ArticleEnvironmental research2023
A cross sectional pilot study to assess the role of phthalates on respiratory morbidity among patients with chronic obstructive pulmonary disease.
Article in Environmental research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 13 citations in OpenAlex.
- Dimethyl phthalate induces cytotoxicity, oxidative stress, pro-inflammatory cytokine expression and fibronectin accumulation in A549 lung epithelial cells.Molecular biology reports · 2026Article
- Machine learning identifies molecular targets of Di (2-ethylhexyl) phthalate in pulmonary arterial hypertension.Frontiers in bioinformatics · 2026Article
- The impact of phthalates on asthma and chronic obstructive pulmonary disease: a comprehensive analysis based on network toxicology and molecular docking.Frontiers in pharmacology · 2025Article
- Simultaneous analysis of several plasticizer classes in different matrices by on-line turbulent flow chromatography-LC-MS/MS.Analytical and bioanalytical chemistry · 2024Article
- Microplastic and plastic pollution: impact on respiratory disease and health.European respiratory review : an official journal of the European Respiratory Society · 2024Review
- Article
- Association Between Urinary Phthalate Metabolites and Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study.International journal of chronic obstructive pulmonary disease · 2024Article
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundChronic Obstructive Pulmonary Disease (COPD) affects ∼16 million U.S. adults. Phthalates, synthetic chemicals in consumer products, may adversely impact pulmonary function and airway inflammation; however, their role on COPD morbidity remains unknown.
objectiveWe examined associations between phthalate exposures and respiratory morbidity among 40 COPD patients who were former smokers.
methodsWe quantified 11 phthalate biomarkers in urine samples collected at baseline in a 9-month prospective cohort study in Baltimore, Maryland. COPD baseline morbidity measures included: health status and quality of life measures (CAT: COPD Assessment Test, CCQ: Clinical COPD Questionnaire, SGRQ: St. George's Respiratory Questionnaire; mMRC: Modified Medical Research Council Dyspnea Scale), and lung function. Information on prospective exacerbation data was monitored monthly during the 9-month longitudinal follow-up period. To examine associations between morbidity measures and phthalate exposures, we used multivariable linear and Poisson regression models for continuous and count outcomes, respectively, adjusting for age, sex, race/ethnicity, education, and smoking pack-years.
resultsHigher mono-n-butyl phthalate (MBP) concentrations were associated with increased CAT(β, 2.41; 95%CI, 0.31-4.51), mMRC (β, 0.33; 95%CI 0.11-0.55), and SGRQ (β, 7.43; 95%CI 2.70-12.2) scores at baseline. Monobenzyl phthalate (MBzP) was also positively associated with CCQ and SGRQ scores at baseline. Higher concentrations of the molar sum of Di (2-ethylhexyl) phthalate (DEHP) were associated with increased incidence of exacerbations during the follow-up period (incidence rate ratio, IRR = 1.73; 95%CI 1.11, 2.70 and IRR = 1.94; 95%CI 1.22, 3.07, for moderate and severe exacerbations, respectively). MEP concentrations were inversely associated with incidence of exacerbations during the follow-up period.
conclusionsWe found that exposure to select phthalates was associated with respiratory morbidity among COPD patients. Findings warrant further examination in larger studies given widespread phthalate exposures and potential implications for COPD patients should relationships observed be causal.
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