Phthalates, Bisphenols, and Childhood Allergic Phenotypes: Findings from Two Birth Cohort Studies

  1. Thomas Boissiere-O’Neill
  2. Nina Lazarevic
  3. Anne-Louise Ponsonby
  4. Peter D. Sly
  5. Aimin Chen
  6. Tamara L. Blake
  7. Jeffrey R. Brook
  8. Cassidy Du Berry
  9. Louise King
  10. Piushkumar J. Mandhane
  11. Theo J. Moraes
  12. Elinor Simons
  13. Padmaja Subbarao
  14. Dwan Vilcins
  15. CHILD investigator groups
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Abstract

Background

Phthalates and bisphenols may disrupt early immune development, but their impact on allergies and lung function remains uncertain. We investigated associations between prenatal and postnatal exposure to these chemicals, allergies, and lung function in preschool children, focusing on atopic and non-atopic phenotypes.

Methods

We used data from the Barwon Infant Study (BIS) and the Canadian Healthy Infant Longitudinal Development Study (CHILD). Urinary metabolites were measured at 36 weeks gestation (BIS) and from three to 36 months postnatally (CHILD). Atopy was assessed via skin prick tests at 4-5 years. Oral food challenge was assessed at one year (BIS). Outcomes included asthma, wheeze, eczema, and rhinitis at 4-5 years. Phenotypes were defined by atopic and outcome status. Lung function at 4-5 years was assessed using multiple-breath washout and oscillometry. We used generalised linear models for single compounds, and quantile G-computation and Bayesian kernel machine regression for exposure mixtures.

Results

Exposure mixtures showed a positive association with asthma. Postnatal phthalate mixtures were associated with higher airway resistance and lower reactance. Prenatal exposure mixtures (odds ratio [OR] = 2.24; 95% confidence interval [CI]: 1.03-4.85), as well as postnatal diethyl (OR = 1.50; 95% CI: 1.10-2.04), dibutyl (OR = 1.71; 95% CI: 1.10-2.68) and butyl-benzyl (OR = 1.33; 95% CI: 1.01-1.77) phthalates, were associated with non-atopic asthma. Conversely, prenatal mixtures showed inverse associations with eczema and food allergy.

Conclusion

Phthalates may predispose pre-school children to non-atopic asthma but not atopic outcomes. Future studies are needed to confirm these associations.

HIGHLIGHTS

  • Pre- and postnatal phthalates were associated with non-atopic asthma in children.

  • Phthalates and bisphenols were not associated with atopic outcomes.

  • Postnatal phthalates were associated with reduced lung function in children.

Article activity feed

  1. Version published to 10.1101/2025.04.19.25325915v1 on medRxiv