Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, Maryland, USA.
Department of Nutritional Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA.
Environ Health Perspect. 2024 Mar;132(3):36001. doi: 10.1289/EHP11760. Epub 2024 Mar 13.
There is growing interest in evidence-based interventions, programs, and policies to mitigate exposures to bisphenols and phthalates and in using implementation science frameworks to evaluate hypotheses regarding the importance of specific approaches to individual or household behavior change or institutions adopting interventions.
This scoping review aimed to identify, categorize, and summarize the effects of behavioral, clinical, and policy interventions focused on exposure to the most widely used and studied bisphenols [bisphenol A (BPA), bisphenol S (BPS), and bisphenol F (BPF)] and phthalates with an implementation science lens.
A comprehensive search of all individual behavior, clinical, and policy interventions to reduce exposure to bisphenols and phthalates was conducted using PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Google Scholar. We included studies published between January 2000 and November 2022. Two reviewers screened references in CADIMA, then extracted data (population characteristics, intervention design, chemicals assessed, and outcomes) for studies meeting inclusion criteria for the present review.
A total of 58 interventions met the inclusion criteria. We classified interventions as dietary (), clinical (), policy (), and those falling outside of these three categories as "other" (). Most interventions (81%, 47/58) demonstrated a decrease in exposure to bisphenols and/or phthalates, with policy level interventions having the largest magnitude of effect.
Studies evaluating policy interventions that targeted the reduction of phthalates and BPA in goods and packaging showed widespread, long-term impact on decreasing exposure to bisphenols and phthalates. Clinical interventions removing bisphenol and phthalate materials from medical devices and equipment showed overall reductions in exposure biomarkers. Dietary interventions tended to lower exposure with the greatest magnitude of effect in trials where fresh foods were provided to participants. The lower exposure reductions observed in pragmatic nutrition education trials and the lack of diversity (sociodemographic backgrounds) present limitations for generalizability to all populations. https://doi.org/10.1289/EHP11760.
人们对基于证据的干预措施、项目和政策越来越感兴趣，这些措施和政策旨在减少双酚类和邻苯二甲酸酯的接触，并利用实施科学框架来评估关于个人或家庭行为改变或机构采用干预措施的具体方法的重要性的假设。
本范围综述旨在确定、分类和总结以实施科学视角为重点的、针对最广泛使用和研究的双酚类物质[双酚 A (BPA)、双酚 S (BPS)和双酚 F (BPF)]和邻苯二甲酸酯暴露的行为、临床和政策干预措施的效果。
使用 PubMed、Web of Science、Cumulative Index to Nursing and Allied Health Literature (CINAHL) 和 Google Scholar 对所有旨在减少双酚类和邻苯二甲酸酯暴露的个体行为、临床和政策干预措施进行了全面搜索。我们纳入了 2000 年 1 月至 2022 年 11 月期间发表的研究。两位审查员在 CADIMA 中筛选参考文献，然后提取符合本综述纳入标准的研究的数据（人口特征、干预设计、评估的化学品和结果）。
共有 58 项干预措施符合纳入标准。我们将干预措施分为饮食干预（）、临床干预（）、政策干预（）和不属于这三类的“其他”干预（）。大多数干预措施（81%，47/58）显示出双酚类和/或邻苯二甲酸酯暴露减少，政策层面的干预措施的影响最大。
评估针对减少商品和包装中邻苯二甲酸酯和 BPA 的政策干预措施的研究显示，这些措施对减少双酚类和邻苯二甲酸酯的暴露产生了广泛而持久的影响。从医疗器械和设备中去除双酚类和邻苯二甲酸酯材料的临床干预措施显示出暴露生物标志物总体减少。饮食干预措施往往会降低暴露水平，在向参与者提供新鲜食品的试验中，效果最大。在实用营养教育试验中观察到的暴露减少程度较低，以及缺乏多样性（社会人口背景），限制了对所有人群的推广。https://doi.org/10.1289/EHP11760.
