Published online February 1, 2008
PEDIATRICS Vol. 121 No. 2 February 2008, pp. e260-e268 (doi:10.1542/peds.2006-3766)
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ARTICLE

Baby Care Products: Possible Sources of Infant Phthalate Exposure

Sheela Sathyanarayana, MD, MPHa,b, Catherine J. Karr, MD, PhDa,b, Paula Lozano, MD, MPHb, Elizabeth Brown, PhDc, Antonia M. Calafat, PhDd, Fan Liu, MSe and Shanna H. Swan, PhDe

a Departments of Occupational and Environmental Health Sciences
b Pediatrics
c Biostatistics, University of Washington, Seattle, Washington
d Centers for Disease Control and Prevention, Atlanta, Georgia
e Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York

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.

Key Words: phthalate • infant • environmental exposure • baby care product

Abbreviations: DEHP—di-2-ethylhexyl phthalate • DBP—dibutyl phthalate • MEP—monoethyl phthalate • MBP—mono-n-butyl phthalate • MBzP—monobenzyl phthalate • MiBP—monoisobutyl phthalate • DiNP—di-isononyl phthalate • SFFI—Study for Future Families, Phase I • SFFII—Study for Future Families, Phase II • MMP—monomethyl phthalate • MCPP—mono-3-carboxypropyl phthalate • DnOP—di-n-octyl phthalate • MEHP—mono-2-ethylhexyl phthalate • MEHHP—mono-2-ethyl-5-hydroxyhexyl phthalate • MEOHP—mono-2-ethyl-5-oxohexyl phthalate • LOD—limit of detection • LPMC—log phthalate metabolite concentration • CI—confidence interval • NHANES—National Health and Nutrition Examination Survey • DEP—diethyl phthalate • BBzP—butylbenzyl phthalate

Accepted Jul 16, 2007.


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