Exposure to chemical found in plastics tied to more than 350,000 CV deaths in 2018
Key takeaways:
- A model estimated 356,238 CV deaths among adults aged 55 to 64 years in 2018 were due to di-2-ethylhexylphthalate (DEHP) exposure.
- CV deaths tied to DEHP exposure accounted for 13.5% of all CV deaths in 2018.
Exposure to one class of phthalate is linked to more than 356,000 cardiovascular deaths in adults aged 55 to 64 years worldwide in 2018, according to findings of a new disease burden model published in eBioMedicine.
Di-2-ethylhexylphthalate (DEHP) is a type of chemical used to soften polyvinylchloride plastics, according to the study. Using a combination of data from the Institute for Health Metrics and Evaluation plus regional chemical exposure data, researchers estimated that 13.5% of CV deaths globally in 2018 were linked to exposure to DEHP.
“Plastics, and the chemicals inside them, have been shown to pose a risk to human health, but these risks are not unavoidable,” Sara Hyman, BS, an associate research scientist at New York University Grossman School of Medicine, told Healio. “Regulations that limit the amount of phthalates in products and limiting personal plastic consumption can help to lower the amounts of these chemicals in our environment and in our bodies.”
Hyman and colleagues utilized estimates for 2018 global population of adults aged 55 to 64 years from World Bank. CV mortality rates were obtained for each country from the Institute for Health Metrics and Evaluation. Exposure to DEHP was obtained from population surveys or study records for areas without survey data.
According to the model, among adults aged 55 to 64 years, an estimated 356,238 CV deaths were attributed to DEHP exposure in 2018. This accounted for 13.5% of all CV deaths worldwide. Of total deaths tied to DEHP, 349,113 were attributed to plastic use.
The regions with the highest DEHP exposure for most types of the chemical were the Middle East and South Asia. Europe had the lowest levels of DEHP exposure across all regions. The percentage of CV deaths tied to DEHP exposure was 16.8% in South Asia and the Middle East, 13.5% in Latin America, 13% in East Asia and the Pacific, 12.7% in Canada, 12.1% in Australia, 11.8% in Africa, 10.4% in the U.S. and 8.4% in Europe.
“Certain regions of the world are exposed to phthalates in higher quantity because of varying plastics manufacturing, waste management and consumer trends,” Hyman said. “Our team hypothesizes that the higher burden modeled in certain regions may be because of increased plastics manufacturing and disposal in these regions. However, underlying CV mortality rate and the size of the adult population aged 55 to 64 years also played a role in our model.”
DEHP exposure was linked to 10.473 million life-years lost globally in 2018, with the highest amounts of life-years lost coming from the Middle East, South Asia, East Asia and the Pacific.
Some regions had disparities in CV mortality based on DEHP exposure level. The greatest disparity was seen in the U.S., where the percentage of CV deaths attributed to DEHP exposure was 30.5 percentage points higher among adults in the 95th quantile of exposure than those in the 10th quantile of exposure.
“This analysis was not designed to establish that DEHP directly or alone caused heart disease, but there is literature supporting the link between phthalate exposure and cardiovascular morbidity and mortality,” Hyman told Healio. “Exposure to phthalates could prompt an overactive immune response in the heart’s arteries, which, over time, is associated with increased risk for myocardial infarction or stroke. Our model quantifies this relationship globally, to illustrate the risks of exposure to these chemicals.”
Hyman said the analysis did not adjust for other CV risk factors and only examined one time point, necessitating the need for more studies. Hyman added that some countries did not have surveys measuring DEHP exposure nationally, and improved infrastructure to measure exposure to that class of phthalates and other endocrine-disrupting chemicals is needed.
For more information:
Sara Hyman, BS, can be reached at sara.hyman@nyulangone.edu.
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