Phthalate exposure through different pathways and allergic sensitization in preschool children with asthma, allergic rhinoconjunctivitis and atopic dermatitis

Gabriel Bekö, Michael Callesen, Charles J. Weschler, Jørn Toftum, Sarka Langer, Torben Sigsgaard, Arne Høst, Tina Kold Jensen, Geo Clausen

Research output: Contribution to journalJournal articleResearchpeer-review


Studies in rodents indicate that phthalates can function as adjuvants, increasing the potency of allergens. Meanwhile, epidemiological studies have produced inconsistent findings regarding relationships between phthalate exposures and allergic disease in humans. The present study examined phthalate exposure and allergic sensitization in a large group of 3-5 year old children: 300 random controls and 200 cases with asthma, rhinoconjunctivitis or atopic dermatitis as reported in questionnaires. The children were clinically examined to confirm their health status. Blood samples were analyzed for IgE sensitization to 20 allergens. Adjusted logistic regressions were used to look for associations between phthalate exposure indicators (mass fractions in dust from children's homes and daycares, metabolites in urine, and estimated daily indoor intakes from dust ingestion, inhalation and dermal absorption) and sensitization and allergic disease. No direct associations were found between phthalate exposures and asthma, rhinoconjunctivitis or atopic dermatitis. However, among children with these diseases, there were significant associations between non-dietary exposures to DnBP, BBzP and DEHP in the indoor environment (mass fractions in dust or daily indoor intakes from dust ingestion, inhalation and dermal absorption) and allergic sensitization. Some exposure pathways were more strongly associated with sensitization than others, although the results are not conclusive and require confirmation. A number of the associations depended on accounting for a child's exposure in more than one environment (i.e., daycare facility as well as home). Significant associations were not observed between phthalate metabolites in urine, which reflected exposure from diet as well as indoor pathways, and allergic sensitization. (C) 2015 Elsevier Inc. All rights reserved.
Original languageEnglish
JournalEnvironmental Research
Pages (from-to)432-439
Number of pages8
Publication statusPublished - 2015


  • allergic rhinoconjunctivitis Conjunctivitis, Allergic (MeSH) respiratory system disease, eye disease, immune system disease epidemiology
  • asthma Asthma (MeSH) respiratory system disease, immune system disease epidemiology
  • atopic dermatitis Dermatitis, Atopic (MeSH) congenital disease, genetic disease, immune system disease, integumentary system disease epidemiology
  • Primates Mammalia Vertebrata Chordata Animalia (Animals, Chordates, Humans, Mammals, Primates, Vertebrates) - Hominidae [86215] human common child
  • Rodentia Mammalia Vertebrata Chordata Animalia (Animals, Chordates, Mammals, Nonhuman Vertebrates, Nonhuman Mammals, Rodents, Vertebrates) - Muridae [86375] rat common
  • BBzP allergen
  • DEHP allergen
  • DnBP allergen
  • IgE
  • phthalate 3198-29-6 allergen
  • 03506, Genetics - Animal
  • 03508, Genetics - Human
  • 10064, Biochemistry studies - Proteins, peptides and amino acids
  • 15002, Blood - Blood and lymph studies
  • 15004, Blood - Blood cell studies
  • 15504, Urinary system - Physiology and biochemistry
  • 16006, Respiratory system - Pathology
  • 18506, Integumentary system - Pathology
  • 20006, Sense organs - Pathology
  • 25000, Pediatrics
  • 25503, Development and Embryology - Pathology
  • 34502, Immunology - General and methods
  • 34508, Immunology - Immunopathology, tissue immunology
  • 35500, Allergy
  • Allied Medical Sciences
  • Clinical Immunology, Human Medicine, Medical Sciences
  • Human Medicine, Medical Sciences
  • blood blood and lymphatics
  • urine excretory system
  • logistic regression mathematical and computer techniques
  • questionnaire clinical techniques, diagnostic techniques
  • Allergy
  • Dermatology
  • Medical Genetics
  • Ophthalmology
  • Pediatrics
  • Pulmonary Medicine
  • Allergic diseases
  • Clinical examination
  • Written questionnaire
  • Eczema
  • Indoor environment


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