A widespread plastic additive found in common household products may be linked to nearly 2 million preterm births and 74,000 newborn deaths globally in a single year, according to a latest study led by researchers at NYU Langone Health.
The toxin, di-2-ethylhexylphthalate (DEHP), is used to build plastics more flexible and appears in a variety of everyday items, including cosmetics, detergents, and bug repellents. Because these chemicals can enter the body through the air, dust, and food, the researchers estimate that in 2018 alone, DEHP contributed to approximately 1.97 million preterm births worldwide.
The ‘Whac-A-Mole’ of plastic regulation
Phthalates belong to a family of synthetic chemicals known as endocrine disruptors. These substances interfere with the body’s hormone production, which is critical for everything from brain development to immune function. While regulatory efforts have attempted to limit specific chemicals, the study suggests these efforts often result in a cycle of substitution rather than a solution.
Dr. Leonardo Trasande, the study’s senior author and professor of pediatrics at NYU Grossman School of Medicine, described the current approach as a “dangerous game of Whac-A-Mole.” The research found that diisononyl phthalate (DiNP), a common replacement for DEHP, may carry similar risks. This suggests that replacing one hazardous chemical with a closely related cousin does not necessarily protect public health.
A baby is considered premature when born before the 37th week of pregnancy. According to the US Centers for Disease Control and Prevention (CDC), infants who survive a premature birth may face significant long-term challenges, including breathing and feeding difficulties, cerebral palsy, developmental delays, and vision or hearing problems.
How these chemicals trigger early labor
While the exact biological mechanisms are still being researched, scientists believe phthalates like DEHP increase the risk of premature birth by disrupting the hormones that regulate pregnancy. This disruption can lead to stress and inflammation in the placenta or impair its function, potentially triggering labor to start too early.
Preterm birth is a leading cause of infant death and lifelong disability. The World Health Organization notes that children born before 37 weeks have a higher risk of struggling with learning and development throughout their lives.
A global disparity in exposure and outcome
This analysis is the first to estimate the global burden of these chemicals by combining exposure data and health outcomes across more than 200 countries. The findings reveal that the impact is not evenly distributed.
More than half of the global burden linked to DEHP exposure is concentrated in South Asia and the Middle East, where rapid industrialization and increased plastic use have driven exposure levels higher. In Africa, the study found a different but equally concerning pattern: while fewer preterm cases were recorded, newborns were more likely to die, a trend researchers attribute to significant gaps in access to neonatal care.
This creates a “double disadvantage” where populations facing the highest environmental risks as well have the weakest health systems to manage the consequences.
Research limitations and the path forward
The researchers emphasize that the study does not establish a direct cause-and-effect relationship. The figures are based on modeling that combines existing exposure data with known health risks, meaning the actual impact could be higher or lower than the estimates provided.
Despite these limitations, the results point to a substantial public health burden. Dr. Trasande and his colleagues are calling for a shift toward class-based regulation of plastic additives—treating the entire family of phthalates as a risk rather than regulating them one by one—alongside improved waste management and monitoring to reduce human exposure.
Common Questions Regarding Phthalates
Where is DEHP most commonly found?
It is frequently used in plastics to add flexibility and is found in household products such as detergents, bug repellents, and some cosmetics.
Why is the “class-wide” regulation mentioned in the study significant?
Because replacement chemicals (like DiNP) often mimic the harmful effects of the chemicals they replace, researchers argue that regulating the entire class of phthalates is the only way to avoid simply substituting one toxin for another.
As plastic use continues to rise globally, how can international regulatory bodies better coordinate to prevent the substitution of one hazardous chemical for another?
