The daily exposure to certain chemicals used to make household plastic items could be linked to more than 356,000 global deaths due to heart disease only in 2018, according to a new analysis of population surveys.
While chemicals, called phthalates, are in generalized use worldwide, the Middle East, Southern Asia, East Asia and the Pacific carried a much greater part of the number of deaths than others, approximately three quarters of the total.
For decades, experts have health problems connected to exposure to certain phthalates found in cosmetics, detergents, solvents, plastic pipes, insect repellent and other products. When these chemicals decompose in microscopic particles and ingest, studies have linked them to a greater risk of conditions that range from obesity and diabetes to fertility and cancer problems.
Directed by researchers from Nyu Langone Health, the current study focused on a kind of phthalate called DI-2-ETILHEXIL Fthalate (DEHP), which is used to make food containers, medical equipment and other softer and more flexible plastics. It has been shown that exposure in other studies causes a hyperactive immune response (inflammation) in the arteries of the heart, which, over time, is associated with a higher risk of heart attack or stroke. In their new analysis, the authors estimated that exposure to DEHP contributed to 356,238 deaths, or more than 13% of all global mortality due to heart disease in 2018 between men and women from 55 to 64 years.
“Highlighting the connection between phthalates and a main cause of death worldwide, our findings add to the large amount of evidence that these chemicals have tremendous danger to human health,” said the main author of the study Sara Hyman, BS, scientist of associated research at the Nyu Grossman School of Medicine.
According to the authors, the economic burden resulting from the deaths identified in their study was estimated at around $ 510 billion and may have reached up to $ 3.74 billion.
In an earlier study of 2021, the research team tied phthalates with more than 50,000 premature deaths every year, mainly due to heart disease, among older Americans. It is believed that his latest research is the first global estimate until the date of cardiovascular mortality, or in fact any result of health, as a result of exposure to chemicals, says Hyman, who is also a student graduated at the Nyu Global Health School in the NYU.
A report on the findings is to publish online on April 29 in the magazine Lancet ebiomedicine.
For research, the team used environmental and health data from dozens of population surveys to estimate DEHP exposure in 200 countries and territories. The information included urine samples containing chemical decomposition products left by the plastic additive. Mortality data were obtained from the Institute of Metricians and Health Evaluation, a research group in the United States that collects medical information worldwide to identify trends in public health.
Among the key findings, the study showed that losses in the combined region of East Asia and the Middle East and the combined region of East Asia and the Pacific represented, respectively, for approximately 42% and 32% of mortality from heart disease linked to DEHP. Specifically, India had the greatest death count in 103,587 deaths, followed by China and Indonesia. The risks of larger cardiac death in these populations remained true even after the researchers adjusted their statistical analysis to take into account the size of the population within the age group studied.
A possible explanation, say the authors, is that these countries face higher rates of exposure to chemicals, possibly because they are experiencing a boom in plastic production but with less manufacturing restrictions than other regions.
“There is a clear disparity in which parts of the world have the worst part of the greatest heart risks of phthalates,” said the main author of the Leonardo Trasande study, MD, MPP. “Our results underline the urgent need for global regulations to reduce exposure to these toxins, especially in the areas most affected by rapid industrialization and plastic consumption,” added Trasande, Jim G. Hendrick, MD, Professor of Pediatrics at the Nyu Grossman School of Medicine.
Transande, who is also a professor in the population’s department of health, warns that the analysis was not designed to establish that DEHP directly or only caused heart disease and that the highest death risks did not take into account other types of phthalates. Nor did it include mortality among those in other age groups. As a result, the number of deaths in general of heart disease related to these chemicals is probably much greater, he says.
Trasande says that researchers then plan to track how reductions in exposure to phthalate can, over time, affect global mortality rates, as well as to expand the study to other health concerns raised by chemicals, such as premature birth. Transande also serves as director of the Environmental Pediatrics Division of the Nyu Grossman School of Medicine and the Environmental Danger Research Center.
The financing for the study was provided by the subsidy of the National Health Institutes P2CE033423. Beyond Petrachemicals provided more study funds.
Transande has received support for trips or meetings of the endocrine society, the World Health Organization, the United Nations Environment Program, the Ministries of Environment and Health of Japan and the American Academy of Pediatrics. He has also received royalties and licenses from Houchton Mfflin Harcourt, Audible, Payós and Kobunsha, and has served in leadership or fiduciary roles in Beautycounter, Ahimsa, Base and Footprint Environmental Education. None of these activities was related to the current study. The terms and conditions of all these relationships are being administered by Nyu Langone Health.
In addition to Hyman and Trasande, other Nyu Langone researchers involved in the study are Jonathan Acevedo, MPH and Chiara Gianarelli, MD, PHD.