Association of current phthalate exposure with neurobehavioral development in a national sample

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• 作者：Eun-Kyung Won^a ; Yeni Kim^a ; ¹ ; ^{yeni1004@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Mina Ha^b ; ¹ ; ^{minaha@dku.edu" class="auth_mail" title="E-mail the corresponding author} ; Eunae Burm^c ; Young-Suk Kim^d ; Hyungryul Lim^b ; Da-Eun Jung^a ; Sinye Lim^e ; Soo-Young Kim^f ; Yu-Mi Kim^g ; Hwan-Cheol Kim^h ; Kee Jae Leeⁱ ; Hae-Kwan Cheong^j ; Hee-Tae Kang^k ; Mia Son^l ; Joon Sakong^m ; Gyung-Jae Ohⁿ ; Chul-Gab Lee^o ; Su Young Kim^p ; Jung Min Ryu^q ; Sue Jin Kim^q
• 关键词：ARS ; Korean Attention Deficit Hyperactivity Disorder Rating Scale ; ADHD ; attention-deficit hyperactivity disorder ; CBCL ; Korean Child Behavior Checklist ; DBP ; dibutyl phthalate ; DEHP ; di-2-ethylhexyl phthalate ; KorEHS-C ; Korean Environmental Health Survey in Children and Adolescents ; MBzP ; mono-benzyl phthalate ; MECPP ; mono-2-ethyl-5-carboxypentyl phthalate ; MEHHP ; mono-2-ethyl-5-hydroxyhexyl phthalate ; MEOHP ; mono-2-ethyl-5-oxohexyl phthalate ; MnBP ; mono-n-butyl phthalate
• 刊名：International Journal of Hygiene and Environmental Health
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：219
• 期：4-5
• 页码：364-371
• 全文大小：700 K

文摘

Previous studies have indicated that phthalate exposure may influence the development of children, but the current data are limited, and controversy remains regarding the sex-specific and age-specific effects of phthalate exposure.

Methods

We investigated the sex- and age-specific associations of current phthalate exposure with neurobehavioral development scores in a nationally representative sample of 6–18-year-olds participating in the Korean Environmental Health Survey in Children and Adolescents (KorEHS-C). Neurobehavioral development was assessed using the Korean Child Behavior Checklist (CBCL, N = 1723) and the Korean Attention Deficit Hyperactivity Disorder Rating Scale (ARS, N = 867). We measured the concentrations of phthalate metabolites in urine samples using high-performance liquid chromatography tandem mass spectrometry. The associations between urine phthalate metabolite concentrations and neurobehavioral development were examined by survey regression analysis for complex sampling and penalized regression splines using a generalized additive model.

Results

Survey regression analysis revealed that a higher mono-n-butyl phthalate (MnBP) level was associated with social (β = 0.60; 95% confidence interval = 0.15–1.05), thought (0.55; 0.08–1.03), and attention (0.68; 0.21–1.14) problems on the CBCL. A significant association was found between the MnBP level and the ARS hyperactivity subscale score (0.42; 0.05–0.58). Higher levels of MnBP (0.87; 0.20–1.54), mono-2-ethyl-5-oxohexyl phthalate (MEOHP, 0.61; 0.11–1.11) and mono-2-ethyl-5-hydroxyhexyl phthalate (MEHHP, 0.51; 0.04–0.97) were associated with an increase in thought problems among the girls. Among the younger children aged 6–11 years, significant positive associations between the MnBP (0.71; 0.09–1.33), MECPP (0.74, 0.14–1.34), MEOHP (0.65; 0.10–1.20), and MEHHP (0.71; 0.21–1.21) levels and social problems and between the MnBP (1.11; 0.37–1.84), MEOHP (0.64; 0.13–1.15), and MEHHP (0.66; 0.18–1.14) levels and attention problems were observed. The penalized regression splines for the age-specific relationships between the urinary MnBP, MEOHP, and MEHHP levels and social and attention problems exhibited positive supralinear relationships with downward curvature in the 6–11 year age group. In contrast, the score for social problems exhibited nearly linear relationships with these levels in the 12–18 year age group.

Conclusions

In this national sample, increased phthalate exposure exhibited supralinear associations with social, thought and attention problems in children aged 6–11 years, who showed greater vulnerability to phthalate exposure. The results highlight the need for the environmental regulation of phthalate exposure in younger children, even at low dosages.