Article Impact Level: HIGH Data Quality: STRONG Summary of eBioMedicine, 105730. https://doi.org/10.1016/j.ebiom.2025.105730 Dr. Sara Hyman et al.
Points
- A recent study linked the plastic additive DEHP to 356,238 global cardiovascular deaths in 2018, accounting for 13.5 percent of all CVD deaths among people aged 55 to 64.
- The greatest burden of DEHP-related cardiovascular mortality was found in South Asia and the Middle East, where up to 16.8 percent of CVD deaths were attributed to DEHP exposure.
- Together, the Middle East, South Asia, East Asia, and the Pacific accounted for over 73 percent of DEHP-attributable cardiovascular deaths, revealing geographic disparities in health risk.
- DEHP exposure also caused an estimated 10.5 million years of life lost globally, underscoring its far-reaching impact on public health outcomes.
- The study calls for urgent international and regional regulations to reduce DEHP exposure and limit its growing contribution to cardiovascular disease mortality worldwide.
Summary
A recent study examined the global impact of di-2-ethylhexylphthalate (DEHP), a chemical additive in plastic polymers, on cardiovascular disease (CVD) mortality. Phthalates, particularly DEHP, are known to increase oxidative stress and contribute to metabolic dysfunction, both of which are linked to the development of CVD. The study utilized cardiovascular mortality data from the Institute for Health Metrics and Evaluation (IHME) and regional DEHP exposure estimates to calculate the burden of DEHP-related CVD mortality worldwide. Hazard ratios for cardiovascular mortality were computed based on exposure data, and excess deaths and years of life lost (YLL) due to DEHP exposure were calculated for each country.
The results revealed that, in 2018, DEHP exposure was responsible for approximately 356,238 cardiovascular deaths globally, representing 13.5% of all CVD deaths among individuals aged 55-64. The highest burden was seen in regions with developing plastic production sectors, such as South Asia and the Middle East, where 16.8% of CVD deaths were attributable to DEHP exposure. Notably, the Middle East, South Asia, East Asia, and the Pacific regions together accounted for 73.2% of global DEHP-attributable CVD deaths. Additionally, DEHP exposure resulted in 10.5 million years of life lost (YLL) globally, highlighting its substantial impact on public health.
This study underscores the significant contribution of plastics, particularly DEHP, to global cardiovascular mortality. The findings indicate that the cardiovascular risks associated with DEHP disproportionately affect regions with emerging plastic industries. The study advocates for urgent regulatory interventions at both global and local levels to mitigate the health risks posed by DEHP exposure and to reduce its contribution to global CVD mortality.
Link to the article: https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(25)00174-4/fulltext
References Hyman, S., Acevedo, J., Giannarelli, C., & Trasande, L. (2025). Phthalate exposure from plastics and cardiovascular disease: Global estimates of attributable mortality and years life lost. eBioMedicine, 105730. https://doi.org/10.1016/j.ebiom.2025.105730
