Two chemicals widely used to make plastics more flexible have been linked to nearly two million premature births and approximately 74,000 newborn deaths globally in 2018, according to a major new study published Tuesday in the Lancet journal eClinicalMedicine.
The study examined the effects of di-2-ethylhexyl phthalate (DEHP) and diisononyl phthalate (DiNP) across 200 countries and territories, drawing on data from large national surveys in the United States, Canada, and Europe, as well as estimates from earlier investigations covering regions that do not collect their own data.
DEHP was estimated to be linked to close to 1.97 million premature births and 74,000 newborn deaths. DiNP was separately linked to 1.88 million premature births and 64,000 newborn deaths in the same year.
The two chemicals belong to a family of synthetic substances called phthalates, which are known to interfere with the body’s hormone-producing endocrine system. Research has connected them to developmental, reproductive, brain, and immune problems. Because they are present in such a vast range of everyday products, including food packaging, children’s toys, personal care products, medical devices, and vinyl flooring, scientists commonly refer to them as “everywhere chemicals.”
Experts have found that these substances can break down into microscopic particles and enter the body through food, air, and dust.
Africa accounted for 26 percent of health problems from DEHP-linked preterm birth and carries a disproportionate share of deaths relative to its overall share of premature cases, a pattern researchers attributed to the region’s higher underlying death toll from preterm birth. The Middle East and South Asia also bear heavy burdens, partly due to rapidly expanding plastics industries and high volumes of global plastic waste.
Researchers from the NYU Grossman School of Medicine, who led the study, said the investigation was not designed to establish that DEHP and DiNP directly cause preterm birth, and acknowledged that other types of phthalates were not analyzed.
Study senior author Leonardo Trasande of NYU Grossman School of Medicine warned that tackling phthalates one chemical at a time and replacing them with poorly understood substitutes is unlikely to resolve the broader problem, arguing that the findings point to an urgent need for stronger, class-wide oversight of plastic additives.
Scientists believe one mechanism involves disruption of placental function. The placenta supplies oxygen and nutrients to the developing fetus, and interference with its operation is thought to raise the risk of early delivery.
Experts advise consumers to choose products labeled phthalate-free, avoid heating food in plastic containers, and improve indoor ventilation to limit exposure. Researchers stress, however, that personal precautions alone are insufficient and that systemic regulatory reform is essential.
