title: Urinary phthalate metabolite concentrations among pregnant women in Northern Puerto Rico: distribution, temporal variability, and predictors.
abstract: BACKGROUND
  Phthalate contamination exists in the North Coast karst aquifer system in Puerto Rico. In light of potential health impacts associated with phthalate exposure, targeted action for elimination of exposure sources may be warranted, especially for sensitive populations such as pregnant women. However, information on exposure to phthalates from a variety of sources in Puerto Rico is lacking. The objective of this study was to determine concentrations and predictors of urinary phthalate biomarkers measured at multiple times during pregnancy among women living in the Northern karst area of Puerto Rico.
  
  
  METHODS
  We recruited 139 pregnant women in Northern Puerto Rico and collected urine samples and questionnaire data at three separate visits (18 ± 2 weeks, 22 ± 2 weeks, and 26 ± 2 weeks of gestation). Urine samples were analyzed for eleven phthalate metabolites: mono-2-ethylhexyl phthalate (MEHP), mono-2-ethyl-5-hydroxyhexyl phthalate, mono-2-ethyl-5-oxohexyl phthalate, mono-2-ethyl-5-carboxypentyl phthalate, mono-ethyl phthalate (MEP), mono-n-butyl phthalate, mono-benzyl phthalate, mono-isobutyl phthalate, mono-3-carboxypropyl phthalate (MCPP), mono carboxyisononyl phthalate (MCNP), and mono carboxyisooctyl phthalate (MCOP).
  
  
  RESULTS
  Detectable concentrations of phthalate metabolites among pregnant women living in Puerto Rico was prevalent, and metabolite concentrations tended to be higher than or similar to those measured in women of reproductive age from the general US population. Intraclass correlation coefficients ranged from very weak (MCNP; 0.05) to moderate (MEP; 0.44) reproducibility among all phthalate metabolites. We observed significant or suggestive positive associations between urinary phthalate metabolite concentrations and water usage/storage habits (MEP, MCNP, MCOP), use of personal care products (MEP), and consumption of certain food items (MCPP, MCNP, and MCOP).
  
  
  CONCLUSIONS
  To our knowledge this is the first study to report concentrations, temporal variability, and predictors of phthalate biomarkers among pregnant women in Puerto Rico. Preliminary results suggest several potentially important exposure sources to phthalates in this population and future analysis from this ongoing prospective cohort will help to inform targeted approaches to reduce exposure.
authors.affiliation: Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA, United States. Electronic address: dcantonwine@partners.org.
authors.forename: David E
authors.initials: DE
authors.lastname: Cantonwine
authors.forename: José F
authors.initials: JF
authors.lastname: Cordero
authors.forename: Luis O
authors.initials: LO
authors.lastname: Rivera-González
authors.forename: Liza V
authors.initials: LV
authors.lastname: Anzalota Del Toro
authors.forename: Kelly K
authors.initials: KK
authors.lastname: Ferguson
authors.forename: Bhramar
authors.initials: B
authors.lastname: Mukherjee
authors.forename: Antonia M
authors.initials: AM
authors.lastname: Calafat
authors.forename: Noe
authors.initials: N
authors.lastname: Crespo
authors.forename: Braulio
authors.initials: B
authors.lastname: Jiménez-Vélez
authors.forename: Ingrid Y
authors.initials: IY
authors.lastname: Padilla
authors.forename: Akram N
authors.initials: AN
authors.lastname: Alshawabkeh
authors.forename: John D
authors.initials: JD
authors.lastname: Meeker
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000652:urine; D005260:Female; D006801:Humans; D010795:Phthalic Acids / Q000652:urine*; D011247:Pregnancy; D037841:Pregnant People; D011446:Prospective Studies; D011647:Puerto Rico; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D013997:Time Factors; D014874:Water Pollutants, Chemical / Q000652:urine*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D010795:Phthalic Acids; D014874:Water Pollutants, Chemical
keywords: Endocrine disruptor; Environment; Epidemiology; Exposure; Phthalates; Pregnancy