A recent global study has raised alarm about the widespread use of phthalates—common chemicals found in everyday plastics—linking them to hundreds of thousands of heart disease deaths worldwide. The research, published this week in the journal eBioMedicine by a team at New York University’s Grossman School of Medicine, estimates that in 2018, phthalate exposure contributed to 350,000 cardiovascular deaths, particularly among adults aged 55 to 64 years old. This translates to approximately 13% of heart disease deaths in that age group, underscoring the potential public health threat posed by chemicals commonly used in food packaging, toiletries, toys, and household products [NYTimes].
For Thai readers, this research is particularly significant as Thailand continues to industrialize rapidly, with widespread consumption of processed foods and plastic-packaged goods. The findings add to already heightened concerns about environmental pollutants and non-communicable diseases, both of which are national health priorities.
Phthalates, often described as “plasticizers,” are added to plastics to improve flexibility and durability. They are widely found in products ranging from shampoo and lotions to food containers, vinyl flooring, and children’s toys. Humans are exposed to them daily—through ingestion of contaminated food, absorption via skin contact, and even inhalation of dust carrying these substances. Several studies have already implicated phthalates as endocrine disruptors, substances that disturb the body’s hormonal balance and are associated with reproductive health problems, pregnancy complications, birth defects, obesity, and Type 2 diabetes [U.S. CDC; WHO].
The new study focused on a specific phthalate known as DEHP, one of the most common compounds in vinyl products such as shower curtains, tablecloths, and hospital equipment. Researchers used previous exposure and disease data to estimate the global toll of DEHP on heart deaths. They found that nearly three-quarters of these deaths occurred in the Middle East, South Asia, East Asia, and the Pacific—regions that include Thailand and where plastic use and pollution are particularly pronounced.
However, experts caution that the study’s alarming figures are based on complex statistical modeling that relies on existing, sometimes imperfect, data. “This is an early step of trying to understand the magnitude of the problem,” explained a cardiologist and global health center co-director at Washington University in St. Louis. He added that the precise number of deaths attributable to phthalates is difficult to determine due to the use of assumptions and estimates within the modeling process. A professor of epidemiology and environmental sciences at the University of Michigan also expressed skepticism, pointing out that while there is clear evidence phthalates are linked to metabolic disorders and possible cardiovascular risks, direct causation has not been conclusively established. The challenge lies in separating the effects of phthalate exposure from confounding factors such as socioeconomic status, dietary habits, and lifestyle, which themselves strongly influence cardiovascular disease rates.
Thai environmental health specialists, while not named in this report, have pointed out in public health forums that Thailand faces growing plastic waste issues. As one official at the Ministry of Public Health noted earlier this year, the nation’s heavy reliance on takeaway and packaged foods—exacerbated by urbanization and lifestyle changes—makes broad swaths of the population vulnerable to potential phthalate exposure.
Historically, Thai society has undergone immense dietary and environmental changes over the past few decades, shifting from traditional market food wrapped in banana leaves to convenience-oriented, plastic-packaged products. These changes have been tied to rising rates of obesity, diabetes, and heart disease across all age groups. Medical experts at leading Bangkok hospitals have also expressed concern about imported consumer products containing unknown or poorly regulated chemical additives.
The new research suggests that one pathway by which phthalates may influence heart health is by increasing oxidative stress and inflammation in the human body. This cellular stress can play a critical role in the development of atherosclerosis and other cardiovascular diseases. The study’s senior author, a professor of pediatrics and population health at New York University, emphasized that any increase in risk, even if small, can result in a sizable health burden at the population level due to the ubiquity of phthalate exposure.
Despite the strong association uncovered by the research, limitations persist. The study relies on data and risk estimates from other countries, such as the United States, which may not be entirely applicable to diverse populations worldwide, including Thailand. Different dietary habits, healthcare access, pollution levels, and genetic backgrounds vary greatly across regions. Therefore, the results, though concerning, should be interpreted with caution, say experts.
On the policy front, an environmental health program director at the University of California, San Francisco, contends that, regardless of precise numbers, evidence continues to mount against the safety of phthalates—not just for heart health but for reproductive outcomes as well. She advocates for proactive reductions in phthalate use in consumer products, a sentiment echoed by Thai and international public health advocates.
Looking forward, experts agree the next step should involve large, long-term studies that track phthalate exposure and cardiovascular outcomes among diverse groups. “A more representative sample that measures exposure and follows people over time would shed more light on this link,” one epidemiologist said in commentary on the research. In practical terms for Thailand, this would mean independent studies sampling populations in both urban and rural areas, given the country’s diversity in plastic use, socioeconomic status, and health outcomes.
Thai regulatory agencies have begun to pay attention, although progress remains slow. The Thai Food and Drug Administration (FDA) has issued guidelines restricting certain phthalates in toys and food packaging, and the Pollution Control Department has encouraged municipalities to reduce single-use plastics. Recent campaigns, such as “Say No to Plastic Bags” at convenience stores, though impactful, represent only initial steps toward broader control of chemical exposures.
Culturally, many Thais still possess knowledge from previous generations on how to avoid plastic in daily life, such as using woven baskets, ceramic tiffins, or wrapping food in banana leaves—methods that are both environmentally friendly and reduce chemical exposure. As modern consumer trends continue to dominate, a blend of innovation and tradition could be the way forward for Thai families hoping to minimize their exposure to plastics and their chemical byproducts.
In the future, sustained public health messaging, more transparent product labeling, and continued research partnerships with universities and international agencies will be needed to clarify the risks and guide safer behavior. Potential technological innovations—such as biodegradable packaging and new food preservation methods—also hold promise for reducing phthalate exposure at a systemic level.
For now, Thai readers can take concrete steps to protect themselves and their families by minimizing the use of plastic containers for hot foods, choosing fresh foods wrapped in natural materials when possible, ventilating living spaces to reduce dust exposure, and staying informed about chemical safety. Parents may wish to choose toys made of wood or natural materials and limit the use of personal care products with unknown chemical content. Finally, as citizens, Thais can advocate for stricter safety standards, clearer labeling, and continued investment in scientific research on the health effects of everyday chemical exposure.
More research is clearly needed to solidify our understanding of the true impact of phthalates on heart health. Yet, as evidence grows, a cautious approach—rooted in both modern science and Thai wisdom—represents the safest path forward.
Sources: The New York Times, US CDC - Phthalates Factsheet, World Health Organization - Endocrine Disruptors