Plastic Chemical Linked to Millions of Preterm Births Globally

A new analysis estimates that exposure to di-2-ethylhexylphthalate (DEHP), a common chemical used to make plastics flexible, may have contributed to approximately 1.97 million preterm births globally in 2018, accounting for over 8 percent of the world's total. Researchers also linked this chemical to 74,000 newborn deaths.

Understanding Phthalates and Their Health Risks

DEHP belongs to a group of chemicals called phthalates, which are found in a wide array of products such as cosmetics, detergents, and bug repellents. These substances can break down into microscopic particles and enter the body through food, air, and dust.

Preterm birth is a significant risk factor for developmental issues and a leading cause of infant death. The study also estimated that DEHP exposure contributed to 1.2 million years lived with disability due to health problems from being born prematurely.

Geographic Hotspots and Disproportionate Burden

This analysis provides the first global estimates of preterm births linked to DEHP exposure.

The Middle East and South Asia represented 54 percent of the estimated illness from preterm birth, attributed to rapidly growing plastics industries and high levels of plastic waste. Africa accounted for 26 percent of health problems, with a disproportionately higher share of deaths reflecting the region's overall higher preterm birth mortality rates.

How Researchers Estimated the Impact

Researchers estimated DEHP exposure in 2018 across 200 countries and territories. They utilized data from national surveys in the United States, Europe, and Canada, supplementing these with estimates from earlier investigations for regions lacking data.

They combined these exposure estimates with prior research on phthalate exposure and preterm birth, as well as global figures on preterm births and deaths, to determine the potential link to DEHP.

Beyond DEHP: The Broader Policy Challenge

The study also examined diisononyl phthalate (DiNP), a common replacement for DEHP. It found that DiNP may pose a similar risk, contributing to an estimated 1.88 million preterm births worldwide. The financial costs associated with newborn deaths from both phthalates ranged from millions to hundreds of billions of dollars.

Study senior author Dr. Leonardo Trasande emphasized that regulating phthalates individually and substituting them with poorly understood alternatives is unlikely to resolve the broader issue. He advocated for stronger, class-wide oversight of plastic additives.

Acknowledging Study Limitations

The investigation did not aim to establish direct causation between DEHP and DiNP and preterm birth, nor did it consider other types of phthalates. Due to data uncertainties, researchers examined a range of possible values, indicating the true impact of DEHP could be up to four times smaller or slightly higher than the main estimate.

Even conservative estimates suggest a substantial health burden. Researchers noted that this global modeling lays groundwork for future studies to refine these results.