A groundbreaking global international analysis published in eBioMedicine (via The Lancet) has quantified the worldwide cardiovascular toll attributed to di-2-ethylhexyl-phthalate (DEHP) — a common plastic additive used to soften the plastic polyvinyl chloride (PVC), which is found in everyday objects such as vinyl records, pipes, and cosmetics. In 2018 alone, DEHP exposure accounted for an estimated 356,238 deaths among adults aged 55 to 64 years, representing 13.5% of all cardiovascular disease (CVD) deaths in that age group.
Conducted by New York University Grossman School of Medicine researchers, the study — “Phthalate exposure from plastics and cardiovascular disease: global estimates of attributable mortality and years life lost” — leveraged exposure data from prior population surveys and cardiovascular mortality statistics from the Institute for Health Metrics and Evaluation (IHME). The team used established hazard ratios to correlate DEHP blood levels with increased CVD mortality, estimating both death counts and years of life lost (YLL).
This analysis reinforces growing evidence that plasticizers are more than environmental contaminants — they pose a serious and direct threat to human health. The authors estimate that exposure to DEHP alone results in the loss of more than 10 million years of life annually, disproportionately affecting vulnerable populations.
The burden is heavily concentrated in regions undergoing rapid plastic production and use. Areas including South Asia, East Asia, the Pacific, and the Middle East together accounted for nearly three-quarters (73%) of the DEHP-linked deaths. The study attributed this elevated risk to fewer manufacturing controls and higher levels of plastic production in these areas.
“The findings underscore the need for urgent global and local regulatory interventions to curb mortality from DEHP exposure,” lead author Sara Hyman and her colleagues write.
DEHP and related phthalates have long been suspected to be hormone-disruptors and metabolic disruptors. They contribute to oxidative stress, vascular inflammation, atherosclerosis, obesity, and type 2 diabetes — all key drivers of CVD. In February 2022, the United Nations Environment Assembly launched negotiations for a global treaty aimed at ending plastic pollution. However, countries with large petrochemical industries have pushed back against proposals to limit plastic production and use, downplaying concerns by claiming that the chemicals in plastics pose minimal health risks.
By integrating their estimated CVD burden into ongoing negotiations or a binding Global Plastic Treaty, the study authors urge governments to reduce plastic additive exposure and enhance safety standards. Public health measures suggest phasing out DEHP usage in food, packaging, medical, and personal care products, strengthening industrial regulations in high-production regions, and promoting safter alternatives and raising awareness about daily exposures from plastics in food containers, beauty items, medical supplies, and household goods. Other suggested action items are improving labeling requirements and waste management practices. This analysis reinforces growing evidence that plasticizers are more than environmental contaminants — they pose a serious and direct threat to human health.
The authors estimate that exposure to DEHP alone results in the loss of more than 10 million years of life annually, disproportionately affecting vulnerable populations. These findings offer urgent justification for phasing out hazardous plastic chemicals — not only to promote environmental sustainability, but also to prevent hundreds of thousands of premature deaths each year. It stands as a clear warning: Reducing reliance on toxic plastic additives must become a central priority in both public health and environmental policy.
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