Acevedo Jonathan M, Kahn Linda G, Pierce Kristyn A, Albergamo Vittorio, Carrasco Anna, Manuel Robbie S J, Singer Rosenberg Marissa, Trasande Leonardo
Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA.
Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.
Int J Hyg Environ Health. 2025 Apr;265:114539. doi: 10.1016/j.ijheh.2025.114539. Epub 2025 Feb 14.
Many phthalates have been identified as endocrine-disrupting chemicals because they alter hormone functions throughout the lifespan. Nationally representative biomonitoring data are available from the United States, Canada, and Europe, but data elsewhere are sparse, making extrapolations of related disease and disability burdens difficult. We therefore examined trends in urinary phthalate metabolite concentrations in non-occupationally exposed populations in countries other than the United States, Canada, and Europe, where representative data are already available at the country level. We systematically reviewed studies published between 2000 and 2023 and analyzed changes in urinary phthalate metabolite concentrations across time using mixed-effects meta-regression models with and without a quadratic term for time. We controlled for region, age, and pregnancy status, and identified heterogeneity using Cochran's Q-statistic and I index. Our final analysis consisted of 216 studies. Non-pregnant and youth populations exhibited nearly 2.0-fold or greater difference in concentration compared to pregnant and adult populations. Phthalates with significant regional differences had 10-fold higher concentrations in the Middle East and South Asia than in other regions. Our meta-regressions identified an exponential increase in DBP exposure through MnBP concentration internationally (beta: 0.65 ng/mL/year) and in Eastern and Pacific Asia (EPA) (beta: 0.78 ng/mL/year). Most DEHP and DnOP metabolites significantly declined internationally and in EPA, while MEP concentration declined by 10.62 ng/mL in Latin America and 8.98 ng/mL in Africa over time. Our findings fill gaps in phthalate exposure data and set the stage for further analysis of the attributable disease burden and cost at regional and international levels, especially in low- and middle-income countries.
许多邻苯二甲酸盐已被确认为内分泌干扰化学物质，因为它们会在整个生命周期中改变激素功能。美国、加拿大和欧洲有全国代表性的生物监测数据，但其他地区的数据稀少，这使得推断相关疾病和残疾负担变得困难。因此，我们研究了美国、加拿大和欧洲以外国家非职业暴露人群尿中邻苯二甲酸酯代谢物浓度的趋势，这些国家在国家层面已有代表性数据。我们系统回顾了2000年至2023年发表的研究，并使用含和不含时间二次项的混合效应元回归模型分析了尿中邻苯二甲酸酯代谢物浓度随时间的变化。我们控制了地区、年龄和怀孕状态，并使用 Cochr an Q统计量和I指数识别异质性。我们的最终分析包括216项研究。与孕妇和成年人群相比，非孕妇和青年人群的浓度差异近2.0倍或更大。具有显著区域差异的邻苯二甲酸盐在中东和南亚的浓度比其他地区高10倍。我们的元回归分析确定，国际上通过单丁基邻苯二甲酸酯（MnBP）浓度衡量的邻苯二甲酸二丁酯（DBP）暴露呈指数增长（β：0.65 ng/mL/年），在东亚和太平洋地区（EPA）也是如此（β：0.78 ng/mL/年）。大多数邻苯二甲酸二（2-乙基己基）酯（DEHP）和邻苯二甲酸二正辛酯（DnOP）代谢物在国际上和EPA地区显著下降，而随着时间推移，拉丁美洲的单乙基己基邻苯二甲酸酯（MEP）浓度下降了1 . 62 ng/mL，非洲下降了8.98 ng/mL。我们的研究结果填补了邻苯二甲酸盐暴露数据的空白，并为进一步分析区域和国际层面，特别是低收入和中等收入国家的可归因疾病负担和成本奠定了基础。
