title: Prenatal phthalate exposures and anogenital distance in Swedish boys.
abstract: BACKGROUND
  Phthalates are used as plasticizers in soft polyvinyl chloride (PVC) and in a large number of consumer products. Because of reported health risks, diisononyl phthalate (DiNP) has been introduced as a replacement for di(2-ethylhexyl) phthalate (DEHP) in soft PVC. This raises concerns because animal data suggest that DiNP may have antiandrogenic properties similar to those of DEHP. The anogenital distance (AGD)--the distance from the anus to the genitals--has been used to assess reproductive toxicity.
  
  
  OBJECTIVE
  The objective of this study was to examine the associations between prenatal phthalate exposure and AGD in Swedish infants.
  
  
  METHODS
  AGD was measured in 196 boys at 21 months of age, and first-trimester urine was analyzed for 10 phthalate metabolites of DEP (diethyl phthalate), DBP (dibutyl phthalate), DEHP, BBzP (benzylbutyl phthalate), as well as DiNP and creatinine. Data on covariates were collected by questionnaires.
  
  
  RESULTS
  The most significant associations were found between the shorter of two AGD measures (anoscrotal distance; AGDas) and DiNP metabolites and strongest for oh-MMeOP [mono-(4-methyl-7-hydroxyloctyl) phthalate] and oxo-MMeOP [mono-(2-ethyl-5-oxohexyl) phthalate]. However, the AGDas reduction was small (4%) in relation to more than an interquartile range increase in DiNP exposure.
  
  
  CONCLUSIONS
  These findings call into question the safety of substituting DiNP for DEHP in soft PVC, particularly because a shorter male AGD has been shown to relate to male genital birth defects in children and impaired reproductive function in adult males and the fact that human levels of DiNP are increasing globally.
authors.affiliation: Department of Health Sciences, Karlstad University, Karlstad, Sweden.
authors.forename: Carl-Gustaf
authors.initials: CG
authors.lastname: Bornehag
authors.forename: Fredrik
authors.initials: F
authors.lastname: Carlstedt
authors.forename: Bo A G
authors.initials: BA
authors.lastname: Jönsson
authors.forename: Christian H
authors.initials: CH
authors.lastname: Lindh
authors.forename: Tina K
authors.initials: TK
authors.lastname: Jensen
authors.forename: Anna
authors.initials: A
authors.lastname: Bodin
authors.forename: Carin
authors.initials: C
authors.lastname: Jonsson
authors.forename: Staffan
authors.initials: S
authors.lastname: Janson
authors.forename: Shanna H
authors.initials: SH
authors.lastname: Swan
mesh_terms: D000328:Adult; D004781:Environmental Exposure / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D005837:Genitalia, Male / Q000033:anatomy & histology / Q000187:drug effects* / Q000254:growth & development; D006801:Humans; D007223:Infant; D008297:Male; D018811:Maternal Exposure / Q000706:statistics & numerical data; D010795:Phthalic Acids / Q000633:toxicity* / Q000652:urine; D010968:Plasticizers / Q000633:toxicity; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000652:urine; D011297:Prenatal Exposure Delayed Effects; D013548:Sweden / Q000453:epidemiology
chemical_list: D010795:Phthalic Acids; D010968:Plasticizers; C012125:diisononyl phthalate; C032279:phthalic acid