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DEHP, used to make plastics more flexible, is found in a broad range of consumer goods including food packaging, vinyl flooring, shower curtains, shampoo, cosmetics, and even medical devices like IV bags and catheters. The study, published in The Lancet eBiomedicine, examined exposure levels in 200 countries and territories using urine samples to estimate how much of the broken-down chemical had entered individuals' bodies. The results were then compared to global cardiovascular death statistics from the Institute for Health Metrics and Evaluation.
Cardiovascular Inflammation and Hormonal Disruption
According to senior study author Dr. Leonardo Trasande, DEHP contributes to 'inflammation and systemic inflammation in the coronary arteries,' which may worsen existing heart conditions and potentially result in fatal outcomes. Dr. Trasande also emphasized the role of phthalates as endocrine disruptors, interfering with hormones that regulate essential biological functions such as metabolism and heart health.
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Phthalates are already well known for their link to male reproductive issues, including reduced sperm count, testosterone disruption, and genital abnormalities. They have also been associated with asthma, obesity, diabetes, and certain cancers. DEHP, in particular, is listed under California's Proposition 65 for its potential to cause reproductive harm and cancer.
Global and Economic Impact
The burden of DEHP-related cardiovascular deaths is not evenly distributed. India reported the highest number of such deaths—over 103,000—followed by China and Indonesia. Collectively, regions including the Middle East, South Asia, East Asia, and the Pacific accounted for nearly 75% of these fatalities. These areas also face heightened exposure due to rapid industrialization and fewer regulatory restrictions on plastic production.
While the study did not establish direct causation, it is considered the first to provide a global estimate of cardiovascular deaths linked to phthalate exposure. Researchers estimate the economic cost of these deaths to range from $510 billion to over $3.7 trillion due to lost productivity.
Minimizing Daily Exposure
Given how prevalent phthalates are, avoiding them entirely may be difficult. However, experts suggest several practical steps to reduce exposure. Consumers are advised not to microwave food in plastic containers, as heat can cause the chemicals to leach into food. Using glass, stainless steel, or ceramic containers for food storage is recommended. Additionally, people should opt for fragrance-free personal care and cleaning products, avoid air fresheners, and check plastic recycling labels—steering clear of products marked with codes 3, 6, and 7.
'Reducing your use of ultraprocessed foods can reduce the levels of chemical exposures,' said Dr. Trasande, who also leads the NYU Center for the Investigation of Environmental Hazards.
Researchers stressed the urgency for stricter global regulations on DEHP and other phthalates, especially in regions with high usage and weak chemical oversight. 'By highlighting the connection between phthalates and a leading cause of death across the world, our findings add to the vast body of evidence that these chemicals present a tremendous danger to human health,' stated lead author Sara Hyman.
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