Phthalate Exposure and Pediatric Asthma: A Case Control Study Among Egyptian Children
Amira S. El Refay1, Ayman F. Armaneous1
, Dina A. Salah1, Mai Youssef1, Ebtissam Salah1, Mones Abu Shady1, Nevien R. El Baroudy2, Safaa Morsy3, Amr Gouda4 and Walaa S. Nazem41Department of Child Health, National Research Centre, Cairo, Egypt.
2Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.
3Department of Biochemistry, National Research Centre, Cairo, Egypt
4Department of Biochemical Genetics, Human Genetics and Genome Research Institute.
Corresponding Author E-mail:fekreyayman@yahoo.com
Abstract: Background: Phthalates, which are diesters of phthalic acid, are commonly used as plasticizers and additives in various consumer products. Several phthalates have been identified as substances of high concern. Exposure to phthalate esters (PAEs) has been linked to asthma in children, but the specific impacts of PAEs on asthmatic children were not well understood. Objective: The objective of this study was to compare urinary phthalate concentrations in asthmatic and non-asthmatic children and to identify potential sources of exposure as risk factors for asthma. Methods: A case control study was conducted for 100 Egyptian children aged 8-16 years (50 asthmatics and 50 healthy controls). Asthma was identified using GINA guidelines. Socio-demographic and probable risk factors were assessed, in addition to measuring phthalate levels in urine samples using high-performance liquid chromatography. Results and conclusion: Mean urinary Mono-methyl as well as Mono-benzyl levels were highly significant in asthmatic children compared to control group (895.26ng/ mL vs 548.55 ng/mL and 13.5 ng/mL vs 2.07 ng/mL respectively) (p= 0.001). The number of asthmatic children living in houses painted with non-plastic paint was significantly lower (P<0.05) than children living in houses painted with other paints. No association between floor type and asthma was reported. The frequent use of personal care products and plastic painting of walls were identified by multiple logistic regression analysis as the highly significant predictors of asthma in the studied subjects. The declared higher levels of urinary phthalate metabolites (Mono-methyl and Mono-benzyl) in Egyptian asthmatic children may reveal the probable risk of phthalate exposure in triggering bronchial asthma.
Keywords: Egyptian Children; Environmental Risk Factors; Pediatric Asthma; Phthalate Exposure; Urinary phthalates Back to TOC