Medications as a Potential Source of Exposure to Phthalates in the U.S. Population
Medications as a Potential Source of Exposure to Phthalates in the U.S. Population
Sonia Hernández-Díaz,1 Allen A. Mitchell,2 Katherine E. Kelley,2 Antonia M. Calafat,3 and Russ Hauser1,4
1Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA; 2Slone Epidemiology Center at Boston University, Boston, Massachusetts, USA; 3National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA; 4Department of Environmental Health, Occupational and Environmental Medicine and Epidemiology Program, Harvard School of Public Health, Boston, Massachusetts, USA
Background: Widespread human exposure to phthalates, some of which are developmental and reproductive toxicants in experimental animals, raises concerns about potential human health risks. Underappreciated sources of exposure include phthalates in the polymers coating some oral medications. Objective: The objective of this study was to evaluate whether users of phthalate-containing medications have higher urinary concentrations of phthalate metabolites than do nonusers.
Methods: We used publically available files from the National Health and Nutrition Examination Survey for the years 1999–2004. For certain survey periods, participants were asked to recall use of prescription medication during the past 30 days, and for a subsample of individuals, the urinary concentrations of phthalate metabolites were measured. We a priori identified medications potentially containing phthalates as inactive ingredients and then compared the mean urinary concentration of phthalate metabolites between users and nonusers of those medications.
Results: Of the 7,999 persons with information on urinary phthalate concentrations, 6 reported using mesalamine formulations, some of which may include dibutyl phthalate (DBP); the mean urinary concentration of monobutyl phthalate, the main DBP metabolite, among these mesalamine users was 50 times higher than the mean for nonusers (2,257 µg/L vs. 46 µg/L; p < 0.0001). Users of didanosine, omeprazole, and theophylline products, some of which may contain diethyl phthalate (DEP), had mean urinary concentrations of monoethyl phthalate, the main DEP metabolite, significantly higher than the mean for nonusers.
Conclusion: Select medications might be a source of high exposure to some phthalates, one of which, DBP, shows adverse developmental and reproductive effects in laboratory animals. These results raise concern about potential human health risks, specifically among vulnerable segments of the general population and particularly pregnant women and children.
Key words: coating, didanosine, medications, mesalamine, omeprazole, phthalates, theophylline.
Environ Health Perspect 117:185–189 (2009).
doi:10.1289/ehp.11766 available via http://dx.doi.
org/ [Online 7 October 2008]
https://dash.harvard.edu/bitstream/handle/1/4888657/2649218.pdf?sequence=1
