Plasma phthalate and bisphenol A levels in children with cerebral palsy

Cerebral palsy (CP) is the most common motor disability of childhood. Bisphenol A (BPA) and phthalates are two of the most common environmental pollutants that have adverse effects on human health. This study aimed to determine concentrations of and potential sources of exposure to BPA and phthalates in children with CP. Children with spastic CP who admitted to the Child Neurology Outpatient Clinic of Mersin University Hospital between October 2020 and December 2020 were included in the study group, and 70 age- and gender-matched healthy children were included in the control group. Environmental history was recorded and plasma BPA, di-(2-ethylhexyl)-phthalate (DEHP), mono-(2-ethylhexyl)-phthalate (MEHP), and dibutyl phthalate (DBP) levels were measured by high pressure liquid chromatography. Multivariable logistic regression models were used to assess the predictors for the highest tertiles of BPA and phthalates. The median plasma BPA and DBP levels were not different between the CP and control groups (10.68 vs. 17.64 ng/mL and 0.25 vs. 0.26 µg/mL, respectively). The median DEHP and MEHP levels of the CP group were significantly lower than those of the healthy controls (0.33 vs. 0.42 µg/mL and 0.24 vs. 0.52 µg/mL, respectively). In CP group, plastic food containers or bags, personal care hygiene products, gender, heating system in the home, city water supply, and household cleaners were found to be associated with higher BPA and/or phthalate levels. In conclusion, CP is not associated with an increased risk of having higher levels of BPA or phthalates. Reducing the sources of BPA and phthalate exposure identified in this study may be a potentially protective intervention for preserving the residual motor, mental, and cognitive functions of children with CP.