Objective Phthalates (PAEs) are widely used in plastics and other daily necessities. Their ubiquitous presence in the environment and high degradation resistance have led to the widespread pollution in food, water, and air; therefore, their exposure levels and potential adverse health effects are concerning. Sensitve periods, such as infancy, are most likely to be affected by PAEs. This study aims to explore the correlaton between PAEs exposure and infant neurobehavioral development through the exposure assessment of PAEs in lactatng infants, aiming to provide a scientfc basis for the preventon and control of PAEs polluton and eugenics.
Methods Using a prospectve follow-up survey design, we collected urine samples and basic informaton at baseline survey from 154 healthy infants aged 0-8 months in Shanghai from March to June 2013, who had permanent residence in Shanghai. We also evaluated the neurobehavioral development of the infants within 2 weeks of the age of 9 months by the Chinese version of Ages & Stages Questonnaire (ASQ-C), and calculated the score of five individual skills including communication, gross motor, fine motor, problem solving, and personal-social skills. Urine samples were collected either under their parent's help in disposable cups or with urine collecton bags if the babies were too young to pee with parents' help. Ultra-high performance liquid chromatography-tandem mass spectrometry was used to detect the concentratons of PAEs metabolites in urine. Logistc regression analysis was used to analyze the correlaton between urinary concentratons of PAEs metabolites and ASQ-C results.
Results The top fve median concentratons of PAEs metabolites in babies were as follows:monoisobutyl phthalate (MiBP, 35.10g/L), mono-nbutyl phthalate (MnBP, 34.70g/L), monoethyl phthalate (MEP, 12.15g/L), mono-2-ethylhexyl phthalate (MEHP, 7.85g/L), and monomethyl phthalate (MMP, 4.73 g/L). The top fve geometric mean concentratons of PAEs metabolites were MiBP (30.90 g/L), MnBP (26.92 g/L), MEP (11.22 g/L), MEHP (8.13 g/L), and mono-2-ethyl-5-carboxypentyl phthalate (MECPP, 3.63 g/L). The average scores of communicaton, problem solving, gross motor, fne motor, and personal-social skills were 48.54, 46.98, 51.49, 49.06, and 48.34, respectvely. The abnormal rates of communicaton (11.7%) and problem-solving (12.3%) were relatvely low; the abnormal rates of gross motor (24.0%) and fne motor (16.9%) were relatvely high; the abnormal rate of personal-social was 14.3%. Infants' urinary concentraton of MEP was positvely associated with the abnormal rates of gross motor skill (OR=2.90, 95%CI:1.15-7.33), problem solving skill (OR=5.34, 95%CI:1.17-24.44), and personal-social skill (OR=4.18, 95%CI:1.18-14.80) (P < 0.05). The abnormal rate of gross motor skill was also positvely associated with the urinary concentratons of MiBP (OR=3.72, 95%CI:1.07-12.91) and MEHHP (OR=1.90, 95%CI:1.01-14.09).
Conclusion Lactatonal PAEs exposure such as MEP, MiBP, and MEHHP may be a risk factor of delayed neurobehavioral development in infants.
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