Intake of phthalate-tainted foods and microalbuminuria in children: The 2011 Taiwan food scandal

Hui-Ju Tsai; Bai-Hsiun Chen; Chia-Fang Wu; Shu-Li Wang; Po-Chin Huang; Yi-Chun Tsai; Mei-Lien Chen; Chi-Kung Ho; Chao A Hsiung; Ming-Tsang Wu

doi:10.1016/j.envint.2016.01.015

Intake of phthalate-tainted foods and microalbuminuria in children: The 2011 Taiwan food scandal

Environ Int. 2016 Apr-May:89-90:129-37. doi: 10.1016/j.envint.2016.01.015. Epub 2016 Jan 28.

Authors

Hui-Ju Tsai¹, Bai-Hsiun Chen², Chia-Fang Wu³, Shu-Li Wang⁴, Po-Chin Huang⁴, Yi-Chun Tsai⁵, Mei-Lien Chen⁶, Chi-Kung Ho⁷, Chao A Hsiung⁸, Ming-Tsang Wu⁹

Affiliations

¹ Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan.
² Department of Laboratory Medicine and Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
³ Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan; Research Center of Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁴ National Environmental Health Research Center, National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
⁵ Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁶ Institute of Environmental and Occupational Health Sciences, College of Medicine, National Yang Ming University, Taipei, Taiwan.
⁷ Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Health, Kaohsiung City Government, Kaohsiung, Taiwan.
⁸ Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan. Electronic address: hsiung@nhri.org.tw.
⁹ Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Research Center of Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Center of Environmental and Occupational Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: 960021@ms.kmuh.org.tw.

PMID: 26827184
DOI: 10.1016/j.envint.2016.01.015

Abstract

Background: A major threat to public health involving phthalate-tainted foodstuffs occurred in Taiwan in 2011. Phthalates, mainly di-(2-ethylhexyl) phthalate (DEHP), were intentionally added to several categories of food commonly consumed by children. This study investigated the relationship between intake of the phthalate-tainted foods and renal function in children.

Methods: Children aged ≤10years with possible phthalate exposure were enrolled in this study between August 2012 and January 2013. Questionnaires were used to collect details of exposure to phthalate-tainted foodstuffs, and blood and urine samples were collected for clinical biochemical workup. The clinical biomarkers of renal injury, including urinary microalbumin, N-acetyl-beta-d-glucosaminidase (NAG), and β2-microglobulin were measured. Exposure was categorized based on recommended tolerable daily intake level defined by the U.S. Environmental Protection Agency (0.02mg/kg/day) and the European Food Safety Authority (0.05mg/kg/day).

Results: We analyzed intake and renal function of 184 children whose intake of DEHP-tainted foods was known. Higher DEHP exposure to DEHP-tainted foods was significantly associated with increase of urine albumin/creatinine ratio (ACR). Children in the high-exposed group (daily DEHP intake (DDI)>0.05mg/kg/day) had 10.395 times the risk of microalbuminuria than the low-exposed group (DDI≤0.02 and >0mg/kg/day) and no-exposed group combined after adjustment (95% CI=1.096-98.580, P=0.04).

Conclusion: Intake of DEHP from phthalate-tainted foods may be a potential risk factor for microalbuminuria, a marker of glomerular injury in children.

Keywords: Children; DEHP; Food scandal; Microalbuminuria; Phthalates; di-(2-ethylhexyl) phthalate.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Albuminuria* / chemically induced
Albuminuria* / epidemiology
Child
Child, Preschool
Diethylhexyl Phthalate / analysis
Diethylhexyl Phthalate / toxicity
Female
Food Contamination / analysis*
Food Safety*
Humans
Kidney Function Tests
Male
Phthalic Acids / analysis*
Phthalic Acids / toxicity
Public Health
Taiwan / epidemiology
United States
United States Environmental Protection Agency

Substances

Phthalic Acids
Diethylhexyl Phthalate