Regular exposure to certain chemicals called phthalates that are used to make plastic household items could be linked to over 356,000 deaths from heart disease around the World in 2018 alone, according to a study recently published in the journal Lancet eBiomedicine led by NYU Langone Health.
Experts have been connecting health problems to phthalates found in pipes, bug repellents, cosmetics, solvents, medical equipment, food containers, detergents, utensils, and other products for decades. Studies indicate that when phthalates break down into microscopic particles and become ingested, it is linked to an increased risk of chronic conditions ranging from fertility issues, obesity, cancer, and diabetes.
Investigating daily exposure to phthalates
This study used health and environmental data from dozens of population surveys to estimate DEHP exposure across 200 countries and territories which included urine samples containing chemicals breaks downs of products left by plastic additives and mortality data obtained from the Institute for Health Metrics and Evaluation to focus on di-2-ethylhexyl phthalate (DEHP), which is used to make food containers, medical equipment, and other plastic softer and more flexible. Exposure to this phthalate has been shown to prompt an overactive immune system, leading to inflammation in the arteries, which, in turn, over time, is linked to an increased risk of stroke or heart attack.
In 2021, phthalates were linked to over 50,000 premature deaths annually, which were mostly from heart disease in older Americans. This new analysis estimates that daily exposure to DEHP contributes to 356,238 deaths or more than 13% of all global mortality from heart disease in 2018 in people between the ages of 55 to 64 years old. The resulting economic burden from these deaths is estimated to be around $510 billion, to as high as $3.74 trillion, according to the study authors.
“By highlighting the connection between phthalates and a leading cause of death across the world, our findings add to the vast body of evidence that these chemicals present a tremendous danger to human health,” said study lead author Sara Hyman, BS, an associate research scientist at NYU Grossman School of Medicine.
The analysis also revealed that the losses in “the combined region of East Asia and the Middle East and the combined region of East Asia and the Pacific accounted, respectively, for about 42% and 32% of the mortality from heart disease linked to DEHP. Specifically, India had the highest death count at 103,587 deaths, followed by China and Indonesia. The larger heart death risks in these populations held true even after the researchers adjusted their statistical analysis to take into account population size within the studied age group.”
“There is a clear disparity in which parts of the world bear the brunt of heightened heart risks from phthalates,” said study senior author Leonardo Trasande, MD, MPP. “Our results underscore the urgent need for global regulations to reduce exposure to these toxins, especially in areas most affected by rapid industrialization and plastic consumption,” added Trasande, the Jim G. Hendrick, MD, Professor of Pediatrics at NYU Grossman School of Medicine.
However, Trasande notes that “the analysis was not designed to establish that DEHP directly or alone caused heart disease and that higher death risks did not take into account other types of phthalates. Nor did it include mortality among those in other age groups. As a result, the overall death toll from heart disease connected to these chemicals is likely much higher.”
Next, the researchers plan to track how decreasing phthalate exposure may, over time, affect global mortality rates, as well as to expand the study to other health concerns posed by the chemicals, such as preterm birth.
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References/Sources/Materials provided by:
https://nyulangone.org/news/heart-disease-deaths-worldwide-linked-chemical-widely-used-plastics
http://dx.doi.org/10.1016/j.ebiom.2025.105730
https://www.ewg.org/news-insights/news/2024/09/what-are-phthalates
