Phthalates From Plastics Responsible For Over 300,000 Global Heart Deaths

Cardiovascular disease continues to be the leading cause of mortality worldwide, responsible for over 17 million deaths annually. In a widespread effort to address various risk factors associated with the disease, researchers have identified obvious factors, such as poor diet and smoking, yet lesser-known factors have been identified, such as the increased exposure to plastics. In fact, a recent study has suggested that a type of chemical commonly found in plastics, phthalates, may also contribute to the global threat that is heart disease.

What are Phthalates?

Phthalates, also known as plasticizers, are a set of chemicals added to plastic to make it more stretchy, softer or more flexible. Outside of plastics, phthalates have been added to beauty products to help maintain their scents. As a result of our continuous exposure, humans are likely to ingest phthalates through food, or absorb them through skincare products.

Unfortunately, continuous exposure to phthalates may have serious ramifications on our health. For example, in 2022, the U.S. Food and Drug Administration revoked the use of 22 phthalates as food additives following a petition calling for the removal of “food contact uses for 23 phthalates and two other substances used as plasticizers, adhesives, defoaming agents, surface lubricants, resins, and slimicides.”

In lieu of past research examining the link between phthalates and health issues, this article will feature a recent study that proposes that these compounds may increase the risk of heart disease.

Plastics and Heart Health

In 2022, the United Nations Environment Assembly announced plans to end plastic pollution by working to negotiate an internationally legally binding instrument.

To support these negotiations, a group of researchers working to assess the global impact that a certain phthalate – DEHP – had on heart mortality.

Di-2-ethylhexyphthalate (DEHP) is a class of phthalates that’s used in a variety of common items, including food containers, shower curtains, upholstery, floor tiles, and garden hoses, due to its ability to make plastics more malleable, softer and more flexible. That said, the compound has been linked to health issues, so much so that California’s Proposition 65 requires companies to place warning labels on products that warn about its possible health effects.

Using existing data from the World Bank 2018 population data for individuals between 55 and 64 years of age, the researchers developed a global disease burden model that estimated the country-specific burden of heart mortality linked to DEHP.

They used the data of global surveys that evaluated exposure to food packaging and DEHP, and then through urine samples, they matched said exposure to the increased risk of cardiovascular death, per country.

Phthalates May Cause Heart Disease

“By highlighting the connection between phthalates and a leading cause of death across the world, our findings add to the vast body of evidence that these chemicals [phthalates] present a tremendous danger to human health.” – Sara Hyman, lead study author and associate research scientist at NYU’s Grossman School of Medicine

According to the study’s findings, published in eBioMedicine, around 13.4% of all global cardiovascular disease deaths worldwide in 2018 were attributed to DEHP exposure.

In elaborating on the findings, senior author Dr. Leonardo Trasande, a professor of pediatrics and population health at New York University’s Grossman School of Medicine, explained how phthalates contribute to inflammation and systemic inflammation in the coronary arteries, which can “accelerate existing disease and lead to acute events including mortality,”

Additionally, around 70% of these deaths occurred in Asia, with the Middle East and South Asia experiencing the highest mortality rates, followed by Latin America, East Asia, the Pacific, Canada, Australia, and Africa.

“There is a clear disparity in which parts of the world bear the brunt of heightened heart risks from phthalates. Our results underscore the urgent need for global regulations to reduce exposure to these toxins, especially in areas most affected by rapid industrialization and plastic consumption.”- Dr. Leonardo Trasande

What Now?

Phthalates are everywhere, and this is not the first study to highlight their dangers. In fact, past research has linked them to reproductive issues and even childhood obesity.

That said, the aforementioned findings were courtesy of an observational study that showed correlation, not causation. With that, Dr. Trasande says that more research is needed to evaluate DEHP’s link to other health concerns. He also hopes to track DEHP’s impact in other countries where plastic regulations are in place.

Limiting phthalate exposure

“Avoid plastics as much as you can. Reducing your use of ultraprocessed foods can reduce the levels of the chemical exposures you come in contact with,” Dr. Trasande advises. “Never put plastic containers in the microwave or dishwasher, where the heat can break down the linings so they might be absorbed more readily.”

Here are other tips to reduce phthalate exposure and protect your heart health:

• Stop using plastic straws and buy reusable stainless steel or glass straw
• Use a reusable produce bag.
• Give up gum. Gum is made of synthetic rubber, aka plastic.
• Buy boxes instead of bottles.
• Buy food from bulk bins and fill a reusable bag or container.
• Reuse containers to store leftovers or shop in bulk.
• Use a reusable bottle or mug for your beverages.
• Bring a container for take-out
• Use matches instead of disposable plastic lighters, or invest in a refillable metal lighter
• Avoid buying frozen foods because their packaging is mostly plastic

Want to know more?

Plastic is everywhere, and so are microplastics. If you’re trying to keep track, we’re exposed to them through packaging, the oceans, and now…chewing gum? A recent study found that chewing gum could be releasing microplastics into your mouth.

References

Hyman, S., Acevedo, J., Giannarelli, C., et al. (2025) Phthalate exposure from plastics and cardiovascular disease: global estimates of attributable mortality and years life lost. eBioMedicine. doi:10.1016/j.ebiom.2025.105730

Lee, S., Lee, H.A., Park, B. et al. (2023). Prospective association between phthalate exposure in childhood and liver function in adolescence: the Ewha Birth and Growth Cohort Study. Environ Health 22, 3. https://doi.org/10.1186/s12940-022-00953-w

Nobles, C. J., Mendola, P., Kim, K., Pollack, A. Z., et al. (2023). Preconception Phthalate Exposure and Women’s Reproductive Health: Pregnancy, Pregnancy Loss, and Underlying Mechanisms. Environmental health perspectives, 131(12), 127013. https://doi.org/10.1289/EHP12287

MAIN IMAGE CREDIT: Photo by Volodymyr Hryshchenko on Unsplash