Early life phthalate exposure and atopic disorders in children: a prospective birth cohort study

Environ Int. 2014 Jan:62:48-54. doi: 10.1016/j.envint.2013.09.002. Epub 2013 Oct 24.


The role of phthalate exposure at different stages in the immune system and atopic disorders is not well-known. This study aims to evaluate the effects of prenatal and postnatal phthalate exposures on immunoglobulin E (IgE) levels and atopic dermatitis (AD) in children by objective biomarkers. We conducted a prospective Taiwan Birth Panel cohort study with 483 mother/infant pairs. Finally, 161 urine specimens at 3rd trimester of pregnancy, 219 urine specimens from children at age 2, and 192 urine specimens at age 5 were analyzed after excluding missing data and loss to follow-up. Urine monoethyl phthalate (MEP), monobutyl phthalate (MBP), monobenzyl phthalate (MBzP), and mono-(2-ethylhexyl) phthalate (MEHP) at 3rd trimester of pregnancy and at ages 2 and 5 were measured by ultra-performance liquid chromatography coupled with tandem mass spectrometry. At ages 2 and 5, information on the development of AD and serum total IgE was collected. The association between urine phthalate metabolite levels at different stages and serum IgE and AD was evaluated by multivariate linear regression and logistic regression. Urine phthalate metabolite levels were higher at age 2 than those at pregnancy and age 5. At each period, urine MBP levels were higher than MEP, MEHP, and MBzP. MEHP levels at age 2 positively correlated with serum IgE levels (per ln-unit: β=0.191, p=0.02). Analyses stratified by gender revealed that MEHP levels positively correlated with serum IgE levels only in boys (per ln-unit: β=0.256, p=0.03). When dividing into quartiles, urine MBzP levels at age 2 had a significant association with AD. We found no statistically significant association of other phthalate metabolites with IgE and AD. Early life phthalate exposure may increase the risk of allergic sensitization and atopic disorders.

Keywords: AD; Atopic dermatitis; BBzP; Cohort study; DBP; DEHP; DEP; GM; IgE; MBP; MBzP; MEHP; MEP; atopic dermatitis; butyl benzyl phthalate; di(2-ethylhexyl) phthalate; dibutyl phthalate; diethylphthalate; geometric mean; immunoglobulin E; mono(2-ethylhexyl) phthalate; monobenzyl phthalate; monobutyl phthalate; monoethyl phthalate.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers / blood
  • Child
  • Cohort Studies
  • Dermatitis, Atopic / epidemiology*
  • Environmental Exposure*
  • Female
  • Humans
  • Immunoglobulin E / blood*
  • Infant
  • Male
  • Maternal Exposure
  • Phthalic Acids / metabolism
  • Phthalic Acids / urine*
  • Pregnancy
  • Pregnancy Trimester, Third
  • Prospective Studies
  • Sex Factors
  • Taiwan / epidemiology


  • Biomarkers
  • Phthalic Acids
  • Immunoglobulin E