Can persistent organic pollutants and plastic-associated chemicals cause cardiovascular disease?

J Intern Med. 2012 Jun;271(6):537-53. doi: 10.1111/j.1365-2796.2012.02536.x. Epub 2012 Mar 30.


During the last decade, associations between persistent organic pollutants (POPs), such as polychlorinated biphenyls, dioxins and pesticides, and cardiovascular (CV) risk factors and overt CV disease (CVD) have been reported in humans. Recently, associations between plastic-associated chemicals (PACs), such as bisphenol A and phthalates, and CVD have also begun to emerge. Several approaches to evaluating such associations have been used: accidents with a high level of exposure, occupational exposure studies, geographical studies of subjects living near a contaminated area and traditional case-control or cohort studies with measurements of circulating levels of different environmental contaminants in the general population. Exposure to POPs has consistently been associated with diabetes using all the approaches described above, including prospective studies. The evidence regarding associations between exposure to POPs and other CV risk factors, such as hypertension, obesity and lipids, is less strong and is mainly based on cross-sectional data. Associations between overt CVD and POPs have been reported using all the above approaches, but prospective data from population-based studies are still lacking to provide firm evidence of an important and independent role of POP exposure in the pathogenesis of CVD. Nevertheless, taken together, current evidence suggests that further longitudinal and experimental studies should be conducted to investigate the effect of exposure to both POPs and PACs, such as bisphenol A and phthalates.

Publication types

  • Review

MeSH terms

  • Air Pollutants, Occupational / adverse effects
  • Atherosclerosis / chemically induced
  • Benzhydryl Compounds
  • Cardiovascular Diseases / chemically induced*
  • Cardiovascular Diseases / epidemiology
  • Coronary Disease / chemically induced
  • Diabetes Complications / chemically induced
  • Diabetes Mellitus / chemically induced
  • Dioxins / adverse effects
  • Environmental Monitoring / methods
  • Environmental Pollutants / adverse effects*
  • Epidemiological Monitoring
  • Evidence-Based Medicine
  • Global Health
  • Hazardous Substances / adverse effects*
  • Humans
  • Peripheral Arterial Disease / chemically induced
  • Pesticides / adverse effects*
  • Phenols / adverse effects
  • Plastics / adverse effects*
  • Polychlorinated Biphenyls / adverse effects*
  • Risk Factors
  • Stroke / chemically induced
  • Sweden / epidemiology


  • Air Pollutants, Occupational
  • Benzhydryl Compounds
  • Dioxins
  • Environmental Pollutants
  • Hazardous Substances
  • Pesticides
  • Phenols
  • Plastics
  • Polychlorinated Biphenyls
  • bisphenol A