Antioxidant vitamins' modification of the adverse health effects induced by phthalate exposure: A scoping review of epidemiological and experimental studies

Abstract

The exposure to and health hazards of phthalates have received abundant attention. However, reducing phthalate exposure and further decreasing the associated health risks are difficult. Nonetheless, it is important to actively seek relevant measures. Recently, antioxidant vitamins have been frequently mentioned to improve phthalate-related issues. This scoping review summarizes the existing epidemiological and experimental studies on the interaction of phthalates with antioxidant vitamins. Through a systematic search, sparse epidemiological studies explored the effects of interaction between phthalates and vitamins on reproduction, the endocrine, respiratory, and nervous system and human aging. Four prospective studies were conducted in China, the United States, Canada and Netherlands. Only one study from Netherlands focused on the female reproductive system.The other three studies focused on neurological damage to fetuses caused by phthalate exposure, and its mitigation by vitamin supplementation during pregnancy. Four cross-sectional studies were conducted based on the United States National Health and Nutrition Examination Survey database. These studies involved hazards in different systems and interactions with different vitamins. Overall, epidemiological evidence suggests that antioxidant vitamins such as vitamin A, B, D, and folic acid probably may alter the health hazards induced by phthalate exposure. Current animal studies often focus on three phthalates, DBP, DEHP and DIDP,² and most commonly, the first two phthalates. These chemicals cause reproductive, urinary, digestive and neurodevelopmental damage; the antioxidant vitamin C, E and B could mitigate the harm caused by phthalates. Possible mechanisms involve reducing oxidative stress, removing methylation,etc. Determining whether these mechanisms are similar to those in humans requires a rigorous experimental study.

Keywords: Hazards of health; Nonpersistent environmental chemical; Nutrition regulation.