National-scale urinary phthalate metabolites in the general urban residents involving 26 provincial capital cities in China and the influencing factors as well as non-carcinogenic risks

Phthalates (PAEs) are widely used in daily products but can cause a variety of adverse effects in humans. Few studies have been carried out on human internal exposure levels of PAEs on a large-scale, especially in developing countries. In the present study, 1161 urine samples collected from residents of 26 provincial capitals in China were analyzed for nine phthalate metabolites (mPAEs). The chemicals were widely detected, and the median specific gravity adjusted urinary concentration of Σ9mPAEs was 278 μg/L. Di-(2-ethylhexyl) phthalate (DEHP) and di-n-butyl phthalate (DnBP) were the main parent PAEs that the residents were exposed to. Demographic characteristics, such as age and educational level, were significantly associated with PAE exposure. Children and the elderly had higher mPAE levels. Subjects with lower educational levels were more frequently exposed to DnBP and DEHP. However, mono-ethyl phthalate showed the opposite trend, i.e., higher concentrations in subjects aged 18-59 years and with higher educational levels. Geographic differences were detected at the national scale. Residents in northeastern and western China had higher levels of mPAEs than those in central China, most likely because of different industrial usage of the chemicals and different living habits and living conditions of the residents. Health risk assessment showed that hazard indices of PAEs ranged from 0.07 to 9.34, with 20.0% of the subjects being concern for potential non-carcinogenic risk as assessed by Monte Carlo simulation. DEHP and DnBP were the primary contributors, representing 96.7% of total risk. This first large-scale study on PAE human internal exposure in China provides useful information on residents' health in a developing country, which could be used for chemical management and health protection.