title: Phthalate exposure through different pathways and allergic sensitization in preschool children with asthma, allergic rhinoconjunctivitis and atopic dermatitis.
abstract: Studies in rodents indicate that phthalates can function as adjuvants, increasing the potency of allergens. Meanwhile, epidemiological studies have produced inconsistent findings regarding relationships between phthalate exposures and allergic disease in humans. The present study examined phthalate exposure and allergic sensitization in a large group of 3-5 year old children: 300 random controls and 200 cases with asthma, rhinoconjunctivitis or atopic dermatitis as reported in questionnaires. The children were clinically examined to confirm their health status. Blood samples were analyzed for IgE sensitization to 20 allergens. Adjusted logistic regressions were used to look for associations between phthalate exposure indicators (mass fractions in dust from children's homes and daycares, metabolites in urine, and estimated daily indoor intakes from dust ingestion, inhalation and dermal absorption) and sensitization and allergic disease. No direct associations were found between phthalate exposures and asthma, rhinoconjunctivitis or atopic dermatitis. However, among children with these diseases, there were significant associations between non-dietary exposures to DnBP, BBzP and DEHP in the indoor environment (mass fractions in dust or daily indoor intakes from dust ingestion, inhalation and dermal absorption) and allergic sensitization. Some exposure pathways were more strongly associated with sensitization than others, although the results are not conclusive and require confirmation. A number of the associations depended on accounting for a child's exposure in more than one environment (i.e., daycare facility as well as home). Significant associations were not observed between phthalate metabolites in urine, which reflected exposure from diet as well as indoor pathways, and allergic sensitization.
authors.affiliation: International Centre for Indoor Environment and Energy, Department of Civil Engineering, Technical University of Denmark, Nils Koppels Allé 402, 2800 Lyngby, Denmark. Electronic address: gab@byg.dtu.dk.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Bekö
authors.affiliation: Department of Pediatrics, HC Andersen Children's Hospital, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense, Denmark.
authors.forename: Michael
authors.initials: M
authors.lastname: Callesen
authors.affiliation: International Centre for Indoor Environment and Energy, Department of Civil Engineering, Technical University of Denmark, Nils Koppels Allé 402, 2800 Lyngby, Denmark; Environmental and Occupational Health Sciences Institute, Rutgers University, 170 Frelinghuysen Road, Piscataway, NJ 08854, United States.
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Weschler
authors.affiliation: International Centre for Indoor Environment and Energy, Department of Civil Engineering, Technical University of Denmark, Nils Koppels Allé 402, 2800 Lyngby, Denmark.
authors.forename: Jørn
authors.initials: J
authors.lastname: Toftum
authors.affiliation: IVL Swedish Environmental Research Institute, P.O. Box 53021, SE-400 14 Göteborg, Sweden.
authors.forename: Sarka
authors.initials: S
authors.lastname: Langer
authors.affiliation: Department of Public Health, Institute of Environmental and Occupational Medicine, University of Aarhus, Bartholins Allé 2, 8000 Aarhus, Denmark.
authors.forename: Torben
authors.initials: T
authors.lastname: Sigsgaard
authors.affiliation: Department of Pediatrics, HC Andersen Children's Hospital, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense, Denmark.
authors.forename: Arne
authors.initials: A
authors.lastname: Høst
authors.affiliation: Department of Environmental Medicine, University of Southern Denmark, J.B. Winsløws Vej 17, 5000 Odense, Denmark.
authors.forename: Tina
authors.initials: T
authors.lastname: Kold Jensen
authors.affiliation: International Centre for Indoor Environment and Energy, Department of Civil Engineering, Technical University of Denmark, Nils Koppels Allé 402, 2800 Lyngby, Denmark.
authors.forename: Geo
authors.initials: G
authors.lastname: Clausen
mesh_terms: D001249:Asthma / Q000139:chemically induced / Q000453:epidemiology* / Q000276:immunology; D002675:Child, Preschool; D003231:Conjunctivitis / Q000139:chemically induced / Q000453:epidemiology / Q000276:immunology; D003718:Denmark / Q000453:epidemiology; D003876:Dermatitis, Atopic / Q000139:chemically induced / Q000453:epidemiology* / Q000276:immunology; D004391:Dust / Q000032:analysis; D004785:Environmental Pollutants / Q000633:toxicity* / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D010795:Phthalic Acids / Q000633:toxicity* / Q000652:urine; D065631:Rhinitis, Allergic / Q000139:chemically induced / Q000453:epidemiology* / Q000276:immunology
chemical_list: D004391:Dust; D004785:Environmental Pollutants; D010795:Phthalic Acids
keywords: Allergic diseases; Clinical examination; Eczema; Indoor environment; Written questionnaire