Plastic Chemical Linked To 356,000 Heart Deaths Globally

A new study, spearheaded by researchers at NYU Langone Health, has uncovered a shocking global health issue: exposure to a ubiquitous class of chemicals found in common plastic consumer products could be behind over 356,000 heart disease deaths in 2018 alone. The chemicals, called phthalates, are commonly employed in the production of plastic household products, food packaging, cosmetics, and medical devices. Among them, one specific compound known as di-2-ethylhexyl phthalate (DEHP) is more closely monitored for its possible health hazards.

Released April 29 in The Lancet eBioMedicine, the research is the initial to offer a worldwide estimate of cardiovascular fatalities associated with exposure to DEHP. As the researchers explain, these fatalities account for over 13 percent of total heart disease-related deaths in men and women between the ages of 55 and 64 in 2018. While phthalates have been linked to a variety of health conditions—including obesity, diabetes, reproductive issues, and cancer—for years, this new study makes a direct link between exposure to DEHP and increased cardiovascular mortality globally.

Phthalates have been known to degrade into very fine particles that the human body can easily ingest or absorb. DEHP, specifically, has been known to induce inflammation in the heart's arteries and lead to heart attacks and strokes, as previous research has indicated. The new study expands on these results, calculating the number of fatalities by examining environmental and health information from many population surveys in 200 countries and territories. The researchers employed urine sample data with chemical residues of phthalates and death statistics from the Institute for Health Metrics and Evaluation.

The findings of the study reveal a disproportionate effect on certain regions, notably the Middle East, South Asia, East Asia, and the Pacific. These regions contributed to about three-fourths of the total deaths due to heart disease attributed to DEHP exposure. India alone accounted for the highest burden, with an estimated 103,587 deaths, followed by China and Indonesia. Interestingly, these numbers were still substantial even after population size adjustment within the age group of interest.

Experts opine that the high exposure in these areas may be a result of a sudden surge in plastic production, usually coupled with lax environmental regulations. This gap highlights the imperative need for more stringent global policies to curb phthalate usage, particularly in nations that are experiencing rapid industrialization. The findings suggest a critical global health disparity, according to senior study author Dr. Leonardo Trasande, professor at NYU Grossman School of Medicine. He underscored the need for regulatory changes to limit exposure to harmful chemicals, especially in areas with the highest levels of plastic pollution and chemical exposure.

Although the conclusions of the study are dire, the researchers point out some limitations. The study only analyzed DEHP and the 55-64 age group, so the true number of heart disease deaths linked to phthalates may be much greater if other chemicals and age groups were considered. Dr. Trasande also explained that the study does not assert that DEHP by itself causes heart disease but rather adds to risk along with other environmental and lifestyle factors.

In the future, the research team hopes to explore further how lowering phthalate exposure could affect mortality rates around the world over time. They also hope to broaden their research to other conditions linked to phthalates, including preterm birth. Dr. Trasande, who also leads NYU's Division of Environmental Pediatrics and the Center for the Investigation of Environmental Hazards, has long been a proponent of stronger environmental health protections. He and his colleagues are hoping that these new results will contribute to the push to eradicate dangerous chemicals in consumer products.

The research was supported by the U.S. National Institutes of Health and environmental activist organization Beyond Petrochemicals. Other support came from Jonathan Acevedo, MPH, and Dr. Chiara Giannarelli of NYU Langone Health.

This landmark study brings attention to the often-missed health effects of ubiquitous plastic use and provides a sobering reminder of the silent threat posed by unregulated chemical exposure. While plastic production is increasing exponentially worldwide, the experts say that unless a quick regulatory response is adopted, the health price may rise even higher.