title: A systematic review on the adverse health effects of di-2-ethylhexyl phthalate.
abstract: Di (ethylhexyl) phthalate (DEHP) is a global environmental pollutant. This study aims to systematically review the literature on health effects of exposure to DEHP including effects on reproductive health, carcinogenesis, pregnancy outcome, and respiratory system. The literature search was done through Scopus, ISI Web of Science, Google Scholar, PubMed, Medline, and the reference lists of previous review articles to identify relevant articles published to June 2016 in each subject area. The inclusion criteria were as follows: original research, cross-sectional studies, case-control studies, cohort studies, interventional studies, and review articles. Both human and animal studies were included. The search was limited to English language papers. Conference papers, editorials, and letters were not included. The systematic review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Overall, 152 of the 407 papers met the inclusion criteria. We provided an up-to-date comprehensive and critical assessment of both human and animal studies undertaken to explore the effects of DEHP. It revealed that in experimental studies, exposure to DEHP mainly targeted the reproductive, neurodevelopment, and respiratory systems. Human studies reported that exposure to this contaminant had carcinogenic effects and influenced neurodevelopment in early life. This systematic review underscored the adverse health effects of DEHP for pregnant women and the pediatric age group. It summarizes different response of humans and experimental animals to DEHP exposure, and some suggested underlying mechanisms.
authors.affiliation: Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.|Environmental Health Department, Environment Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Zarean
authors.affiliation: Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Keikha
authors.affiliation: Environmental Health Department, Environment Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran. p.poursafa@hlth.mui.ac.ir.|Students' Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. p.poursafa@hlth.mui.ac.ir.
authors.forename: Parinaz
authors.initials: P
authors.lastname: Poursafa
authors.affiliation: Students' Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.|Kimia Gostar Saba, Isfahan, Iran.
authors.forename: Pooyan
authors.initials: P
authors.lastname: Khalighinejad
authors.affiliation: Environmental Health Department, Environment Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mohammadmehdi
authors.initials: M
authors.lastname: Amin
authors.affiliation: Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Roya
authors.initials: R
authors.lastname: Kelishadi
mesh_terms: D000818:Animals; D004051:Diethylhexyl Phthalate / Q000737:chemistry / Q000633:toxicity*; D004781:Environmental Exposure; D004785:Environmental Pollutants / Q000737:chemistry / Q000633:toxicity*; D004787:Environmental Pollution; D006801:Humans; D010795:Phthalic Acids / Q000633:toxicity
chemical_list: D004785:Environmental Pollutants; D010795:Phthalic Acids; D004051:Diethylhexyl Phthalate
keywords: Environmental exposures; Health; Phthalates; Systematic review; Toxicity