OBJECTIVES. Phthalates are man-made chemicals found in personal care and other products. Recent studies suggest that some phthalates can alter human male reproductive development, but sources of infant exposure have not been well characterized. We investigated the relationship between phthalate metabolite concentrations in infant urine and maternal reported use of dermally applied infant care products.
METHODS. We measured 9 phthalate metabolites in 163 infants who were born in 2000–2005. An infant was considered to have been exposed to any infant care product that the mother reported using on her infant within 24 hours of urine collection. Results of multiple linear regression analyses are reported as the ratio of metabolite concentrations (with 95% confidence intervals) in exposed and unexposed infants. We standardized concentrations by forming z scores and examined combined exposure to multiple metabolites.
RESULTS. In most (81%) infants, ≥7 phthalate metabolites were above the limit of detection. Exposure to lotion was predictive of monoethyl phthalate and monomethyl phthalate concentrations, powder of monoisobutyl phthalate, and shampoo of monomethyl phthalate. Z scores increased with number of products used. Most associations were stronger in younger infants.
CONCLUSIONS. Phthalate exposure is widespread and variable in infants. Infant exposure to lotion, powder, and shampoo were significantly associated with increased urinary concentrations of monoethyl phthalate, monomethyl phthalate, and monoisobutyl phthalate, and associations increased with the number of products used. This association was strongest in young infants, who may be more vulnerable to developmental and reproductive toxicity of phthalates given their immature metabolic system capability and increased dosage per unit body surface area.
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Recommendations
You did not mention in the info that I read what products were tested. I would be interested in that info and to see what your recommendations are as part of my role is teaching new moms re: infant care, various products that are available, etc.
Conflict of Interest:
None declared
Phthalates are Ubiquitous
Satyanarayana S, et al’s article depicting the ubiquity of the phthalates in baby products is pertinent and well written. As the information about the clinical effects of different ingredients like phthalates is gradually being dispersed, it is worth knowing that many healthcare products also contain phthalates. The list is exhaustive. Weuve J et al was successful in showing that babies in Neonatal ICU had significantly elevated levels of phthalate metabolites which was attributed to the use of healthcare devices made of plasticizer di(2- ethylhexyl) phthalate (DEHP). With this information, it behooves on the healthcare community to incorporate nontoxic alternates to Phthalate in healthcare /medical products, which would go a long way in upholding the primary Hippocratic principle of no harm. There might be another explanation to the relative high Z score in babies of age less than 8 months who are exposed to baby lotion, as depicted in the article; multiple references have suggested that the phthalates are lipophilic which would explain the enhanced the dermal absorption. This effect is, conceivably, multiplied in neonates and infants because of the immature cutaneous system and relatively increased fat content in the skin compared to that of adults. In addition, apart from the fact that baby lotions are being dispatched in phthalate constituted containers, many commercial types of baby lotions contain propylene glycol, other lipids and alcoholic compounds. Emulsions containing propylene glycol has been studied for as an effective vehicle to enhance dermal drug delivery in topical preparations (Subramanyan N et al 2004). In another study, Pellings et al was successful in showing that the rate and extent of phthalate absorption through epidermis was greatly increased (40- to 80- fold) using 50% ethanol/water as receptor fluid compared with using saline as vehicle; it is not uncommon to find alcohol components in many commercial baby products.
1.Weuve J, Sánchez BN, Calafat AM, Schettler T, Green RA, Hu H, Hauser R. Exposure to phthalates in neonatal intensive care unit infants: urinary concentrations of monoesters and oxidative metabolites. Environ Health Perspect. 2006 Sep;114(9):1424-31
2.Subramanian N, Ghosal SK, Moulik SP. Topical delivery of celecoxib using microemulsion. Acta Pol Pharm. 2004 Sep-Oct;61(5):335-41
3.http://www.johnsonsbaby.com/product.do?id=24 ( accessed on Feb 4 2008)
4.Pelling D, Phillips JC, Cunningham ME. Absorption of Hydrophilic and lipophilic compounds through epidermal and sub epidermal strata of rat skin in vitro. Toxicology in vitro 1997;12(1):47-55
Conflict of Interest:
None declared