MONDAY, June 2, 2003 (HealthDayNews) -- A panel of child health experts wants more research into the possible harmful effects of plastic softeners used in kids' toys and a wide range of other products from perfumes to flooring.
The substances, a group of chemicals called phthalates, can cause cancer, harm fetal development and affect reproduction in rodents. Whether they do the same damage in people isn't clear. The Centers for Disease Control and Prevention has found traces of the chemicals in blood, but the significance of that discovery isn't clear.
"The big piece of the puzzle that's missing is having a good understanding of how much of this stuff gets into people," says Dr. Katherine Shea, a pediatrician in Chapel Hill, N.C., and the leader of the panel that wrote the report for the American Academy of Pediatrics (AAP).
The report calls for more study on the toxicity of phthalates to infants from exposures across the placenta, in breast milk, and from medical and non-medical sources. That includes whether the chemicals can harm human reproduction, especially the healthy formation of the testes in boys.
A Harvard-led study released late last year found that the presence of one kind of phthalate in urine was associated with DNA damage to sperm in men. A study released in May found that some phthalates may lower sperm count, stunt their motility, and harm their shape, problems that could affect fertility.
The new report appears in the June issue of the AAP's journal Pediatrics. It focuses on two phthalates, diethylhexyl phthalate (DEHP) and diisononyl phthalate (DINP), although the family of fat-loving chemicals contains many more members.
Medical devices are the source of the greatest exposures to phthalates in humans, and people who work in the industry can possibly have the levels linked to harm in animals, Shea says. Exposures from diet -- through food production, processing, and packaging -- and other routes are generally far below that from medical goods, such as IV and blood bags.
"The dietary exposures are the highest general exposures, but we don't believe they are of a magnitude that's worrisome," Shea says. "But the only data that we have says the models may not be adequate" to extrapolate the risk from animals to humans.
The European Commission banned phthalates in soft children's toys in 1999. Toy makers in the United States voluntarily stopped using DEHP in their chew products. Some are also substituting DINP, which is thought to be less toxic, for DEHP.
However, Shea says hand-me-downs and other toys not specifically designed for the mouth but which, kids being kids, find their way there may still contain DEHP.
But Dr. Gil Ross, medical director of the American Council on Science and Health, a New York City public health education group, criticized the new report.
"There are thousands of chemicals to which we are exposed in trace levels in the environment. Why focus on DINP and DEHP? These are highly beneficial, and there are no substitutes with a proven track record of safety and efficiency," Ross says. "It seems to me to be a waste of time, effort and scarce resources to evaluate exposures to these substances."
His group released a report in 1999, which claimed that phthalates weren't a threat to human health. That document, headed by former U.S. Surgeon General C. Everett Koop, came under sharp criticism from consumer watchdogs as a sop to the chemicals industry.
Dr. Ted Schettler, science director for the Science and Environmental Health Network, a public health group based in Ames, Iowa, says it makes sense to avoid phthalates whenever possible, such as in cosmetics and certain medical devices.
"I think some are clearly more problematic than others, and we should look at the places where we're using them where we don't need to be using them," says Schettler, a staff physician at Boston Medical Center who was among those who publicly took issue with the Koop report.
Last year, the U.S. Food and Drug Administration encouraged hospitals to minimize the use of devices with DEHP in patients considered most at risk of being harmed by the substance. These include premature babies in intensive care, babies requiring multiple blood transfusions, young boys undergoing kidney dialysis, and other select groups.
More information
For more on phthalates, try the U.S. Food and Drug Administration or the American Chemistry Council.
