A new peer-reviewed article links phthalates, a group of neurotoxic chemicals found in hundreds of consumer products including toys, floor coverings and food packaging, to long-lasting neurodevelopmental harm in fetuses, infants and children.

The authors of the study, a group of leading scientists and health professionals from Project TENDR, are calling for an immediate ban on the chemicals, according to CNN.

The study, “Neurotoxicity of Ortho-Phthalates: Recommendations for Critical Policy Reforms to Protect Brain Development in Children,” was published Feb. 18 in the American Journal of Public Health.

Project TENDR, which stands for Targeting Environmental Neuro-Development Risks, is a collaboration of leading scientists, health professionals and environmental advocates who came together over growing scientific evidence linking toxic environmental chemicals to neurodevelopmental disorders.

According to the study, data from longitudinal birth cohort studies conducted over the last decade have shown associations between prenatal exposure to phthalates and attention deficit disorder, hyperactivity, behavior problems and adverse cognitive development including lower IQ, poorer, psychomotor development and impaired social communication.

To protect child brain development, Project TENDR is calling for the removal of phthalates from consumer products that contribute to exposure of pregnant women, women of reproductive age, infants and children.

The study’s lead author, Stephanie Engel, professor of epidemiology at the University of North Carolina at Chapel Hill Gillings School of Global Public Health, told CNN:

“What we want to accomplish is to move the public health community, including regulators, toward this goal of elimination of phthalates. We have enough evidence right now to be concerned about the impact of these chemicals on a child’s risk of attention, learning and behavioral disorders.”

Responding to the study, Eileen Conneely, senior director of the chemical products and technology division of the American Chemistry Council, told CNN that while encouraged by continuous research efforts into the science and health of phthalates, “we believe that studies acknowledging a causal link between phthalates and human adverse health effects have been overinterpreted.”

What are phthalates? 

Phthalates are high-production volume chemicals used most often as a plasticizer in polyvinyl chloride (PVC) and are added back into plastics to make them more flexible and harder to break. According to European Plasticizers, an industry trade association, 8.4 million metric tonnes of phthalates and other plasticizers are consumed annually.

Phthalates are found in hundreds of auto, home, food and personal care items such as food packaging, detergents, vinyl flooring, clothing, furniture and shower curtains, lubricating oils and adhesives, rain and stain-resistant products, shampoo, soap, hairspray and nail polish, children’s toys, coatings on medications, medical supplies, home materials, cosmetics and personal care products.

Under the current U.S. Food and Drug Administration (FDA) regulations, phthalates must be listed on product labels unless they are added as fragrance, which could be as much as 20% of a product.

Neurodevelopment harm in infants and children

According to CNN, numerous studies have connected phthalates to childhood obesity, asthma, cardiovascular issues, cancer and reproductive problems. More recently, an increasing number of prospective epidemiological studies have shown the negative effects of prenatal exposure to phthalates on neurodevelopment of infants and children.

By 2019, more than 30 studies had examined prenatal exposure to different types of phthalates, and long-term studies had been done in 11 different countries or territories, according to Project TENDR. Findings showed a consistent pattern of hyperactivity, aggression, defiance, emotional reactivity, delinquent behaviors, deficits in executive function, ADHD symptoms or ADHD after exposure to phthalates.

For example, in one 2018 study published by Environmental Health Perspectives, mothers with the highest levels of phthalates in their urine during their second trimester had almost three times the odds of having a child diagnosed with ADHD compared to mothers who had the lowest tested levels.

Another study published by Public Health Implications of a Changing Climate  discovered children who were exposed to higher levels of phthalates in utero had poorer working memory and a reduction in child IQ. Phthalates were associated with decreased processing speed, perceptual reasoning and verbal comprehension.

In an interview with CNN, the American Chemistry Council’s Conneely pointed to select systematic reviews on neurobehavioral and cognition effects which concluded “there was no association between DINP and DIDP and neurobehavioral or cognitive effects.”

Diisononyl phthalate (DINP) and di-isodecyl phthalate (DIDP) are two of the many types of chemicals known as phthalates.

In addition, Conneely told CNN, “data from the U.S. Centers for Disease Control and Prevention clearly show exposure levels to phthalates are well below the levels determined by U.S. Environmental Protection Agency and other regulatory bodies to be safe.”

Unlike heavy metals such as lead, arsenic, cadmium and mercury, phthalates are more rapidly metabolized and typically leave the body once exposure is removed according to CNN.

“They have much shorter biological half lives than, say, the heavy metals, which can hang around for decades,” said David Bellinger, a professor of neurology and psychology at Boston Children’s Hospital and a member of Project TENDR.

The problem, Bellinger added, is that “once the baby’s developing brain is impacted by the chemical in utero, the damage has been done.”

Eliminating phthalates

Scientists and health experts behind the Project Project TENDR paper are urging both federal and state agencies to move rapidly to eliminate the use of phthalates to decrease exposure of women of reproductive age, pregnant women, infants and children, adding that “states should not wait for the federal government to act, as state action can galvanize federal regulation.”

Banning them one-by-one won’t adequately lessen the threat, Engel told CNN:

“We’re exposed to multiple phthalates, and that mixture can come within a single product, but also across multiple products that people are exposed to in a day. The reality is that we need to think of phthalates as a class because that’s how people are exposed to them.”

The authors of the Project TENDR study recommended consumers reduce their exposure to phthalates found in dietary products, medical products and medications, personal care and household products, and building materials. They also warned against substituting one harmful phthalate for another.

The substitution of safer alternatives for phthalates is critical given the risk these chemicals pose to child brain development, according to the study.

Critics point to the expense of removing an entire class of chemicals, but manufacturers have already successfully removed phthalates from a wide range of products.

Apple has removed “phthalates as a class from almost all products,” while other companies like CVS and The Home Depot have “reduced the use of phthalates in beauty, personal care products, household products and vinyl flooring,” according to CNN.

Boston Children’s Bellinger said the public can play a significant role in accomplishing change. He pointed to the removal of Bisphenol A (BPA) from baby bottles and sippy cups after mothers demanded companies remove the hormone disruptor from their products. Six major companies removed the chemical three years before the FDA required it.

Petitions awaiting action

This isn’t the first time a group has called on the FDA to consider banning an entire class of chemicals due to their overall impact.

A petition submitted last year by the Environmental Defense Fund and supported by 11 groups including the American Academy of Pediatrics, American Public Health Association and Center for Food Safety called on the FDA to consider the “cumulative effects” of the more than 10,000 chemicals allowed in foods and food packaging.

Some of those chemicals, like phthalates and another class of chemicals called PFAS (perfluoroalkyl and polyfluoroalkyl substances), are known hormone disruptors linked to developmental, cognitive and other health problems in babies and adults.

According to CNN, the FDA is currently reviewing two food additives petitions requesting the agency amend their food additive regulations removing authorization for the use of phthalates in food-contact applications.

“Completing our review of these petitions and publishing our response in the Federal Register is a priority for the FDA,” said an FDA spokesperson.

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