Hyman Sara, Acevedo Jonathan, Giannarelli Chiara, Trasande Leonardo
Department of Paediatrics, New York University Grossman School of Medicine, New York, NY, USA.
Division of Cardiology, Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA; Department of Pathology, New York University Grossman School of Medicine, New York, NY, USA.
EBioMedicine. 2025 Apr 29;117:105730. doi: 10.1016/j.ebiom.2025.105730.
New evidence has emerged that plastic polymers and their chemical additives, particularly di-2-ethylhexylphthalate (DEHP), contribute to cardiovascular disease (CVD). Phthalates are commonly used in the production of plastic materials and have been linked to increased oxidative stress, metabolic dysfunction, and cardiovascular disease. Estimates of phthalate-attributable cardiovascular mortality have been made for the US, but global estimates are needed to inform ongoing negotiations of a Global Plastics Treaty.
Cardiovascular mortality data from the Institute for Health Metrics and Evaluation (IHME) and regional DEHP exposure estimates from several sources were used to estimate burden. Hazard ratios of CV mortality were calculated using published exposure estimates, and country-level cardiovascular mortality rates were used to calculate excess deaths and years of life lost (YLL) due to DEHP exposure.
In 2018, an estimated 356,238 deaths globally were attributed to DEHP exposure, representing 13.497% of all cardiovascular deaths among individuals aged 55-64. Of these, 349,113 were attributed to the use of plastics. Geographic disparities were evident, with South Asia and the Middle East suffering the greatest percentage of cardiovascular deaths attributable to DEHP exposure (16.807%). The Middle East, South Asia, East Asia, and the Pacific accounted for the largest shares of DEHP-attributable CVD deaths (73.163%). Globally, DEHP resulted in 10.473 million YLL.
Plastics pose a significant risk to increased cardiovascular mortality, disproportionately impacting regions which have developing plastic production sectors. The findings underscore the need for urgent global and local regulatory interventions to kerb mortality from DEHP exposure.
Bloomberg Philanthropies and the National Institutes of Health.
新证据表明，塑料聚合物及其化学添加剂，尤其是邻苯二甲酸二（2-乙基己基）酯（DEHP），与心血管疾病（CVD）有关。邻苯二甲酸盐常用于塑料材料生产，与氧化应激增加、代谢功能障碍和心血管疾病有关。美国已对邻苯二甲酸盐导致的心血管死亡率进行了估算，但需要全球估算结果为正在进行的全球塑料条约谈判提供参考。
利用健康指标与评估研究所（IHME）的心血管死亡率数据以及多个来源的区域DEHP暴露估算值来估算负担。使用已公布的暴露估算值计算心血管死亡率的风险比，并利用国家层面的心血管死亡率计算因DEHP暴露导致的超额死亡人数和生命损失年数（YLL）。
2018年，全球估计有356,238例死亡归因于DEHP暴露，占55至64岁个体所有心血管死亡病例的13.497%。其中，349,113例归因于塑料使用。地理差异明显，南亚和中东因DEHP暴露导致的心血管死亡比例最高（16.807%）。中东、南亚、东亚和太平洋地区占DEHP所致CVD死亡病例的最大份额（73.163%）。在全球范围内，DEHP导致1047.3万生命损失年。
塑料对心血管死亡率上升构成重大风险，对塑料生产部门正在发展的地区影响尤为严重。研究结果强调迫切需要在全球和地方层面进行监管干预，以降低因DEHP暴露导致的死亡率。
彭博慈善基金会和美国国立卫生研究院。
