A recent study published in The Lancet eBioMedicine has identified a significant link between exposure to di-2-ethylhexyl phthalate (DEHP) — a chemical commonly used to make plastics more flexible — and heart disease deaths.
Among the 200 countries evaluated, India had the highest burden of DEHP-linked cardiovascular deaths and accounted for almost a third of the global mortalities.
DEHP is prevalent in numerous household items, including food containers, medical equipment, toys, shampoos and lotions.
The study, conducted by researchers at NYU Langone Health, analysed urine samples and environmental data from over 200 countries and territories. They found that in 2018, DEHP exposure was associated with around 356,238 deaths among individuals aged 55 to 64, accounting for over 13 per cent of global heart disease deaths in that age group.
India recorded the highest number of DEHP-attributable heart disease deaths globally, with an estimated 103,587 fatalities among individuals aged 55 to 64.
In comparison, China, also a major producer and consumer of plastics, recorded 33,858 such deaths, placing it third after Indonesia, which had 52,219 deaths.
This stark difference underscores the disproportionate burden India bears, accounting for almost a third of the estimated 356,238 global deaths in this age group linked to DEHP exposure.
The researchers attributed India’s elevated mortality to the rapid expansion of its plastics industry, widespread use of DEHP-containing products and weaker regulatory controls compared to some other nations.
Delay in policy intervention in the affected regions could have been significantly contributed to these grim outcomes, the researchers indicated. While countries like Canada, Japan, Australia and the United States started taking action as early as in 2008, efforts in China and India started much later. "Since 2018, the Chinese government reports it has banned 24 categories of foreign waste including plastics waste, while India has incorporated DEHP restrictions into its food packaging sector, but these regulations have been very recent," the authors wrote in the report.
DEHP exposure is linked to inflammation in the heart's arteries, increasing the risk of heart attacks and strokes over time.
Around 75 per cent of the deaths occurred in regions like Asia, the Middle East and the Pacific, highlighting the disproportionate impact on developing countries.
While the study focused on a specific age group, researchers suggested that the true scale of mortality linked to plastic exposure may be even higher.
Beyond cardiovascular mortality, DEHP exposure has been linked to various health issues, including obesity, diabetes, fertility problems and cancer.
The researchers advocated for further research to evaluate the broader health implications of phthalates, including their role in conditions such as premature birth.
The economic implications of DEH exposure are also significant, the authors noted. The estimated economic impact of DEHP-related deaths ranges from $510 billion to over $3.7 trillion, highlighting the substantial burden on healthcare systems and economies worldwide.
The study emphasised the urgent need for global regulations to reduce exposure to these toxins, especially in rapidly industrialising countries.
The researchers also advocated for personal efforts to reduce plastic use. Consumers were encouraged to avoid products containing vague ingredient labels like “fragrance” and to use tools like the Environmental Working Group databases to select safer personal care and cleaning products.