University of Oulu

Po-Chin Huang, Chih-Hsin Tsai, Chu-Chih Chen, Ming-Tsang Wu, Mei-Lien Chen, Shu-Li Wang, Bai-Hsiun Chen, Ching-Chang Lee, Jouni J.K. Jaakkola, Wen-Chiu Wu, Min-Kung Chen, Chao A. Hsiung, RAPIT Group, Intellectual evaluation of children exposed to phthalate-tainted products after the 2011 Taiwan phthalate episode, Environmental Research, Volume 156, 2017, Pages 158-166, ISSN 0013-9351,

Intellectual evaluation of children exposed to phthalate-tainted products after the 2011 Taiwan phthalate episode

Saved in:
Author: Huang, Po-Chin1,2; Tsai, Chih-Hsin1; Chen, Chu-Chih3;
Organizations: 1National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
2Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
3Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
4Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
5Institute of Environmental and Occupational Health Sciences, National Yang Ming University, Taipei, Taiwan
6Department of Laboratory Medicine and Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
7Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
8Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
9Research Center of Environmental Trace Toxic Substance, National Cheng Kung University, Tainan, Taiwan
10Center for Environmental and Respiratory Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
11Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
12Department of Pediatrics, Taipei Hospital, Ministry of Health and Welfare, New Taipei,Taiwan
13Department of Pediatrics, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
14Members of the Risk Assessment of Phthalate Incident in Taiwan (RAPIT) Group
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
Persistent link:
Language: English
Published: Elsevier, 2017
Publish Date: 2019-07-31


Introduction: Phthalate exposure may reduce intellectual development in young children. In 2011, numerous Taiwanese children had been reported to have consumed phthalate-tainted products. We investigated the effects of phthalate exposure on the intellectual development of these children after the 2011 Taiwan di-2-ethylhexyl phthalate (DEHP) episode.

Methods: We recruited 204 children, aged 3–12 y, from 3 hospitals in Taiwan between 2012 and 2013. First-morning urine samples were collected for analyzing 5 phthalate metabolites. We applied a Bayesian model to estimate the past DEHP exposure (estDEHPADD) of each participant before the 2011 DEHP episode. Demographic information, consumption of phthalate-tainted products, and maternal education, of each participant were obtained using a questionnaire. We used the Wechsler intelligence evaluation tools for assessing the children’s and maternal intelligence quotient.

Results and discussion: The median levels of mono-2-ethylhexyl phthalate, mono(2-ethyl-5-hydroxyhexyl) phthalate, mono(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono-n-butyl phthalate, and mono-iso-butyl phthalate in the children were 9.97, 45.8, 32.2, 46.2, and 24.3 μg/g creatinine, respectively. Using the aforementioned urinary phthalate metabolites, we found that the children’s verbal comprehension index (N =98) was significantly negatively associated with urinary log₁₀ MEOHP (β, −11.92; SE, 5.33; 95%CI, −22.52~ −1.33; P=0.028) and log₁₀ ΣDBP metabolites (β, −10.95; SE, 4.93; 95%CI, −20.74~ −1.16; P=0.029) after adjustment for age, gender, maternal IQ and education, passive smoking, estDEHPADD, active and passive smoking during pregnancy. Through a tolerable daily intake-based approach, we only found a significant negative association between past estimate DEHPADD and VIQ≥3–<6 in preschool children whereas no correlation was observed between current DEHP exposure and IQ≥3–<6 score with/ without estimate DEHPADD adjustment. It revealed that the effect of past high-DEHP exposure on verbal-related neurodevelopment of younger child are more sensitive.

Conclusion: Our results are consistent with the hypothesis that exposure to DEHP and DnBP affects intellectual development in preschool and school-aged children, particularly their language learning or expression ability.

see all

Series: Environmental research
ISSN: 0013-9351
ISSN-E: 1096-0953
ISSN-L: 0013-9351
Volume: 156
Pages: 158 - 166
DOI: 10.1016/j.envres.2017.03.016
Type of Publication: A1 Journal article – refereed
Field of Science: 1172 Environmental sciences
1181 Ecology, evolutionary biology
3142 Public health care science, environmental and occupational health
Funding: This study was funded by the National Health Research Institutes (NSC 100-3114-Y-043-005, EH-102-SP-01, EH-103-SP-01, EH-104-SP-01, EH-102-PP-05, EH-103-PP05, EH-104-PP05, EM-105-PP15).
Copyright information: © 2017 Elsevier Inc. All rights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license