Effects of exposure to phthalates and a phthalate substitute on food sensitization in children in China: evidence from a population study

Background
Phthalates are among the most ubiquitous environmental pollutants and endocrine disruptors. However, the effect of phthalates exposure on food allergies remains unclear.
Objectives
This study examined the relationship between exposure to phthalates and a phthalate substitute and food sensitization in children.
Methods
A study was conducted including 198 children with self-reported food allergy and 202 healthy children. Specific immunoglobulin E (sIgE) test and skin prick test were applied to evaluate the susceptibility to food sensitization. Urine samples were analyzed for 17 metabolites of phthalates and a phthalate substitute. Logistic regression and weighted quantile sum regression models were used to examine the correlations between exposure and food sensitization. Bayesian benchmark dose models were established to calculate benchmark dose values for these metabolites.
Results
In single compound models, mono-2-ethyl-5-hydroxyhexyl terephthalate (MEHHTP) was associated with increased sensitization to almond, crab, shrimp, and total foods, and mono-2-methyl-2-hydroxypropyl phthalate (MHiBP) was associated with positive skin prick tests for wheat, peanut, and blue mussel (all p < 0.05). Mixed exposure only increased susceptibility for total foods sensitization with higher levels of sIgE (Odds Ratio = 1.25, 95 % confidence intervals: 1.01–1.56, p = 0.04), and MEHHTP had the dominant contribution.
Conclusion
Phthalates exposure is linked to a higher risk of food sensitization in children in China. Further studies are warranted to confirm these findings and the role of phthalate substitutes.