Impact of Phthalate and Microplastic Exposure on Childhood Allergic Diseases: A Review of Epidemiological Evidence and Mechanisms

BACKGROUND: Phthalates are global pollutants with an annual consumption of 8.4 million tons, frequently leaching from products into the environment. Their widespread use parallels the rising prevalence of childhood allergic diseases, such as asthma and atopic dermatitis. OBJECTIVE: This review summarizes epidemiological and molecular evidence regarding the impact of phthalate and microplastics (MPs) exposure on the development of childhood allergies. METHODS: A comprehensive review of English-language literature from the last decade was conducted via PubMed, using keywords including "phthalates," "childhood allergy," and "microplastics." KEY FINDING: Exposure sources shift across developmental milestones, involving personal care products, house dust, and food. Research indicates that low molecular weight phthalates are strongly associated with respiratory issues, while high molecular weight variants correlate with asthma severity and skin barrier dysfunction. MPs act as both physical stressors and chemical vectors, inducing oxidative stress and NF-κB activation. Mechanistically, these pollutants function as environmental adjuvants that promote Th2-polarized immune responses and disrupt epithelial integrity. Additionally, MPs may heighten food allergy susceptibility by altering gut microbiota and increasing intestinal permeability. CONCLUSION: While evidence suggests a link between plastic-derived chemicals and allergic diseases, some associations remain inconsistent, necessitating further research into the cumulative risks of chemical mixtures. There is an urgent need for increased awareness among healthcare providers to promote safer alternatives for vulnerable children.