Urinary Phthalate Metabolites in Relation to Children's Asthmatic and Allergic Symptoms in Shanghai

摘要

BACKGROUND: Few studies can be found on phthalates exposure in relation to childhood asthma and allergic symptoms from mainland of China, where a persistent increase of childhood asthma and allergic disease has been observed. OBJECTIVES: We aimed to find out the exposure levels of phthalates and its relationship with children's asthmatic and allergic symptoms in Shanghai. METHODS: A follow-up study(2013-2014) in 434 children 5-10 years of age was completed, based on the China, Children, Homes, Health(CCHH) study(2011-2012). Asthmatic and allergic symptoms (wheeze, rhinitis, eczema) were collected by questionnaire and 10 phthalate metabolites were analyzed in morning urine samples. Multiple logistic regression was applied to estimate the associations between symptoms and 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 93.2%). By multiple regression analyses, the 4th quartile of MnBP(reference: The 1st quartile) had the adjusted odds ratios(AOR) and 95% confidence interval(95%CI) by 2.48(1.15-5.37), 2.18(1.05-4.54) and 3.09(1.22-7.83) for wheezing, rhinitis and eczema, respectively, while MiBP for rhinitis and eczema by 2.31(1.12-4.73) and 2.95(1.05-8.51), respectively. MEHHP and MEOHP were significantly associated with eczema by 3.14(1.12-8.83) and 2.65(1.02-6.85), respectively. By summing up the 4 low molecular weight(MW) metabolites and all 9 metabolites, the 4th quartiles of the sums were significantly associated with all symptoms. Subjects with 2 or 3 concomitant symptoms(reference: no symptoms) had significant positive associations with most of the above phthalate metabolites. CONCLUSIONS: Low MW metabolites such as DnBP and DiBP, high MW of DEHP and the total amount of phthalate metabolites might have adverse health effects on asthma and allergic symptoms in Chinese children.