Urinary phthalate metabolites in relation to childhood asthmatic and allergic symptoms in Shanghai

Wenming Shi; Zhijing Lin; Chenxi Liao; Jialing Zhang; Wei Liu; Xueying Wang; Jiao Cai; Zhijun Zou; Heng Wang; Dan Norback; Haidong Kan; Chen Huang; Zhuohui Zhao

Environment International (Dec 2018)

Urinary phthalate metabolites in relation to childhood asthmatic and allergic symptoms in Shanghai

Wenming Shi,
Zhijing Lin,
Chenxi Liao,
Jialing Zhang,
Wei Liu,
Xueying Wang,
Jiao Cai,
Zhijun Zou,
Heng Wang,
Dan Norback,
Haidong Kan,
Chen Huang,
Zhuohui Zhao

Affiliations

Wenming Shi: Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China
Zhijing Lin: Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China
Chenxi Liao: School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai 200093, China
Jialing Zhang: School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai 200093, China
Wei Liu: School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai 200093, China
Xueying Wang: School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai 200093, China
Jiao Cai: School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai 200093, China
Zhijun Zou: School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai 200093, China
Heng Wang: Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan 316021, China
Dan Norback: Department of Medical Sciences, Uppsala University, Uppsala SE 751-85, Sweden
Haidong Kan: Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety of the Ministry of Education, Key Laboratory of Health Technology Assessment, National Health and Family Planning Commission of the People's Republic of China, Shanghai Key Laboratory of Meteorology and Health, Shanghai 200032, China
Chen Huang: School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai 200093, China; Correspondence to: C. Huang, 516 Jungong Road, Yangpu District, Shanghai, China.
Zhuohui Zhao: Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety of the Ministry of Education, Key Laboratory of Health Technology Assessment, National Health and Family Planning Commission of the People's Republic of China, Shanghai Key Laboratory of Meteorology and Health, Shanghai 200032, China; Correspondence to: Z. Zhao, 130 Dong-An Road, Xuhui District, Shanghai, China.

Journal volume & issue: Vol. 121
pp. 276 – 286

Abstract

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Background: Few studies can be found on phthalate exposure in relation to childhood asthma and allergic symptoms from Mainland China, where a persistent increase in prevalence of childhood asthma and allergic disease has been observed. Objectives: This study aimed to assess the exposure levels to phthalates and its relationship with asthmatic and allergic symptoms among children in Shanghai, which has the highest prevalence of childhood asthma in Mainland China. Methods: A follow-up study (2013–2014) of 434 children aged 5–10 years was conducted, based on the China, Children, Homes, Health (CCHH) study (2011−2012) in Shanghai, China. Information on asthmatic and allergic symptoms (wheeze, rhinitis, and eczema) were collected using validated questionnaires. Ten phthalate metabolites in morning urine samples were analyzed by high-performance liquid chromatography with triple quadrupole tandem mass spectrometry (HPLC-MS/MS). Multivariable logistic regression was used to estimate the associations between symptoms and urinary phthalate metabolites controlling for demographics, family history of allergic diseases and other covariates. Results: Nine out of 10 phthalate metabolites were detected in all subjects (average detection rate of 93.2%). By multivariable logistic regression analyses, the 4th quartile of Mono‑n‑butyl phthalate (MnBP) (reference: 1st quartile) had adjusted prevalence odds ratios (aPORS) and 95% confidence intervals (95%CIs) of 2.27(1.06–4.88), 2.14(1.02–4.46) and 2.98(1.19–7.50) for wheeze, rhinitis and eczema, respectively, while those of Mono‑isobutyl phthalate (MiBP) were 2.23(1.08–4.62) and 2.96(1.02–8.60) for rhinitis and eczema, respectively. The highest quartile of mono‑2‑ethyl‑5‑hydroxyhexyl phthalate(MEHHP) and mono‑2‑ethyl‑5‑oxohexyl phthalate(MEOHP) had aPORS and 95%CIs of 3.10(1.10–8.74) and 2.63(1.02–6.80) for eczema, respectively. By summing up the 4 low molecular weight metabolites (∑4LMWP) and all 9 metabolites (∑9Total), the highest quartiles of ∑4LMWP and∑9Total were significantly associated with all symptoms. In most of the above associations, a significantly increasing trend from the 1st to the 4th quartile was observed. Subjects with 2 or 3 concomitant symptoms (reference: no symptoms) had significant positive associations with a higher level (the 4th quartile) of phthalate metabolites. Conclusions: Low MW metabolites such as MnBP and MiBP, high MW DEHP and the total amount of phthalate metabolites might have adverse health effects on asthma and allergic symptoms in Chinese children. Keywords: Asthma, Children, Phthalates, Eczema, Allergic disease

Published in Environment International

ISSN: 0160-4120 (Print)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Geography. Anthropology. Recreation: Environmental sciences
Website: https://www.journals.elsevier.com/environment-international

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