Is there any association between phthalate exposure and precocious puberty in girls?

Considerable increase in the prevalence of precocious puberty (PP) during the last decade has raised a lot of concerns. Some environmental endocrine disruptor chemicals (EDCs), such as phthalate esters, have intrinsic estrogen activity or increase endogenous sex hormone levels leading to PP. This study was conducted to investigate the association between exposure to phthalate esters and PP in a sample of girls. Plasma levels of seven phthalate ester metabolites were measured in 87 girls with PP and 63 age- and sex-matched controls by dispersive liquid-liquid microextraction and GC/MS analysis. History of exposure to main sources of phthalates was obtained by a checklist. Diethyl hexyl phthalate (DEHP) metabolite levels were significantly higher in those with PP than that in controls (p < 0.05), but this difference was not significant for other phthalate metabolites. 30.1% girls with PP and 12.2% of controls had played for more than 2 h/day with plastic toys in their childhood. 65.1% girls with PP and 32.8% of controls have regularly used some cosmetic products. Consumption of bottled water and beverages by those with PP was about twofold higher than that in the control group. A positive correlation was found between bottled ware consumption and plasma concentrations of four phthalate metabolites. The frequency of seafood consumption was not significantly different between the groups studied. Our findings confirm positive association between phthalate exposure and incidence of PP in girls. Control and reduction of children exposure to phthalate esters should be considered as a health priority.