A landmark international study has revealed that phthalates—a class of chemicals widely used in common household plastics—may be responsible for more than 350,000 deaths from heart disease around the world in a single year. The research specifically identifies di(2-ethylhexyl)phthalate (DEHP), a primary plasticizer in consumer products ranging from food packaging to personal care items, as a significant contributor to cardiovascular mortality, marking an urgent public health concern for both global and Thai communities (CNN, Washington Post, NYU Langone).
The importance of these findings for Thai readers cannot be overstated. Thais, like people worldwide, encounter phthalates daily through products such as food storage containers, cosmetics, cleaning agents, and even children’s toys. With heart disease already being the second leading cause of death in Thailand, understanding and responding to new environmental risk factors is crucial for individual families and health authorities alike (World Health Organization: Thailand NCD profile).
The study, published in eBiomedicine, analyzed DEHP exposure data and mortality statistics from over 200 countries, focusing on adults aged 55 to 64. Researchers estimated that DEHP exposure contributed to approximately 356,000 deaths worldwide in 2018 within this age group, accounting for more than 10% of all global mortality from heart disease among men and women of this demographic. The highest burden was observed in Africa (30% of deaths connected to DEHP), followed by East Asia and the Middle East (each 25%), underscoring the pervasive reach of this “everywhere chemical” (CNN).
Phthalates, including DEHP, are used to make plastics flexible and durable. They are found not only in food packaging but also in items such as PVC pipes, rain-resistant clothing, medical equipment, and fragrances. Exposure occurs through ingestion, inhalation, and skin contact—from eating processed foods, breathing contaminated air, or handling plastic products. According to the US Centers for Disease Control and Prevention, everyday habits like microwaving food in plastic containers or using scented personal care products can increase exposure risk (CDC: Factsheet, Wikipedia: Phthalates).
Cardiovascular toxicology expert from NYU Langone attributed these risks to phthalates’ ability to cause systemic and coronary artery inflammation, thereby accelerating atherosclerosis and triggering acute cardiac events. He further explained, “Phthalates are known to disrupt testosterone production, and low testosterone is a predictor of adult cardiovascular disease, particularly in men.” Earlier research led by the same group linked high urinary phthalate levels with elevated risks of early death from various causes, primarily cardiovascular events, even after adjusting for conventional risk factors and co-existing conditions.
Non-profit organizations such as the Environmental Working Group emphasize the vast health and economic burden of DEHP exposure. However, some limitations exist in the current study, such as basing global death estimates on US hazard ratios. This approach may not fully account for regional variations in exposure, cardiovascular care, and detection, a point raised by the group’s chief science officer in an email to CNN.
Thailand has its own unique context in the global story of plastic usage. The country is known as a major user of plastics and, until recent years, was one of the world’s top importers of plastic waste. Although Thailand banned certain categories of plastic waste imports in 2020, domestic demand for plastics remains high. The Ministry of Public Health, along with environmental protection agencies, has called for greater exposure monitoring and more stringent controls on plastic additives, yet regulatory gaps persist, and DEHP continues to be found in various locally sold products (Bangkok Post), (Ministry of Public Health: Plastics).
Internationally, phthalates, especially DEHP, have been regulated more aggressively in the United States, Canada, and European Union. These regions have banned or restricted their use in children’s toys, cosmetics, and food packaging. In contrast, regulatory action in Thailand is still developing, and enforcement remains challenging in the face of pervasive plastic production and consumption.
Phthalates are not only linked to heart disease. Past research has associated them with reproductive system disruptions, asthma, childhood obesity, cancer, and abnormal hormone function. For instance, DEHP exposure has been tied to reduced sperm counts and testosterone levels in males, genital malformations in infants, and increased risks of congenital heart disease, as documented in studies using both human epidemiological data and animal models (PubMed: Maternal DEHP exposure, Wikipedia: Phthalates).
Culturally, Thailand’s widespread use of single-use plastics, particularly for take-away food, presents specific risks. Many small vendors and local markets package ready-to-eat meals in plastic bags, sometimes containing hot, oily foods particularly likely to leach phthalates. This tradition, while convenient and affordable, may require reevaluation in the light of new health data. Experts also note that the tropical climate can increase the rate at which plastics degrade and release DEHP, especially when exposed to heat or sunlight.
Looking forward, there is rising concern in the Thai medical and public health community regarding environmental health hazards posed by plastics. The Royal College of Physicians of Thailand and local environmental research institutes have called for a coordinated effort to study and monitor phthalate exposure among Thai people, especially in urban areas with high plastic consumption. Advocacy groups are pushing government ministries to update product safety laws, improve labeling of plastic materials, and promote public education campaigns.
To help Thai families and consumers minimize phthalate exposure, researchers and health agencies recommend a series of practical steps: avoid microwaving or storing food in plastic containers, choose unscented or “phthalate-free” lotions and detergents, opt for glass, stainless steel, ceramic, or wood for food storage, and reduce consumption of canned or highly processed foods. Simple changes, such as regularly washing hands and steering clear of plastics labeled with recycling codes 3, 6, and 7, can also make a difference. Parents are especially urged to scrutinize children’s toys and avoid those that are not clearly labeled as plasticizer-free (CNN, CDC).
The implications of this research reach well beyond the academic community. As Thailand strives to reduce its burden of non-communicable diseases and create healthier environments, awareness of the hidden dangers in everyday products is more important than ever. For policymakers, the path forward could include tighter regulation of DEHP, investment in green alternatives for consumer products, and systematic national testing for phthalate metabolites in the population.
In conclusion, while household plastics offer convenience, the latest evidence urges caution—especially for Thais who already face high rates of heart disease. Reducing unnecessary plastic use, choosing safer packaging, and putting pressure on manufacturers for transparency can help make every home a healthier place. With support from health professionals and government regulators, Thai society can reduce phthalate risks while continuing to enjoy the affordable benefits of modern living.