title: Concentrations of phthalate metabolites in breast milk in Korea: estimating exposure to phthalates and potential risks among breast-fed infants.
abstract: Phthalates have been associated with endocrine disruption and developmental effects in many experimental and epidemiological studies. Developing infants are among the most susceptible populations to endocrine disruption. However, limited information is available on phthalate exposure and its associated risks among breast-fed newborn infants. In the present study, breast milk samples were collected from 62 lactating mothers at 1 month post-partum from four cities of Korea in 2012 and were evaluated for six phthalate metabolites (mono-isobutyl phthalate (MiBP), mono-n-butyl phthalate (MnBP), mono(2-ethyl-hexyl) phthalate (MEHP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) and monoethyl phthalate (MEP)). MEP was detected in all breast milk samples, with a median concentration of 0.37 μg/L, and MiBP, MnBP and MEHP were detected in 79-89% of samples, with median concentrations of 1.10, 1.70, and 2.08 μg/L, respectively. However, MEHHP and MEOHP, the oxidized forms of di-ethyl-hexyl phthalate (DEHP), were detected in only one sample. For exposure assessment, the levels of phthalate diesters were estimated based on the parent:metabolite ratios in the breast milk that are reported elsewhere. For risk assessment, the endocrine-related toxicity of the monoester was assumed to be the same as that of its diester form. Median daily intake estimates of phthalates, including both monoester and diester forms, through breast milk consumption ranged between 0.91 and 6.52 μg/kg body weight (bw) for DEHP and between 0.38 and 1.43 μg/kg bw for di-n-butyl phthalate (DnBP). Based on the estimated daily intake, up to 8% of infants exceeded the reference dose of anti-androgenicity (RfD AA) for DEHP, and 6% of infants exceeded the tolerable daily intake (TDI) for DnBP. Breast milk MiBP and MnBP concentrations showed significant positive associations with maternal consumption of whipped cream or purified water. Considering vulnerability of young infants, efforts to mitigate phthalate exposure among lactating women are warranted.
authors.affiliation: School of Public Health, Seoul National University, Seoul, Republic of Korea; Institute of Health & Environment, Seoul National University, Seoul, Republic of Korea.
authors.forename: Sunmi
authors.initials: S
authors.lastname: Kim
authors.affiliation: School of Public Health, Seoul National University, Seoul, Republic of Korea; Institute of Health & Environment, Seoul National University, Seoul, Republic of Korea.
authors.forename: Jangwoo
authors.initials: J
authors.lastname: Lee
authors.affiliation: College of Natural Sciences, Soonchunhyang University, Asan, Republic of Korea.
authors.forename: Jeongim
authors.initials: J
authors.lastname: Park
authors.affiliation: College of Medicine, Korea University, Seoul, Republic of Korea.
authors.forename: Hai-Joong
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: College of Medicine, Korea University, Seoul, Republic of Korea.
authors.forename: Geumjoon
authors.initials: G
authors.lastname: Cho
authors.affiliation: College of Medicine, Korea University, Seoul, Republic of Korea.
authors.forename: Gun-Ha
authors.initials: GH
authors.lastname: Kim
authors.affiliation: College of Medicine, Korea University, Seoul, Republic of Korea.
authors.forename: So-Hee
authors.initials: SH
authors.lastname: Eun
authors.affiliation: College of Medicine, Soonchunhyang University, Seoul, Republic of Korea.
authors.forename: Jeong Jae
authors.initials: JJ
authors.lastname: Lee
authors.affiliation: College of Medicine, Soonchunhyang University, Seoul, Republic of Korea.
authors.forename: Gyuyeon
authors.initials: G
authors.lastname: Choi
authors.affiliation: College of Medicine, Soonchunhyang University, Seoul, Republic of Korea.
authors.forename: Eunsook
authors.initials: E
authors.lastname: Suh
authors.affiliation: College of Medicine, Inha University, Incheon, Republic of Korea.
authors.forename: Sooran
authors.initials: S
authors.lastname: Choi
authors.affiliation: College of Medicine, Hanllym University, Seoul, Republic of Korea.
authors.forename: Sungjoo
authors.initials: S
authors.lastname: Kim
authors.affiliation: College of Medicine, Hanllym University, Seoul, Republic of Korea.
authors.forename: Young Don
authors.initials: YD
authors.lastname: Kim
authors.affiliation: College of Medicine, Hanllym University, Seoul, Republic of Korea.
authors.forename: Sung Koo
authors.initials: SK
authors.lastname: Kim
authors.affiliation: College of Medicine, Jeju National University, Jeju, Republic of Korea.
authors.forename: Su Young
authors.initials: SY
authors.lastname: Kim
authors.affiliation: College of Medicine, Jeju National University, Jeju, Republic of Korea.
authors.forename: Seunghyo
authors.initials: S
authors.lastname: Kim
authors.affiliation: College of Medicine, Yonsei University, Seoul, Republic of Korea.
authors.forename: Soyong
authors.initials: S
authors.lastname: Eom
authors.affiliation: Department of Marine Sciences and Convergent Technology, Hanyang University, Ansan, Republic of Korea.
authors.forename: Hyo-Bang
authors.initials: HB
authors.lastname: Moon
authors.affiliation: School of Public Health, Seoul National University, Seoul, Republic of Korea; Institute of Health & Environment, Seoul National University, Seoul, Republic of Korea.
authors.forename: Sungkyoon
authors.initials: S
authors.lastname: Kim
authors.affiliation: School of Public Health, Seoul National University, Seoul, Republic of Korea; Institute of Health & Environment, Seoul National University, Seoul, Republic of Korea. Electronic address: kyungho@snu.ac.kr.
authors.forename: Kyungho
authors.initials: K
authors.lastname: Choi
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D004785:Environmental Pollutants / Q000378:metabolism*; D005260:Female; D006801:Humans; D018811:Maternal Exposure / Q000706:statistics & numerical data*; D008895:Milk, Human / Q000378:metabolism*; D010795:Phthalic Acids / Q000378:metabolism*; D056910:Republic of Korea; D018570:Risk Assessment
chemical_list: D004785:Environmental Pollutants; D010795:Phthalic Acids; C032279:phthalic acid
keywords: CHECK; DEHP; Daily intake; DnBP; MEHP