Feminine hygiene products: A potential source of phthalate exposure among pregnant African American women in Atlanta, GA Open Access

Claire, Gursharan (2017)

Permanent URL: https://etd.library.emory.edu/concern/etds/6w924c74z?locale=en
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Abstract

Background: Phthalate acid esters, more familiarly known as phthalates, are a family of industrial chemicals that are commonly used in a variety of consumer products. Phthalate exposure is considered an environmental public health concern, because of their well-documented developmental, endocrine, and reproductive system toxicity. Phthalate exposure in the United States has been reported higher among African Americans than any other racial/ethnic group. Little research has been conduct on feminine hygiene product use as possible source of phthalate exposure.

Objective: To evaluate feminine hygiene products, as a hypothesized source of phthalate exposure, among pregnant African American women in Atlanta, GA.

Methods: The study population consisted of pregnant African American women, approximately 8-14 weeks' gestation with singleton pregnancies, who were free of chronic medical conditions, living in Atlanta, GA. Via survey questionnaire, women self-reported the use of feminine hygiene products: vaginal douches, feminine sprays, and vaginal creams. Spot urine samples were taken at the time of the survey. Samples were analyzed for phthalate concentration using HPLC-MS/MS. Descriptive statistics and univariate analysis was conducted on natural log transformed metabolite concentrations to determine differences in exposure among feminine hygiene product users and non-users. Multivariate logistic regression models were constructed to further examine the association between feminine hygiene product use and urinary phthalate metabolite concentrations.

Results: Both unadjusted and adjusted multivariate linear models did not report significant association between phthalate metabolite concentrations and self-reported feminine product use. In an adjusted model, women who reported any type of feminine product use in the past month, had a 32.53 % (95% CI: -66.01, 133.95) lower concentration of SMBzP than non-users (P-trend= 0.0339), suggesting a negative association. There was evidence of a positive association between vaginal spray use and MEP metabolite concentration (152.43% change; CI: -18.16, 778.67), but it did not reach statistical significance.

Conclusion: This study is only one, of few, to assess self-reported feminine hygiene product use as a source of phthalate metabolite exposure. Although this pilot analysis presented null results, evaluation can be conducted as more data is collected on this cohort. Since this study did not make any direct connections to adverse health effects, there is potential for further analysis and follow up with the infants in this study population as well.

Table of Contents

Table of Contents

INTRODUCTION ........................................................................... 7 Phthalates ................................................................................... 7 Health effects .............................................................................. 9 Phthalate Exposure ....................................................................... 10 Personal care products .................................................................. 11 METHODS .................................................................................... 13 Research Context .......................................................................... 13 Study Population ........................................................................... 13 Data Collection ............................................................................. 14 Survey Data ................................................................................. 14 Urine Sample ............................................................................... 15 Statistical Analysis ........................................................................ 16 Descriptive Statistics & Univariate Analysis ....................................... 17 Multivariate Analysis & Model Construction ....................................... 18 RESULTS ..................................................................................... 19 Demographic Characteristics and Feminine Hygiene Product Use ......... 19 Univariate Analysis ....................................................................... 20 Multivariate Linear Regression ........................................................ 21 DISCUSSION ............................................................................... 22 Study Limitations .......................................................................... 22 Study Strengths ........................................................................... 26 CONCLUSION ............................................................................... 26 REFERENCES ................................................................................ 28 TABLES & FIGURES ....................................................................... 32

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