Phthalates have been used as plasticizers in numerous consumer applications and therefore, their metabolites have been detected in human urine worldwide. Despite concerns regarding their potential adverse health effects, few exposure assessments have been conducted among young populations in Middle Eastern countries. In this study, children (n = 109, aged 3-9 years) were recruited from four elementary schools in Riyadh, Saudi Arabia, in 2017, and major phthalate metabolites were measured in their urine. Their parents were asked to complete a questionnaire on their behalf to assess potential exposure sources of phthalates. In addition to 18 phthalate metabolites, malondialdehyde (MDA) and 8-hydroxy-2'-deoxyguanosine (8-OHdG) were measured in urine samples by LC/MS/MS. Among the children of Saudi Arabia, urinary levels of monoisobutyl phthalate (MiBP) and monobutyl phthalate (MnBP) were higher than those reported previously in children worldwide. Monoethyl phthalate (MEP) was also detected at high levels. Several phthalate metabolites showed significant associations with the levels of MDA or 8-OHdG. Hazard quotients (HQs) derived for certain phthalates were greater than one. In particular, the HQs for di(2-ethylhexyl) phthalate (DEHP) were greater than one in 34% of the participating children. Levels of monocyclohexyl phthalate (MCHP), monoisodecyl phthalate (MiDP), mono(2-ethylhexyl) phthalate (MEHP), and mono[2-(carboxymethyl)hexyl] phthalate (MCMHP) in the urine samples were positively associated with the consumption frequency of certain foods. Very high levels of exposure to phthalates, along with positive associations with oxidative stress markers, outline the importance of follow-up investigations for identification of phthalate exposure sources and potential health implications among the young population of Saudi Arabia.
Keywords: Children; Oxidative stress; Phthalates; Risk; Sources.
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