Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, 10016, USA.
Department of Population Health, New York University Grossman School of Medicine, New York, NY, 10016, USA.
Environ Res. 2024 Jul 1;252(Pt 2):118955. doi: 10.1016/j.envres.2024.118955. Epub 2024 Apr 18.
Organophosphate esters (OPEs) are a class of chemicals now widely used as flame retardants and plasticizers after the phase-out of polybrominated diphenyl ethers (PBDEs). However, OPEs carry their own risk of developmental toxicity, which poses concern for recent birth cohorts as they have become ubiquitous in the environment. In this review, we summarize the literature evaluating the association between OPE exposure and maternal, perinatal, and child health outcomes. We included original articles investigating associations of OPE exposure with any health outcome on pregnant women, newborns, children, and adolescents. We found 48 articles on this topic. Of these, five addressed maternal health and pregnancy outcomes, 24 evaluated prenatal OPE exposure and child health, 18 evaluated childhood OPE exposure and child/adolescent health, and one article evaluated both prenatal and childhood OPE exposure. These studies suggest that OPE exposure is possibly associated with a wide range of adverse health outcomes, including pregnancy loss, altered gestational duration and smaller birthweight, maternal and neonatal thyroid dysfunction, child metabolic dysregulation and abnormal growth, impaired neurodevelopment, and changes in immune response. Many of the reported outcomes associated with OPE exposure varied by child sex. Findings also varied substantially by OPE metabolite and exposure time. The OPEs most frequently measured, detected, and found to be associated with health outcomes were triphenyl phosphate (TPHP, metabolized to DPHP) and tris(1,3-dichloro-2-propyl) phosphate (TDCIPP, metabolized to BDCIPP). The extensive range of health outcomes associated with OPEs raises concern about their growing use in consumer products; however, these findings should be interpreted considering the limitations of these epidemiological studies, such as possible exposure misclassification, lack of generalizability, insufficient adjustment for covariates, and failure to consider chemical exposures as a mixture.
有机磷酸酯 (OPE) 是一类化学物质，在多溴二苯醚 (PBDE) 淘汰后，现已广泛用作阻燃剂和增塑剂。然而，OPE 本身存在发育毒性风险，这对最近出生的人群构成了担忧，因为它们在环境中无处不在。在这篇综述中，我们总结了评估 OPE 暴露与孕产妇、围产期和儿童健康结果之间关联的文献。我们纳入了研究 OPE 暴露与孕妇、新生儿、儿童和青少年任何健康结果之间关联的原始文章。我们找到了 48 篇关于这个主题的文章。其中，有 5 篇文章涉及孕产妇健康和妊娠结局，24 篇文章评估了产前 OPE 暴露与儿童健康，18 篇文章评估了儿童时期 OPE 暴露与儿童/青少年健康，一篇文章评估了产前和儿童时期 OPE 暴露。这些研究表明，OPE 暴露可能与广泛的不良健康结果相关，包括妊娠丢失、妊娠持续时间改变和出生体重降低、母婴甲状腺功能障碍、儿童代谢失调和异常生长、神经发育受损以及免疫反应改变。许多与 OPE 暴露相关的报告结果因儿童性别而异。研究结果还因 OPE 代谢物和暴露时间而有很大差异。最常测量、检测到并与健康结果相关的 OPE 是三苯基磷酸酯 (TPHP，代谢为 DPHP) 和三(1,3-二氯-2-丙基)磷酸酯 (TDCIPP，代谢为 BDCIPP)。OPE 与广泛的健康结果相关，这引起了人们对其在消费产品中日益增加的使用的关注；然而，考虑到这些流行病学研究的局限性，例如可能存在的暴露分类错误、缺乏普遍性、对协变量的调整不足以及未能考虑化学暴露作为混合物，这些发现应该被解释。
