DEHP: A Threat to Male Fertility

By Kirstie Ruby 

Boys born to women who are exposed to phthalates during the first trimester of pregnancy may have a greater risk of infertility later in life, according to a new report in Human Reproduction

Phthalates are used to soften plastics and are commonly found in medical tubing, building and consumer products, food packaging, and personal care products. This recent study found that males who were exposed in utero to diethylhexyl phthalate (DEHP) had a significantly shorter anogenital distance than their peers, which has been linked to infertility and low sperm count in animal studies. 

Just last year, a study published in the journal Fertility and Sterility reaffirmed this finding. Phthalate levels measured in female participants were shown to have little effect on fertility outcomes, but three distinct phthalates found in the urine of male partners were found to be associated with a reduced fecundity

While completely avoiding DEHP is quite difficult, this research highlights the importance of limiting exposure during the first trimester of pregnancy. Given that many women do not know they are pregnant for the first few weeks of fetal development, and because DEHP is so ubiquitous, the reduction of overall exposure to this phthalate must remain a top priority. Safer alternatives are available for nearly all uses, but without proper labeling, health care providers face a serious impediment in pushing for change. 

The European Union has led the way on the regulation of phthalates, requiring the labeling of all medical devices that contain DEHP. Here in the United States, Health Care Without Harm first petitioned the Food and Drug Administration (FDA) in 1999 to address the issue of plasticizers leaching out of medical devices. Although the FDA has issued a Public Health Notification addressing this issue, they have so far refused to require labeling by manufacturers and have failed to finalize industry guidelines surrounding this issue. Without proper regulation by the FDA, the responsibility of minimizing exposure to this chemical falls primarily on health care facilities.

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Over the last three years, Health Care Without Harm has targeted DEHP as a priority chemical through our Healthier Hospitals Initiative. Phthalate-free alternatives are available, and we are working with hospitals throughout the country to make the switch to these safer products. Kaiser Permanente is one such success story, having transitioned to DEHP-free IV bags and tubing. Manufacturers are also starting to take note of the growing concern over phthalates, and alternative products are being brought to market by companies like B. Braun. In the absence of labeling requirements, progress is achievable if we continue to highlight these issues and support health care facilities in their efforts to reduce DEHP exposure.

Pregnant women and developing males deserve protection from this chemical – we all do. Continued action to phase out DEHP must remain a priority. Human epidemiological studies are starting to produce results that are consistent with the health effects repeatedly observed in animals studies. With research reaffirming the relationship between these chemicals and fertility issues, continued action to minimize exposure is absolutely necessary in order to protect human health.  

[Image credit: hugrakka]

Kirstie Ruby provides communications support for our Safer Chemicals program.