An article published on August 18, 2018, in the peer-reviewed journal Environmental Research, reports about the results of a systematic review focused on exposure to di-(2-ethylhexyl) phthalate (DEHP, CAS 117-81-7) and neurodevelopmental outcomes in children. Dong-Wook Lee and colleagues from the Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea, performed a systematic review and meta-analysis of studies focusing on the association between DEHP exposure and child neurodevelopment, paying “particular attention to study design (longitudinal vs. cross-sectional).” Initially, 106 studies were located in public databases, from which “eight longitudinal studies and two cross-sectional studies were included in the meta-analysis.”

With regard to prenatal DEHP exposure, the scientists found “significant association between DEHP exposure measured in prenatal period [in mothers’ urine] and the psychomotor development outcomes measured later” in their children. Concerning postnatal exposure, cross-sectional studies showed “a statistically significant association between the concentrations of DEHP metabolites and the neurodevelopment outcomes of children,” such as intelligence quotients.

The authors discuss “methodological limitations due to measuring intervals, duration of longitudinal cohort studies, and quantitative and qualitative analysis on differences among tests for cognitive development.” In order to characterize “more accurate trajectories of neurotoxic effects of phthalates,” it would be necessary to perform “prospective cohort studies of large population with repeated measures of mental and psychomotor development with both urine and serum concentration of phthalates over longer periods of time, taking into account environmental and individual factors.” These studies “should consider better experimental design with appropriately controlled confounding factors, refined measurement methods of biological exposure indices, and timely assessment of neurodevelopment,” the authors suggest.

The authors conclude that “DEHP carries risks of disturbed neurodevelopment in children” and warn that “the severity of problem is not negligible since DEHP is still the most commonly used phthalate.” They emphasize that “precautionary policies . . . for health hazards of DEHP should be made to protect neurodevelopment of children.”


Lee, D.-W., et al. (2018). “Prenatal and postnatal exposure to di-(2-ethylhexyl) phthalate and neurodevelopmental outcomes: A systematic review and meta-analysis.Environmental Research 167: 558-566.