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. 2015 Jan;123(1):101-7.
doi: 10.1289/ehp.1408163. Epub 2014 Oct 29.

Prenatal phthalate exposures and anogenital distance in Swedish boys

Carl-Gustaf Bornehag  1 , Fredrik Carlstedt, Bo A G Jönsson, Christian H Lindh, Tina K Jensen, Anna Bodin, Carin Jonsson, Staffan Janson, Shanna H Swan
Affiliations

Prenatal phthalate exposures and anogenital distance in Swedish boys

Carl-Gustaf Bornehag et al. Environ Health Perspect. 2015 Jan.

Abstract

Background: Phthalates are used as plasticizers in soft polyvinyl chloride (PVC) and in a large number of consumer products. Because of reported health risks, diisononyl phthalate (DiNP) has been introduced as a replacement for di(2-ethylhexyl) phthalate (DEHP) in soft PVC. This raises concerns because animal data suggest that DiNP may have antiandrogenic properties similar to those of DEHP. The anogenital distance (AGD)--the distance from the anus to the genitals--has been used to assess reproductive toxicity.

Objective: The objective of this study was to examine the associations between prenatal phthalate exposure and AGD in Swedish infants.

Methods: AGD was measured in 196 boys at 21 months of age, and first-trimester urine was analyzed for 10 phthalate metabolites of DEP (diethyl phthalate), DBP (dibutyl phthalate), DEHP, BBzP (benzylbutyl phthalate), as well as DiNP and creatinine. Data on covariates were collected by questionnaires.

Results: The most significant associations were found between the shorter of two AGD measures (anoscrotal distance; AGDas) and DiNP metabolites and strongest for oh-MMeOP [mono-(4-methyl-7-hydroxyloctyl) phthalate] and oxo-MMeOP [mono-(2-ethyl-5-oxohexyl) phthalate]. However, the AGDas reduction was small (4%) in relation to more than an interquartile range increase in DiNP exposure.

Conclusions: These findings call into question the safety of substituting DiNP for DEHP in soft PVC, particularly because a shorter male AGD has been shown to relate to male genital birth defects in children and impaired reproductive function in adult males and the fact that human levels of DiNP are increasing globally.

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Conflict of interest statement

The authors declare they have no actual or potential competing financial interests.

Figures

Figure 1
Figure 1
Adjusted odds ratio (OR) for having a short AGD (in the 1st quartile) compared with a long AGD (4th quartile) as a function of quartile of phthalate metabolite concentration in the pregnant women’s urine: (A) AGDas; (B) AGDap. ref, reference (1st quartile). Adjusted for age (months), gestational week of urine sampling, weight-for-age percentile, and creatinine.
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