ArticleEnvironmental pollution (Barking, Essex : 1987)2022
Phthalates and attributable mortality: A population-based longitudinal cohort study and cost analysis.
Article in Environmental pollution (Barking, Essex : 1987), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Filling gaps in population estimates of phthalate exposure globally: A systematic review and meta-analysis of international biomonitoring data.International journal of hygiene and environmental health · 2025Pooled it
- Review
- Article
- Paternal Microplastic Exposure Alters Sperm Small Noncoding RNAs and Affects Offspring Metabolic Health in Mice.Journal of the Endocrine Society · 2026Article
- Health impacts of exposure to synthetic chemicals in food.Nature medicine · 2025Review
- The benefits of removing toxic chemicals from plastics.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
- Article
- Analytical Investigation of Phthalates and Heavy Metals in Edible Ice from Vending Machines Connected to the Italian Water Supply.Foods (Basel, Switzerland) · 2024Article
- Identification and characterisation of moderately thermostable diisobutyl phthalate degrading esterase from a Great Artesian BasinBiotechnology reports (Amsterdam, Netherlands) · 2024Article
- Screening of Environmental Chemicals to Characterize Exposures in Participants With Systemic Lupus Erythematosus.Arthritis & rheumatology (Hoboken, N.J.) · 2024Article
- Prevalence and clinical implications of heightened plastic chemical exposure in pediatric patients undergoing cardiopulmonary bypass.Transfusion · 2024Article
- Response to Letter to the Editor From Landrigan et al: "Chemicals Used in Plastic Materials: An Estimate of the Attributable Disease Burden and Costs in the United States".Journal of the Endocrine Society · 2024Article
- Letter to the Editor From Landrigan et al: "Chemicals Used in Plastic Materials: An Estimate of the Attributable Disease Burden and Costs in the United States".Journal of the Endocrine Society · 2024Article
- Plastic Food Packaging from Five Countries Contains Endocrine- and Metabolism-Disrupting Chemicals.Environmental science & technology · 2024Article
- Association between 2,4-dichlorophenoxyacetic acid and cognitive impairment in older adults: a cross-sectional study from NHANES 2001-2002 and 2011-2014.Journal of exposure science & environmental epidemiology · 2024Article
- Endocrine-disrupting chemicals: Mainstream recognition of health effects and implications for the practicing internist.Journal of internal medicine · 2024Article
- Chemicals Used in Plastic Materials: An Estimate of the Attributable Disease Burden and Costs in the United States.Journal of the Endocrine Society · 2024Article
- Evidence for the cardiodepressive effects of the plasticizer di-2-ethylhexyl phthalate.Toxicological sciences : an official journal of the Society of Toxicology · 2023Article
- Effect of Microplastic Particles on the Rheological Properties of Human Saliva and Mucus.International journal of environmental research and public health · 2023Article
- The regulation of endocrine-disrupting chemicals to minimize their impact on health.Nature reviews. Endocrinology · 2023Review
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
contextAccelerating evidence of endocrine-related morbidity has raised alarm about the ubiquitous use of phthalates in the human environment, but studies have not directly evaluated mortality in relation to these exposures.
objectivesTo evaluate associations of phthalate exposure with mortality, and quantify attributable mortality and lost economic productivity in 2013-4 among 55-64 year olds.
designThis nationally representative cohort study included 5303 adults aged 20 years or older who participated in the US National Health and Nutrition Examination Survey 2001-2010 and provided urine samples for phthalate metabolite measurements. Participants were linked to mortality data from survey date through December 31, 2015. Data analyses were conducted in July 2020.
main outcome measuresMortality from all causes, cardiovascular disease, and cancer.
resultsMultivariable models identified increased mortality in relation to high-molecular weight (HMW) phthalate metabolites, especially those of di-2-ethylhexylphthalate (DEHP). Hazard ratios (HR) for continuous HMW and DEHP metabolites were 1.14 (95% CI 1.06-1.23) and 1.10 (95% CI 1.03-1.19), respectively, with consistently higher mortality in the third tertile (1.48, 95% CI 1.19-1.86; and 1.42, 95% CI 1.13-1.78). Cardiovascular mortality was significantly increased in relation to a prominent DEHP metabolite, mono-(2-ethyl-5-oxohexyl)phthalate. Extrapolating to the population of 55-64 year old Americans, we identified 90,761-107,283 attributable deaths and $39.9-47.1 billion in lost economic productivity.
conclusionsIn a nationally representative sample, phthalate exposures were associated with all-cause and cardiovascular mortality, with societal costs approximating $39 billion/year or more. While further studies are needed to corroborate observations and identify mechanisms, regulatory action is urgently needed.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.