Academic journal article Environmental Health Perspectives

Prenatal Exposure to Phthalates and the Development of Eczema Phenotypes in Male Children: Results from the EDEN Mother-Child Cohort Study

Academic journal article Environmental Health Perspectives

Prenatal Exposure to Phthalates and the Development of Eczema Phenotypes in Male Children: Results from the EDEN Mother-Child Cohort Study

Article excerpt


Phthalates are man-made chemicals widely used in our daily life [e.g., food wrappings, cosmetic products, children's toys, cleaning products, medical devices, pharmaceuticals, polyvinyl chloride (PVC) flooring, building materials] because of their properties of transparency, durability, and flexibility (Meeker et al. 2009; Bornehag et al. 2005; Arbuckle et al. 2014). People can be exposed to phthalates through inhalation, dermal absorption (including air-to-skin transport), contact with contaminated surfaces, and use of personal care products and ingestion (including dietary ingestion and incidental ingestion) (Swan 2008). Urinary concentrations of phthalate metabolite are the most reliable measures for exposure assessment (Swan 2008). The ubiquitous presence of phthalates in the environment and the potential consequences of human exposure to phthalates have raised concerns, particularly in vulnerable populations such as pregnant women and infants. Prenatal and early life are critical in the development of the immune system; exposure to toxic pollutants during this period can result in an increased risk of adverse health outcomes later in life.

Animal as well as epidemiological studies in infants and children have found various health effects of specific phthalates, including abnormal reproductive outcomes (Meeker et al. 2009; Abdel-Maksoud et al. 2015; Niermann et al. 2015; Aydogan Ahbab and Barlas 2015; Jurewicz and Hanke 2011), children's neurodevelopmental and behavioral problems (Whyatt et al. 2012; Ejaredar et al. 2015; Braun et al. 2013), and asthma and allergies (Bornehag et al. 2004b; Whyatt et al. 2014; Stelmach et al. 2015; Just et al. 2012; Hsu et al. 2012), although not consistently.

The prevalence of eczema in childhood, including its allergic-related phenotype, varies globally from 3% to 37% and is steadily increasing worldwide (Asher et al. 2006; Nutten 2015; Eichenfield et al. 2014; Deckers et al. 2012). The causes of eczema and of its increased prevalence are still unclear but are likely to be multifactorial in nature and depend on both genetic and environmental factors (Nutten 2015; Pyun 2015). During in utero life, the skin of the fetus may be exposed to various products absorbed by the mothers, including phthalates given that some phthalates have been detected in amniotic fluid (Jensen et al. 2015). Later in life, children's dermal exposure can occur through the use of emollients, personal care products, and dermal contact with plastic products, soil, and dust, which can add to the total intake of certain phthalates through other routes such as inhalation and ingestion (Wormuth et al. 2006; Overgaard et al. 2017).

Eczema pathogenesis involves immunologic dysfunction and skin barrier defects (Pyun 2015). Phthalates might influence the epidermal barrier development processes, which can take several years to occur, and this influence could be stronger in allergic individuals due to the fragility of their mucosae. Although dermal absorption of phthalates and its impact on child health is established, contradictory results exist regarding eczema development after phthalate exposure in utero (Just et al. 2012; Smit et al. 2015; Weschler et al. 2015; Gong et al. 2015; Pan et al. 2014).

The objective of the present study was to evaluate the potential associations between maternal exposure to phthalates during the second trimester (between the 24th and 28th weeks) of pregnancy and occurrence of eczema phenotypes in male children in their first 5 y of life using data collected in the French EDEN mother-child prospective cohort study. The association was explored according to atopic status as defined by total immunoglobulin E (IgE) in a subsample of boys for which this assessment was available.


Study Population and Data Collection

The population in this study is a subgroup of the French EDEN (Etude des Determinants pre et post natals du developpement de la sante de l'Enfant) mother-child prospective birth cohort restricted to boys (https://eden. …

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