatal growth following gestational or early
postnatal exposure; this generally occurred at doses associated with
maternal effects, consistent with the observation that DEP is not a potent
developmental toxicant. The evidence for liver effects was considered
moderate
based on consistent changes in relative liver
weight at higher dose levels; histopathological and biochemical changes
indicative of hepatic effects were also observed, but primarily in studies
that had significant concerns for risk of bias and sensitivity. The evidence
for female reproductive effects was considered
slight
based
on few reports of statistically significant effects on maternal body weight
gain, organ weight changes, and pregnancy outcomes. Evidence for cancer and
effects on kidney were judged to be...