title: Exposure to phthalates and bisphenol A are associated with atopic dermatitis symptoms in children: a time-series analysis.
abstract: Despite increasing evidence on the relationship between exposure to phthalates and bisphenol A with allergies and asthma, reports on atopic dermatitis (AD) with these chemicals are few. We assessed the association between AD symptoms and the exposure to phthalates and bisphenol A and in children.
  
  
  
  We surveyed 18 boys with AD (age 3-7 years) in a day care center in Seoul between May 2009 and April 2010. AD symptoms were recorded by using a daily symptom diary. We collected 460 series of pooled urine twice a day, in the morning and afternoon, over 230 working days and measured the concentrations of mono-2-ethyl-5-oxohexyl phthalate (5-oxo-MEHP), mono-2-ethyl-5-hydroxyhexyl phthalate (5-OH-MEHP), mono-isobutyl phthalate (MnBP) and bisphenol A glucuronide (BPAG) in the pooled urine. Logistic regression was used for statistical analysis.
  
  
  
  Most phthalate metabolite levels were higher in the morning than in the afternoon (p < 0.0001). There was seasonal variation in the levels of phthalates and bisphenol A metabolites. Levels of 5-OH-MEHP, MnBP, and BPAG were highest in summer (p < 0.0001). Manifestation of AD symptoms was associated with an increase in urinary levels of MnBP (adjusted odds ratio, aOR = 2.85, 95% CI: 1.12-7.26 per 1 μg/L of MnBP) and BPAG (aOR = 1.79, 95% CI: 0.91-3.52 per 1 μg/L BPAG) on the same day. The levels of MnBP and BPAG in the previous day increased AD symptoms (aOR = 2.74, 95% CI: 1.21-6.20, for 1 μg/L of MnBP and aOR = 2.01, 95% CI: 1.08-3.74 for 1 μg/L BPAG).
  
  
  
  Our results suggest that exposure to phthalates and bisphenol A is associated with aggravation of AD symptoms in children.
authors.affiliation: Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, 2066 Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do, 16419, Republic of Korea.|Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea.
authors.forename: Eun-Hye
authors.initials: EH
authors.lastname: Kim
authors.affiliation: Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, 2066 Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do, 16419, Republic of Korea.|Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea.
authors.forename: Byoung-Hak
authors.initials: BH
authors.lastname: Jeon
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea.|Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, 06351, Republic of Korea.
authors.forename: Jihyun
authors.initials: J
authors.lastname: Kim
authors.affiliation: Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, 06351, Republic of Korea.
authors.forename: Young-Min
authors.initials: YM
authors.lastname: Kim
authors.affiliation: Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, 06351, Republic of Korea.
authors.forename: Youngshin
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea. kmaped@skku.edu.|Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, 06351, Republic of Korea. kmaped@skku.edu.
authors.forename: Kangmo
authors.initials: K
authors.lastname: Ahn
authors.affiliation: Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, 2066 Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do, 16419, Republic of Korea. hkcheong@skku.edu.|Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea. hkcheong@skku.edu.
authors.forename: Hae-Kwan
authors.identifier: 0000-0003-2758-9399
authors.initials: HK
authors.lastname: Cheong
mesh_terms: D001559:Benzhydryl Compounds / Q000009:adverse effects* / Q000652:urine; D002648:Child; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000453:epidemiology* / Q000652:urine; D004781:Environmental Exposure / Q000009:adverse effects* / Q000032:analysis; D004785:Environmental Pollutants / Q000009:adverse effects* / Q000652:urine; D006801:Humans; D008297:Male; D010636:Phenols / Q000009:adverse effects* / Q000652:urine; D010795:Phthalic Acids / Q000009:adverse effects* / Q000652:urine; D056910:Republic of Korea / Q000453:epidemiology; D000098826:Bisphenol A Compounds
chemical_list: D001559:Benzhydryl Compounds; D004785:Environmental Pollutants; D010636:Phenols; D010795:Phthalic Acids; C006780:bisphenol A; D000098826:Bisphenol A Compounds
keywords: Atopic dermatitis; Bisphenol A; Endocrine disrupting compounds; Panel study; Phthalate