Prenatal Exposure to Phthalates Significantly Associated With Elevated Rate of Language Delay in Children in Sweden and the U.S.
In the first study of its kind, researchers from the Icahn School of Medicine at Mount Sinai and Karlstad University in Sweden have found an elevated rate of language delay in children at 30 months old who were born to mothers exposed to phthalates, synthetic chemicals found in common household items and personal care products.
The study, the first to examine early language development in relation to first-trimester phthalate exposure as measured in urine levels, was published in JAMA Pediatrics.
The Swedish Environmental Longitudinal, Mother and Child, Asthma and Allergy study (SELMA) in Sweden and The Infant Development and the Environment Study (TIDES) in the United States provided data for the research.
Information was gathered from 963 pregnant women and their children from the Swedish study and 370 women and their children from the U.S. study. Parents were asked how many words their children understood at 30 months in SELMA and at 37 months in TIDES. Ten percent of children in both studies experienced language delay, with higher rates in boys than in girls. Children who understood fewer than 50 words were classified with language delay. Phthalate levels were measured in urine samples obtained from the women at median 10th week of pregnancy in both cohorts. The risk for language delay was higher by up to 30 percent in children whose mothers had doubled exposure levels of two chemicals: dibutyl phthalate (DBP) and butyl benzyl phthalate (BBP), both of which are commonly found in household products including older vinyl flooring, cosmetics, and plastic toys.
Before statistical adjustment results were statistically significant in both studies. After adjusting for potential confounders, results were significant in the Swedish study, but not in the U.S. study, likely due to its smaller sample size
“Given the prevalence of prenatal exposure to these chemicals and the importance of language development, pregnant women should try to reduce their exposure to phthalates by choosing scent-free personal care products and phthalate-free nail polish,” said the study’s senior author, Shanna Swan, PhD, Professor of Environmental and Public Health at the Icahn School of Medicine at Mount Sinai. “However, these phthalates are hidden in many household products like older vinyl floor covering and upholstery and are hard to avoid since there is no labeling of ingredients in these products.”
“We were surprised by how similar the results were between the two very different populations in Sweden and the U.S.” said principal investigator Carl-Gustaf Bornehag, PhD, Professor, Karlstad University, Sweden and adjunct professor at Icahn School of Medicine at Mount Sinai. “It’s important for us to look at language development because it has shown to be predictive of other neurodevelopmental problems in children.”
The SELMA and TIDES studies will follow the children and re-examine language development at seven and six years respectively.
Other researchers from Mount Sinai include Avraham Reichenberg, PhD, Professor of Psychiatry, and Sarah Evans, PhD, Assistant Professor, Environmental Medicine and Public Health. Other institutions involved in this study include Karlstad University in Sweden, Institute of the Ruhr-University in Germany, and Lund University in Sweden, and the University of Rochester School of Medicine, University of Minnesota, University of Washington and University of California-Berkeley.
This study was supported by grants from the National Institute of Environmental Health Sciences, the Swedish Research Council Formas and from the County Council of Varmland, Sweden.
About the Mount Sinai Health System
The Mount Sinai Health System is New York City's largest integrated delivery system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai's vision is to produce the safest care, the highest quality, the highest satisfaction, the best access and the best value of any health system in the nation. The Health System includes approximately 7,480 primary and specialty care physicians; 11 joint-venture ambulatory surgery centers; more than 410 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. The Icahn School of Medicine is one of three medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report's "Best Medical Schools", aligned with a U.S. News & World Report's "Honor Roll" Hospital, No. 12 in the nation for National Institutes of Health funding, and among the top 10 most innovative research institutions as ranked by the journal Nature in its Nature Innovation Index. This reflects a special level of excellence in education, clinical practice, and research. The Mount Sinai Hospital is ranked No. 14 on U.S. News & World Report's "Honor Roll" of top U.S. hospitals; it is one of the nation's top 20 hospitals in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Geriatrics, Gynecology, Nephrology, Neurology/Neurosurgery, and Orthopedics in the 2019-2020 "Best Hospitals" issue. Mount Sinai's Kravis Children's Hospital also is ranked nationally in five out of ten pediatric specialties by U.S. News & World Report. The New York Eye and Ear Infirmary of Mount Sinai is ranked 12th nationally for Ophthalmology and the South Nassau Communities Hospital is ranked 35th nationally for Urology. Mount Sinai Beth Israel, Mount Sinai St. Luke's, Mount Sinai West, and South Nassau Communities Hospital are ranked regionally.