Phthalates, chemicals used in the manufacture of plastics, are found in products such as cosmetics, detergents, solvents, PVC pipes and bug repellants. One type of phthalate, di-2-ethylhexyl phthalate (DEHP), is used to make medical equipment and plastic food containers among other items.

Phthalates have been associated with health problems like infertility, diabetes, obesity and cancer. DEHP can cause inflammation of the arteries in the heart, which can increase the risk of heart attack or stroke.

Daily exposure to DEHP could be linked to more than 356,000 deaths from cardiovascular disease among men and women between the ages of 55 and 64 worldwide, New York University Langone Health researchers recently found.

Avoid plastic containers that have a 3, 6 or 7 stamped on them in the center of the recycling symbol. It indicates phthalates were used in their manufacture.

The researchers estimated the economic burden of these deaths to be about $510 billion and may be as high as $3.74 trillion. “By highlighting the connection between phthalate exposure and cardiovascular disease, the leading cause of death worldwide, these findings add to the body of evidence that these chemicals are a danger to human health,” Sara Hyman, lead author on the study, said in a statement.

The researchers analyzed health and environmental data from dozens of population surveys to measure DEHP exposure across 200 countries and territories. The data included urine samples containing DEHP metabolites, products from the breakdown of DEHP. Heart disease mortality data were provided by the Institute for Health Metrics and Evaluation, a U.S. research group that collects global health information to identify trends in public health.

Deaths from DEHP are not spread evenly around the globe. Geographic disparities in cardiovascular disease mortality linked to DEHP exposure were also found. South Asia, the Middle East, East Asia and the Pacific accounted for 42 percent and 32 percent, respectively, of these deaths. India had the highest number of deaths at 103,587 deaths, followed by China (almost 61,000 deaths) and Indonesia (more than 19,700 deaths).

The impact of DEHP exposure surprised Leonardo Trasande, senior author on the study. He was surprised to see that it was so significant in lower- and middle-income countries, which already have a disproportionate burden of other chronic diseases. The findings underscore the need for regulations on a global scale to reduce the exposure to toxins like phthalates, particularly in low- and middle-income countries where rapid industrialization leads to high levels of plastic consumption.

These countries will be the majority producers and consumers of these chemicals by 2030, according to the Organisation for Economic Co-operation and Development.

The Global Plastics Treaty is currently being negotiated by about 175 countries. It would monitor exposure to phthalates and sources of exposure across the multiple steps in which plastics are used or produced.

Exposures to toxins like phthalates are unlikely to decrease anytime soon without further action. Trasande, the Jim G. Hendrick, MD, Professor of Pediatrics at NYU Grossman School of Medicine, said “That is what the Global Plastics Treaty is supposed to do”.

In March 2022, the United Nations adopted a resolution to develop a legally binding instrument to reduce plastic pollution. The Global Plastics Treaty is currently being negotiated by about 175 countries. It would monitor exposure to phthalates and sources of exposure across the multiple steps in which plastics are used or produced, Trasande explained.

Here are a few ways you can reduce your phthalate exposure:

  • Use wax paper or aluminum foil instead of plastic wrap.
  • Eat more fresh foods, rather than canned foods or foods packaged in plastic.
  • Don't microwave foods packaged in plastic.
  • Wash plastic food containers out by hand rather than in the dishwasher since dishwasher detergent can scratch the containers and may cause them to leach more phthalates into the food.
  • Avoid plastic containers that have a 3, 6 or 7 stamped on them in the center of the recycling symbol. Phthalates are used to manufacture these containers.

The researchers plan to follow up on this study by tracking how reductions in phthalate exposure affect global mortality rates over time.

The study is published in Lancet eBiomedicine.