Personal care product use among adults in NHANES: associations between urinary phthalate metabolites and phenols and use of mouthwash and sunscreen

J Expo Sci Environ Epidemiol. 2017 May;27(3):326-332. doi: 10.1038/jes.2016.27. Epub 2016 May 11.


Personal care product use is a well-established pathway of exposure for notable endocrine disrupting compounds (EDCs), including phthalates, parabens, triclosan, benzophenone-3 (BP3), and bisphenol-A. We utilized questionnaire data from the National Health and Nutrition Examination Survey 2009-2012 cycles to examine the associations between use of sunscreen and mouthwash and urinary concentrations of phthalate metabolites and phenols in a nationally representative population of US adults (n=3529). Compared with individuals who reported "Never" using mouthwash, individuals who reported daily use had significantly elevated urinary concentrations of mono-ethyl phthalate, methyl and propyl parabens, and BP3 (28%, 30%, 39%, and 42% higher, respectively). Individuals who reported "Always" using sunscreen had significantly higher urinary concentrations of triclosan, methyl, ethyl, and propyl parabens, and BP3 (59%, 92%, 102%, 151%, and 510% higher, respectively) compared with "Never" users of sunscreen. Associations between exposure biomarkers and sunscreen use were stronger in women compared with men, and associations with mouthwash use were generally stronger in men compared with women. These results suggest that sunscreen and mouthwash may be important exposure sources for EDCs.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Biomarkers / urine
  • Endocrine Disruptors
  • Female
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Mouthwashes / metabolism*
  • Nutrition Surveys
  • Phenols / urine*
  • Phthalic Acids / urine*
  • Sex Distribution
  • Sunscreening Agents / metabolism*
  • United States


  • Biomarkers
  • Endocrine Disruptors
  • Mouthwashes
  • Phenols
  • Phthalic Acids
  • Sunscreening Agents
  • phthalic acid