Medications as a potential source of exposure to phthalates among women of childbearing age

ObjectiveTo evaluate the association between the use of medications potentially containing phthalates and urinary concentrations of specific phthalate metabolites around conception.MethodsWomen enrolled in the Environment and Reproductive Health project from 2006 to 2009 completed questionnaires about the use of medications and provided multiple urine samples before and after conception. We compared the mean urinary concentration of phthalate metabolites between users of phthalate containing medications and a matched unexposed control group.ResultsOne woman used Asacol® (mesalamine), which utilizes dibutyl phthalate (DBP) as a delayed release coating material, and had a mean urinary concentration of the main DBP metabolite 200 times higher than the controls (8176 μg/L vs. 37.5 μg/L). The three users of stool softeners had a higher concentration of the main diethyl phthalate (DEP) metabolite (8636 μg/L vs. 714.2 μg/L). Neither the three additional Prilosec® (omeprazole) users nor one cyclobenzaprine user had higher urinary concentration than controls.ConclusionSelected medications may be important sources of DBP and DEP exposures around conception.

► Some phthalates have anti-androgenic effects in male animals exposed prenatally. ► Dibutyl phthalate (DBP) and diethyl phthalate (DEP) are used for coatings on oral medications. ► We evaluated the association between the use of these medications and urinary concentrations of phthalate metabolites around conception. ► One woman used Asacol® (mesalamine) and had an urinary concentration of the main DBP metabolite 200 times higher than the controls. ► Selected medications may be important sources of much higher than background exposures to DBP and DEP in pregnancy.