Global study connects chemical in everyday items to cardiovascular deaths
These chemicals break down into tiny particles that enter our bodies mainly through food and drink. Previous studies have linked phthalates to obesity, diabetes, fertility problems and even cancer. Now the focus is on their role in cardiovascular disease.
What you need to know:
- Your plastic lunch box contains chemicals linked to heart disease deaths.
- A global study found DEHP in everyday items caused over 356,000 deaths in 2018.
- Developing countries bear the heaviest burden with limited regulations.
Is your plastic lunch box a silent heart disease risk?
A global study has revealed a concerning link between common plastics and heart disease deaths worldwide.
Researchers at NYU Langone Health have discovered a connection between exposure to di-2-ethylhexyl phthalate (DEHP) - a chemical widely used to make plastics soft and flexible - and more than 356,000 global deaths from heart disease in 2018 alone.
Most of these deaths occurred in people aged 55 to 64. DEHP is found in everyday items including food containers, medical devices, cosmetics, detergents, insect repellents, and plastic water pipes.
These chemicals break down into tiny particles that enter our bodies primarily through food and drink. While previous studies have linked phthalates to obesity, diabetes, fertility problems, and cancer, this new research focuses on their role in cardiovascular disease.
Published in The Lancet eBioMedicine, the study is the first to provide a global estimate of heart disease deaths linked to DEHP exposure. Researchers analysed health and environmental data from 200 countries, including urine samples showing the chemical's breakdown products, and compared their findings with mortality data from the Institute for Health Metrics and Evaluation.
Also read: Study finds every tested plastic toy contains chemicals linked to cancer and reproductive disorders
The results are alarming: DEHP exposure may be responsible for 13 per cent of all heart disease deaths worldwide in the age group studied. The chemical causes inflammation of heart arteries, making people susceptible to stroke.
The impact varies significantly across regions. South Asia, East Asia, the Middle East, and the Pacific accounted for nearly three-quarters of the global death burden. India had the highest number at 103,587 deaths, followed by China and Indonesia. Researchers believe this disparity may stem from increased plastic production in these regions, which often lack strict safety regulations.
Africa was also heavily affected, with more than 37,000 DEHP-related deaths in 2018, representing nearly 12 per cent of the continent's cardiovascular mortality in the same age group.
While specific figures for Kenya weren't provided, the country's growing use of plastics—especially in urban areas where plastic packaging and water bottles are widespread—suggests many Kenyans could be unknowingly exposed to harmful levels of phthalates.
Dr Ayub Macharia, the director in charge of Information and Public Participation at the National Environment Management Authority (Nema), told Nation that some chemicals used in plastic production are banned globally, though DEHP is not among them.
Border points
"When a chemical is banned internationally and Kenya is party to the treaty, then it is automatically banned in Kenya," explains Dr Macharia. "If it is not banned internationally, it may find its way to the market. We cannot tell other countries what to ban and what not to ban."
He added that while black markets might exist, the government is enforcing Kenya's ban from border points through the Kenya Bureau of Standards (Kebs). "If you bring illegal things, then the law will pursue you," he said.
Dorothy Otieno, Programs Manager at the Centre for Environmental Justice and Development (CEJAD), told Nation that since Kenya is a net importer of plastics, producers need to be transparent about the chemicals used.
"Developing countries do not have money to go and test each and every plastic and therefore, as it stands, that lack of transparency is keeping us at a point where we don't know what is in it," she says.
"We wish to test but we don't have the capacity in terms of finance and even technology because these items are normally expensive. We also need more personnel at the border entry to be able to do this," she adds.
Ms Otieno explained that improper disposal creates additional risks.
"When plastic becomes waste and is thrown to the dumpsites, the chemicals could leach and find themselves in the food chain, especially when free-range chicken feed from the dumpsites," she says.
Children's exposure
She calls phthalates "everywhere chemicals" because they are ubiquitous in most plastic products. Exposure occurs through inhalation, ingestion, or skin contact. She noted that recycling merely extends the lifecycle of these harmful chemicals, increasing exposure risks.
"There has been pushback in addressing toxic chemicals in the plastic treaty because of the existing conventions. But for chemicals like phthalates which are toxic but do not fit in the conventions, need to be factored in the plastic treaty," she explains.
Otieno added that it's cheaper for plastic-importing countries to know the production formula to reduce costs, which is why scientists are demanding transparency.
In the European Union, which reported fewer deaths linked to DEHP, the chemical has been banned in all toys and childcare products. The EU cited a Danish study that found high DEHP levels in plastic erasers, raising concerns about children's exposure when they unknowingly suck on these items.
In the United States, states including California, Vermont, and Washington have either banned or restricted phthalates in children's products, personal care items, and food packaging. California has extended this ban to medical products as well.
Kenya Bureau of Standards (Kebs) gazetted regulations on phthalates in 2022, specifically limiting its use in footwear, and published another regulation in 2021 for textiles.
Cardiovascular disease (CVD) is a major health problem in Kenya, accounting for about 13 per cent of all deaths and 25 per cent of hospital admissions, according to the Ministry of Health. The overall CVD mortality rate was reported to be 13.8 per cent in 2019, with a premature (30-70 years) CVD mortality rate of eight per cent, highlighting the significant burden of heart disease in the country.
Dr Leonard Trasande, lead author of the study, emphasised that while the research doesn't claim DEHP alone causes heart disease, the strong association calls for immediate public health intervention. The team suspects the actual number of deaths may be even higher, as only one phthalate and one age group was analysed.
"There is a clear disparity in which parts of the world bear the brunt of heightened heart risks from phthalates. Our results underscore the urgent need for global regulations to reduce exposure to these toxins, especially in areas most affected by rapid industrialisation and plastic consumption," Dr Trasande said.
The researchers plan to investigate whether reducing phthalate exposure could lower the global death rate and explore links to other health conditions, such as premature birth.
Globally, momentum toward creating a plastic treaty is increasing, with countries preparing for possible final discussions in August this year.
Hellen Dena Kahaso, Pan African Project Lead for plastic at Greenpeace Africa, told Nation that a global treaty is timely to curb the proliferation of harmful chemicals in plastics.
Global treaty
"As much as Africa is not one of the biggest producers, there is an issue of a lot of importation in our continent—including plastic waste that sometimes comes in the guise of donations," she says.
"It is a once in a generation opportunity that will help in curbing production of plastic. We have conventions that are supposed to stop shipping of hazardous waste for instance, but the problem still exists. The global treaty is a solution because if member states ratify it, then it means that countries will have better adherence," she adds.
A 2021 report published by Unep also shows that marginalised communities, mostly found in the Global South where the new study reports most deaths occurred, are disproportionately affected by plastic pollution.
"Environmental justice means educating those on the frontlines of plastic pollution about its risks, including them in decisions about its production, use, and disposal, and ensuring their access to a credible judicial system," Unep Executive Director, Inger Andersen said at the time.
