February 18, 2021

In a peer-reviewed article published in the American Journal of Public Health, leading scientists and health professionals of Project TENDR identify ortho-phthalates as neurotoxic chemicals that increase children’s risks for learning, attention and behavioral disorders. In particular, prenatal exposures to phthalates can contribute to attention problems in children.

The TENDR experts call for swift government and corporate action to eliminate the use of the entire class of ortho-phthalates to protect child brain development. Phthalates are used in personal care products and cosmetics, in food packaging and processing equipment, flooring and other building materials.

Phthalates readily transfer from the mother to the fetus. Women have higher exposure than men to phthalates from personal care products, and Black and Latina women have higher exposure to phthalates than white women, independent of income level.

Phthalates have long been known to harm reproductive tract development in males, but this study shares recent mounting evidence in humans and experimental animal studies, which conclude phthalates can do lasting harm to child brain development. The article authors note that some manufacturers have stopped using phthalates, demonstrating the feasibility of wholesale elimination of phthalates from products that expose pregnant women, infants and children.

Dr. Stephanie Engel

Dr. Stephanie Engel

Lead author Stephanie Engel, PhD, professor of epidemiology at the University of North Carolina at Chapel Hill’s Gillings School of Global Public Health, states, “There are now dozens of studies from countries around the world finding adverse associations between phthalate exposure and multiple aspects of brain development, including effects on behavior, cognitive function and even brain white matter microstructure. There is no compelling rationale to continue waiting for more evidence when phthalates can be eliminated from most uses.”

Co-author Russ Hauser, MD, ScD, of Harvard University’s T.H. Chan School of Public Health — also the co- author of the 2014 Chronic Health Advisory Panel (CHAP) report on phthalates that led the Consumer Product Safety Commission (CPSC) to ban certain phthalates from toys — says, “Having served on the CPSC CHAP that reviewed the health risks of phthalates in children’s toys and childcare articles, I realized how important it was to undertake this new review of the rapidly accumulating data on neurotoxicity of phthalates. Six years after the CPSC report, our new paper on neurotoxicity of phthalates makes it clear we need government action to protect children’s brains from exposure to phthalates in products apart from toys and child care articles.”

The article published today in AJPH calls for a multipronged regulatory approach at federal and state levels, as well as action by retailers and manufacturers to eliminate phthalates as a class from products that lead to exposure of pregnant women, women of reproductive age, infants and children.

The Project TENDR authors call for urgent action, especially to reduce exposures among socially vulnerable populations such as communities of color, who frequently experience higher exposures.

Co-author Robin Whyatt, Professor Emeritus with the Columbia Center for Children’s Environmental Health at Columbia University’s Mailman School of Public Health, notes, “Due to ubiquitous use of phthalates, people are exposed to mixtures of these chemicals simultaneously. The policy reforms we are recommending would eliminate phthalates as a class from this vast array of exposure sources. We believe this goal is entirely feasible, as certain manufacturers have already voluntarily removed phthalates from multiple products in each exposure category.”


Contact the UNC Gillings School of Global Public Health communications team at sphcomm@unc.edu.

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