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Environ Pollut. 2017 Oct;229:655-660. doi: 10.1016/j.envpol.2017.06.083. Epub 2017 Jul 7.

Phthalate esters and childhood asthma: A systematic review and congener-specific meta-analysis.

Author information

1
National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
2
Department of Environmental and Occupational Medicine, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan.
3
National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Department of Environmental and Occupational Medicine, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan; Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan. Electronic address: leonguo@ntu.edu.tw.

Abstract

INTRODUCTION:

Exposure to phthalate esters (PAEs) has been associated with childhood asthma, but the congener-specific effects of PAEs on childhood asthma were unclear. We aimed to systematically review and meta-analyze observational studies on the associations between specific effects of PAEs and the risk of childhood asthma.

MATERIAL AND METHODS:

Relevant studies were identified by searching three databases up to October 20, 2016. The reference lists of the retrieved articles were also reviewed. We included observational studies that reported risk estimates with 95% confidence intervals (CIs) for the associations between phthalate exposure and the risk of childhood asthma. Fixed-effects models were generally applied to calculate pooled risk estimates. When heterogeneity was present, random-effects models were applied.

RESULTS:

A total of nine studies featuring 43 data points were included in our final meta-analyses. Results indicated that the benzyl butyl phthalate (BBzP) exposure had a significant association with the risk of childhood asthma. The Odd Ratios (ORs) were from 1.39 to 1.41 for different combination strategies. Subgroup analyses by different exposure period or samples used showed that prenatal exposure to BBzP had a stronger association with the risk of childhood asthma (OR = 1.38, 95% CI = 1.09-1.75), compared to those with postnatal exposure. Besides, the association was evident when the phthalate exposure was measured from dust samples. The OR for the associations between di-2-ethylhexyl phthalate (DEHP) in dust and childhood asthma was 2.71 (95% CI = 1.39-5.28), and 2.08 (95% CI = 1.10-3.92) for BBzP.

CONCLUSIONS:

Our study suggested a positive association between DEHP and BBzP exposure and childhood asthma. Future studies are warranted to identify the underlying mechanisms of the association.

KEYWORDS:

Childhood asthma; Meta-analysis; Phthalate esters; Systematic review

PMID:
28692937
DOI:
10.1016/j.envpol.2017.06.083
[Indexed for MEDLINE]

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