Phthalate exposure and neurodevelopmental outcomes in early school age children from Poland

Some phthalates are known endocrine disrupting chemicals (EDC). They are widely present in the environment thus their impact on children's health is of particular scientific interest. The aim of the study was to evaluate the association between phthalate exposure and neurodevelopmental outcomes, in particular behavioral, cognitive and psychomotor development, in 250 early school age children from the Polish Mother and Child Cohort (REPRO_PL). Urine samples were collected at the time of children's neurodevelopmental assessment and were analysed for 21 metabolites of 11 parent phthalates. Behavioral and emotional problems were assessed by the Strengths and Difficulties Questionnaire (SDQ) filled in by the mothers. To assess children's cognitive and psychomotor development, Polish adaptation of the Intelligence and Development Scales (IDS) was administered. The examination was performed by trained psychologists. Dimethyl phthalate (DMP) and di-n-butyl phthalate (DnBP) were the two phthalates showing the highest statistically significant associations, with higher total difficulties scores (β = 1.5, 95% CI 0.17; 2.7; β = 1.5, 95% CI 0.25; 2.8, respectively) as well as emotional symptoms and hyperactivity/inattention problems for DnBP (β = 0.46, 95% CI -0.024; 0.94; β = 0.72, 95% CI 0.065; 1.4, respectively), and peer relationships problems for DMP (β = 0.37, 95% CI -0.013; 0.76). In addition, DnBP and DMP have been found to be negatively associated with fluid IQ (β = -0.14, 95% CI -0.29; 0.0041) and crystallized IQ (β = -0.16, 95% CI -0.29; -0.025), respectively. In the case of mathematical skills, three phthalates, namely DMP (β = -0.17, 95% CI -0.31; -0.033), DEP (β = -0.16, 95% CI -0.29; -0.018) and DnBP (β = -0.14, 95% CI -0.28; 0.0012), have also shown statistically significant associations. This study indicates that exposure to some phthalates seems to be associated with adverse effects on behavioral and cognitive development of early school age children. Further action including legislation, educational and interventional activities to protect this vulnerable population is still needed.

This work has received financial support from the European Union's Seventh Framework Programme under grant agreement No. 603946 (Health and Environment-wide Associations based on Large population Surveys, HEALS); the National Science Centre, Poland, under grant No. DEC-2014/15/B/NZ7/00998 and the Medical Faculty of the Ludwig-Maximilians-Universität München, Germany, under grant No. WIFOMED-80926024. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Peer reviewed