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Intellectual evaluation of children exposed to phthalate-tainted products after the 2011 Taiwan phthalate episode.

Intellectual evaluation of children exposed to phthalate-tainted products after the 2011 Taiwan phthalate episode.
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Huang PC, Tsai CH, Chen CC, Wu MT, Chen ML, Wang SL, Chen BH, Lee CC, Jaakkola JJK, Wu WC, Chen MK, Hsiung CA, Group R,


Huang PC, Tsai CH, Chen CC, Wu MT, Chen ML, Wang SL, Chen BH, Lee CC, Jaakkola JJK, Wu WC, Chen MK, Hsiung CA, Group R, (click to view)

Huang PC, Tsai CH, Chen CC, Wu MT, Chen ML, Wang SL, Chen BH, Lee CC, Jaakkola JJK, Wu WC, Chen MK, Hsiung CA, Group R,

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Environmental research 2017 03 27156() 158-166 pii S0013-9351(16)30911-2
Abstract
INTRODUCTION
Phthalate exposure may reduce intellectual development in young children. In 2011, numerous Taiwanese children had been reported to have consumed phthalate-tainted products. We investigated the effects of phthalate exposure on the intellectual development of these children after the 2011 Taiwan di-2-ethylhexyl phthalate (DEHP) episode.

METHODS
We recruited 204 children, aged 3-12 y, from 3 hospitals in Taiwan between 2012 and 2013. First-morning urine samples were collected for analyzing 5 phthalate metabolites. We applied a Bayesian model to estimate the past DEHP exposure (estDEHPADD) of each participant before the 2011 DEHP episode. Demographic information, consumption of phthalate-tainted products, and maternal education, of each participant were obtained using a questionnaire. We used the Wechsler intelligence evaluation tools for assessing the children’s and maternal intelligence quotient.

RESULTS AND DISCUSSION
The median levels of mono-2-ethylhexyl phthalate, mono(2-ethyl-5-hydroxyhexyl) phthalate, mono(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono-n-butyl phthalate, and mono-iso-butyl phthalate in the children were 9.97, 45.8, 32.2, 46.2, and 24.3μg/g creatinine, respectively. Using the aforementioned urinary phthalate metabolites, we found that the children’s verbal comprehension index (N =98) was significantly negatively associated with urinary log10 MEOHP (β, -11.92; SE, 5.33; 95%CI, -22.52~ -1.33; P=0.028) and log10 ΣDBP metabolites (β, -10.95; SE, 4.93; 95%CI, -20.74~ -1.16; P=0.029) after adjustment for age, gender, maternal IQ and education, passive smoking, estDEHPADD, active and passive smoking during pregnancy. Through a tolerable daily intake-based approach, we only found a significant negative association between past estimate DEHPADD and VIQ≥3-<6 in preschool children whereas no correlation was observed between current DEHP exposure and IQ≥3-<6 score with/ without estimate DEHPADD adjustment. It revealed that the effect of past high-DEHP exposure on verbal-related neurodevelopment of younger child are more sensitive. CONCLUSION
Our results are consistent with the hypothesis that exposure to DEHP and DnBP affects intellectual development in preschool and school-aged children, particularly their language learning or expression ability.

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