Two chemicals used to make plastic flexible, DEHP (di-2-ethylhexylphthalate) and DiNP (diisononyl phthalate), are linked to nearly 2 million premature births and 74,000 newborn deaths worldwide in 2018, according to new research published in eClinicalMedicine. The findings underscore how pervasive these synthetic chemicals are in everyday consumer products, raising questions about exposure across all age groups and populations.

Phthalates are a family of synthetic chemicals added to plastics to make them more flexible and durable. They're called "everywhere chemicals" because they appear in countless consumer products: children's toys, art supplies, food storage containers, vinyl flooring, shower curtains, garden hoses, and medical devices. They also help lubricate substances and carry fragrances in personal care products like deodorants, nail polishes, perfumes, hair gels, shampoos, soaps, and body lotions.

What Makes Phthalates So Dangerous?

Phthalates interfere with the body's hormone system, known as the endocrine system. Even small hormonal disruptions can cause significant developmental and biological effects, according to the National Institute of Environmental Health Sciences. Research has linked phthalates to reproductive problems such as genital malformations and undescended testes in baby boys, lower sperm counts and testosterone levels in adult males, childhood obesity, asthma, cardiovascular issues, and cancer.

"This is a dangerous class of chemicals," said Dr. Leonardo Trasande, senior author of the new study and the Jim G. Hendrick, M.D., Professor of Pediatrics at NYU Langone's Grossman School of Medicine in New York City.

Dr. Leonardo Trasande, Professor of Pediatrics at NYU Langone's Grossman School of Medicine

The new study examined the effects of DEHP and DiNP across 200 countries and territories in 2018, pulling data from large national surveys in Canada, Europe, and the United States as well as estimates from regions without their own data collection. Africa, the Middle East, and South Asia carried the brunt of the premature health burden, with some of those areas having rapidly growing plastics industries and high levels of global plastic waste.

How Do Phthalates Harm Developing Babies?

Although more research is needed, scientists have identified several pathways through which phthalates may contribute to preterm birth. One key mechanism involves disruption of placental function, which has been documented to be affected by phthalates and other endocrine-disrupting chemicals. The placenta, which attaches to the uterine wall, provides oxygen, nutrients, and immune support to the developing fetus. When placental function is compromised, it can trigger complications that lead to premature birth.

Inflammation caused by phthalate exposure may also impair placental adhesion and facilitate ruptured membranes, according to Dr. Trasande. Ruptured membranes, a lack of adhesion to the uterine wall, and a loss of key nutrients to the fetus may trigger uterine contractions and early labor. Babies who survive premature birth may face breathing problems, feeding difficulties, cerebral palsy, developmental delay, vision problems, and hearing problems, according to the U.S. Centers for Disease Control and Prevention.

Dr. Trasande

Prematurity is on the rise in the United States and other nations. About 1 in 10 infants in the U.S. was born premature in 2024, according to the 2025 March of Dimes Report Card.

Ways to Reduce Phthalate Exposure in Your Home

• Minimize Flexible Plastic Use: Reduce reliance on flexible plastic products in the kitchen and home. Replace plastic food storage containers with glass alternatives, and avoid plastic wrap when possible, as phthalates are used in cling-type plastic wrapping commonly used in food packaging.
• Choose Natural Personal Care Products: Since phthalates help carry fragrances in deodorants, nail polishes, perfumes, hair gels, shampoos, soaps, and body lotions, look for fragrance-free or naturally scented alternatives that do not rely on phthalate carriers.
• Avoid Vinyl and PVC Products: Vinyl flooring, shower curtains, and other PVC-based household items often contain phthalates. When replacing these items, opt for natural materials like wood, ceramic tile, or plant-based alternatives.
• Check Product Labels: While not all manufacturers disclose phthalate content, look for products labeled "phthalate-free" or "non-toxic." Third-party certifications provide additional assurance that products have been tested for harmful chemicals.

The good news is that phthalates have a short half-life and leave the body within a few days, meaning that careful planning to avoid plastics can have a significant impact. For expecting families and mothers looking to minimize exposure, reducing contact with flexible plastics during pregnancy and early childhood is one of the most practical steps available.

Why Aren't These Chemicals Already Banned?

In 2008, the U.S. banned DEHP in concentrations greater than 0.1% in children's toys and child-care articles, and two states, California and North Carolina, are working to ban DEHP in IV solution bags. However, manufacturers often respond to chemical bans by switching to replacements that may carry similar or worse risks. DiNP, now under scrutiny in the new study, became a common replacement for DEHP.

"We are playing a dangerous game of Whac-A-Mole with hazardous chemicals. We have a situation in which concerns come up about one chemical, and industry simply replaces it with a chemical analog that may have the same, if not worse, effects," said Dr. Trasande.

Dr. Leonardo Trasande, Professor of Pediatrics at NYU Langone's Grossman School of Medicine

The American Chemistry Council's High Phthalates Panel told CNN that the U.S. Environmental Protection Agency conducted a comprehensive risk evaluation of DiNP and concluded that it does not pose an "unreasonable risk of injury to human health for consumers, the general population, or the environment". However, the council provided no comment on DEHP.

Dr. Trasande and other experts are calling for a global plastic treaty that limits chemicals of concern commonly used in plastics, which would provide more comprehensive protection than current piecemeal bans. Until such regulations are in place, reducing personal exposure through informed consumer choices remains one of the most effective strategies available.