Plastic-related endocrine disrupting chemicals significantly related to the increased risk of estrogen-dependent diseases in women.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational studies
PubMed 38640992 · doi:10.1016/j.envres.2024.118966
What was done
A systematic review and meta-analysis was conducted across PubMed, Web of Science, and Cochrane Library databases for articles published up to April 21, 2023. The authors evaluated associations between exposure to plastic-related endocrine-disrupting chemicals (EDCs)—specifically Bisphenol A (BPA), phthalates, cadmium, and lead—and the risk of polycystic ovary syndrome (PCOS), endometriosis, and endometrial cancer in women. Statistical analyses were performed using STATA/MP 17.0 across 22 studies encompassing 83,641 female participants aged 18 to 83 years.
What was found
Exposure to several plastic-related EDCs was significantly associated with elevated risks of estrogen-dependent conditions: - Endometriosis risk was significantly increased with BPA exposure (effect size [ES] 1.82, 95% CI: 1.50, 2.20), cadmium exposure (ES 2.54, 95% CI: 1.71, 3.77), lead exposure (ES 1.74, 95% CI: 1.13, 2.69), and the phthalate metabolites MEOHP (ES 1.87, 95% CI: 1.21, 2.87) and MEHHP (ES 1.98, 95% CI: 1.32, 2.98). - PCOS risk was significantly increased with BPA exposure (ES 1.61, 95% CI: 1.39, 1.85). - Endometriosis risk was not significantly associated with MBP (ES 1.07, 95% CI: 0.86, 1.33), MEP (ES 1.05, 95% CI: 0.87, 1.28), MEHP (ES 1.15, 95% CI: 0.67, 1.98), or MBzP (ES 0.97, 95% CI: 0.63, 1.49). - Cadmium exposure was not statistically significantly associated with endometrial cancer risk based on the reported effect size (ES 1.14, 95% CI: 0.92, 1.41).
Why it matters
This review synthesizes observational evidence linking everyday plastic-associated EDC and heavy metal exposures to increased risks of common female reproductive disorders, particularly endometriosis and PCOS.
Limits
The included literature consists of observational studies, precluding causal inference. The abstract does not detail study designs, heterogeneity levels, adjustment for confounders, or biological sample timing, and exhibits discrepancies between narrative conclusions and the reported effect sizes for certain phthalates.
Cited by
- supports In women, higher phthalate exposure is associated with irregular menstrual cycles and an increased risk of endometriosis.