PVC flooring and its relation to human uptake of phthalates in infants. A
pilot study to the SELMA-study.
Fredrik Carlstedt1, *, Mikael Hasselgren1, Bo A Jönsson2, Malin Larsson3, Carl-Gustaf
Bornehag3
1
Primary Care Research Centre, County Council of Värmland, Karlstad, Sweden
Environmental Analytical Chemistry, Lund University, Lund, Sweden
3
Public Health Science, Karlstad University, Karlstad, Sweden
2
*Corresponding email Fredrik.carlstedt@liv.se
Keywords: polyvinyl chloride flooring, infant, endocrine disruptors, phthalates
1 Introduction
Poly Vinyl Chloride (PVC) flooring is a well
known emitter of suspected endocrine disrupting
chemicals (EDCs), such as different phthalates
(Bornehag et al., 2005), used as plasticizers. It is
further suspected that foetal environment and
early life exposures are programming risk of
allergic disease in later life (Carrington and
Langley-Evans 2006; Bornehag and Nanberg
2009). It has also been shown that asthma and
allergies among children are associated with
exposures from plasticized PVC such as
phthalates (Bornehag, Sundell et al. 2004;
Kolarik, Naydenov et al. 2008). The aim of the
current study was to investigate the feasibility of
measuring phthalates and their metabolites in
urine from infants and if any relations between
these variables and environmental factors could
be seen. It was conducted as a pilot study for the
Swedish Environmental Longitudinal Mother
and child Asthma and allergy study (SELMA),
an ongoing prospective mother-child study in
Sweden (www.selmastudy.se).
2 Materials/Methods
Consecutive infants between two and six months
old and their mothers, who were scheduled for a
regular visit at children’s health care centres,
were invited to participate. The mothers were
asked 33 multiple choice questions that dealt
with symptoms of allergic disease, heredity and
housing characteristics. Urine samples from the
child were analyzed for the content of pthalate
metabolites (monoesters) related to the mother
substances diethyl-hexyl phthalate (DEHP),
butylbenzyl phthalate (BBzP), dibutyl phthalate
(DBP) and diethyl phthalate (DEP) where the
corresponding monoesters were: MEHP, MBzP,
MBP, and MEP. The concentration of the
monoesters in the children’s urine was adjusted
for creatinine concentration in order to minimize
influence of water dilution.
3 Results
Of 209 invited mother-child pairs, 110 (52%)
accepted to participate. Urine samples were
obtained from 83 of these children. As shown in
table 1 and figure 1, urine levels of Monobenzyl Phthalate (MBzP), a metabolite of BBzP,
was significantly higher in infants with PVC
flooring in their bedrooms (p<0.007).
Table 1. Urinary phthalate metabolite levels in
the infants, PVC flooring in the bedroom
compared to wood and linoleum, creatinine
correlated ng/ml / (mmol/l). *p<0.007
PVC Wood/
Phthalate
linoleum
N
29
49
MBzP
Median 9.6
6.0
Range
2.40.8-40.2
57.8
GM
10.3* 6.0*
Figure 2. Distribution of PVC-flooring in the
bedrooms compared to urinary MBzP levels,
shown as quartiles.
4 Conclusions
Urinary levels of phthalates during early life are
significantly related to PVC flooring in the
bedroom. The clinical consequences of these
findings are not known. The findings will be
further explored in the longitudinal SELMA
study. The present findings indicate that the
previously seen association between PVC
flooring and allergic disease may be due to
increased phthalate uptake.
5 References
Bornehag, C.-G., J. Sundell, et al. 2004. The
association between asthma and allergic
symptoms in children and phthalates in
house dust: a nested case-control study.
Environmental Health Perspectives
112(14): 1393-1397.
Bornehag, C. G. and E. Nanberg 2009. Phthalate
exposure and asthma in children.
International Journal of Andrology
33(2): 333-345.
Carrington, L. J. and S. C. Langley-Evans 2006.
Wheezing and eczema in relation to
infant anthropometry: evidence of
developmental programming of disease
in childhood. Matern Child Nutr 2(1):
51-61.
Kolarik, B., K. Naydenov, et al. 2008. The
association between phthalates in dust
and allergic diseases among Bulgarian
children. Environmental Health
Perspectives 116(1): 98-103.