The study, led by researchers at NYU Langone Health and NYU Grossman School of Medicine, estimates that di-2-ethylhexylphthalate (DEHP) was linked to approximately 1.97 million preterm births globally in 2018. That is about 8 percent of all cases.
Researchers also estimated that exposure to the plastic chemical was associated with about 74,000 newborn deaths.
The findings were discovered after researchers analyzed population survey data from multiple regions, including North America and Europe, and modeled DEHP exposure across 200 countries and territories in 2018.
They combined those findings with prior studies on phthalates and preterm birth, along with global birth and mortality data.
“Experts have found that these substances can break down into microscopic particles and enter the body through food, air, and dust,” states the press release.
Phthalates can also enter the human body through ingestion, inhalation, or skin contact, according to research cited in the study.
The study also examined diisononyl phthalate, or DiNP, a chemical commonly used as a substitute for DEHP, and found it may pose a risk.
Researchers estimated DiNP was linked to about 1.88 million preterm births worldwide. DiNP is used in products such as vinyl flooring, automotive interiors, toys, wire insulation, footwear, and gloves. It also acts as a softener in adhesives, sealants, paints, and inks.
The World Health Organization defines preterm birth as delivery before 37 weeks of pregnancy. It is a leading cause of infant death and can result in long-term developmental and health problems.
"By estimating how much phthalate exposure may contribute to preterm birth worldwide, our findings highlight that reducing exposure, especially in vulnerable regions, could help prevent early births and the health problems that often follow," said Sara Hyman, the study’s lead author, in a statement released by NYU Langone.
The analysis found significant regional disparities. The Middle East and South Asia accounted for about 54 percent of the estimated illness burden, while Africa represented 26 percent of health problems linked to DEHP-related preterm birth.
“These areas have rapidly growing plastics industries and high levels of global plastic waste,” stated the press release.
The study also estimated that DEHP exposure contributed to about 1.2 million years lived with disability, a measure of the long-term impact of disease.
“Our analysis makes clear that regulating phthalates one at a time and swapping in poorly understood replacements is unlikely to solve the larger problem," said study senior author Leonardo Trasande, Professor of Pediatrics at NYU Grossman School of Medicine.
"We are playing a dangerous game of Whac-A-Mole with hazardous chemicals, and these findings highlight the urgent need for stronger, class-wide oversight of plastic additives to avoid repeating the same mistakes,” Trasande said.