Screening for phthalates biomarkers and its potential role in infertility outcomes in Jordan

Nour Abdo; Hana Al-Khalaileh; Marwan Alajlouni; Jehan Hamadneh; Abdalmajeed M Alajlouni

doi:10.1038/s41370-022-00517-7

Screening for phthalates biomarkers and its potential role in infertility outcomes in Jordan

J Expo Sci Environ Epidemiol. 2023 Mar;33(2):273-282. doi: 10.1038/s41370-022-00517-7. Epub 2023 Jan 2.

Authors

Nour Abdo¹, Hana Al-Khalaileh², Marwan Alajlouni², Jehan Hamadneh³, Abdalmajeed M Alajlouni⁴

Affiliations

¹ Department of Public Health and Family Medicine, College of Medicine, Jordan University of Science and Technology, P.O. Box, 3030, Irbid, 22110, Jordan. nmabdo@just.edu.jo.
² Department of Public Health and Family Medicine, College of Medicine, Jordan University of Science and Technology, P.O. Box, 3030, Irbid, 22110, Jordan.
³ Department of Obstetrics and Genecology, College of Medicine, Jordan University of Science and Technology, P.O. Box, 3030, Irbid, 22110, Jordan.
⁴ Aqaba International Laboratories/BENHAYYAN, ASEZA, Aqaba, 77110, Jordan.

Abstract

Background: Phthalates are endocrine disrupting chemicals that are used in plastic and personal care products. Phthalate exposure has been linked to reproductive and fertility outcomes.

Objectives: This study aimed to assess the phthalate exposures using both urinary level of two DEHP metabolites in females and questionnaires. It also aimed to investigate the association between phthalate levels and reproductive and fertility outcomes.

Methods: 325 females with and without fertility problems at gynaecology clinics filled out a questionnaire and provided a urine sample. Urine samples were analyzed for two DEHP metabolites: MEHHP, mono (2-ethyl-5-hydroxyhexyl) phthalate; MEOHP, mono (2-ethyl-5-oxohexyl) phthalate, using an HPLC/MS/MS analytical method.

Results: We observed a significant difference between cases and controls in terms of heating plastic in the microwave and use of skin and eye make-up, sunscreen, and nail polish. Our findings showed that MEOHP exposure is significantly associated with infertility among Jordanian women (Adjusted OR = 1.66, 95% CI: 1.14, 2.40, p-value = 0.002).

Significance: To the best of our knowledge, our study is the first of its kind done in Jordan to screen for phthalate exposure and investigate its association with infertility. Our study demonstrated high exposure of the Jordanian population to DEHP. It confirms the association between DEHP exposure and infertility.

Impact statement: We measured phthalates in infertile and fertile women, in a community unaware of phthalate sources or its impacts, and with no regulation limits set. We aimed to increase awareness to environmental exposure to phthalates, emphasize the importance of implementation of public health interventions to control and minimize the effects of phthalate exposure and provide a base for further studies and future research to aid in the formation of policies and guidelines for the manufacturing and use of phthalates.

Keywords: DEHP; Daily intake; Infertility; Phthalates; Reproductive.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Biomarkers / urine
Diethylhexyl Phthalate* / metabolism
Environmental Exposure / analysis
Environmental Pollutants* / urine
Female
Humans
Infertility*
Jordan
Phthalic Acids* / urine
Plastics
Tandem Mass Spectrometry

Substances

phthalic acid
Diethylhexyl Phthalate
Phthalic Acids
Biomarkers
Plastics
Environmental Pollutants