Lately, it seems like a new study on the health impacts of phthalates comes out every week. The chemicals are everywhere: they’re used in everything from household cleaners to food packaging to fragrance, cosmetics, and personal-care products.

In 2003, researchers at the US Center for Disease Control documented widespread exposure to a high level of a group of chemicals called phthalates (pdf) across the general American public. The chemicals act as binding agents and also make plastics flexible.

The CDC recommended that the chemicals and their effect on human health be studied further, a recommendation that helped unlock funding for dozens of studies focused on phthalates, resulting in a tidal wave of recently published reports that largely indicate the CDC’s concern was warranted.

The CDC’s warning on phthalates also caught the attention of senators Barbara Boxer and former US representative Henry Waxman, who included the class of chemicals in their Consumer Product Safety bill, passed in 2008. That bill banned the use of some phthalates in children’s products, passed an interim ban on others, and required that the Consumer Product Safety Commission take a close look at the chemicals.

The resulting report on phthalates – the Chronic Hazard Advisory Panel (Chap) on Phthalates (pdf) – was finalized in late 2014, and despite the chemical industry’s efforts to soften the commission’s recommendations, public health advocates are largely pleased with the effort, a rarity when it comes to government-penned reports on chemical safety.

With academic studies and policy reports consistently voicing concern over the health impacts of phthalates, and consumers beginning to sit up and take notice, regulation may not be far behind.

“The Chap report is the first major regulatory document in the federal government that’s highlighting the extent of the new science on the risks of phthalates,” says Erik Olson, senior strategic director of food and agriculture and health programs for the Natural Resources Defense Council. “The fact that the commission is looking both at phthalates as a group and at the toxicology of individual phthalates is really important,” he says.

Olson was the deputy staff director for the US Senate’s environment and public works committee when the Consumer Product Safety Bill was written and passed. Between the Chap report, a National Academy of Sciences report looking at phthalates as a class and what he calls “the tidal wave of research that’s been coming out fast and furious” in the past year or so, he said, “we’re getting past the phase of complete denial from the industry – they can no longer claim that there’s no risk at all with phthalates.”

What’s the harm?

Name a major public health concern over the past two decades and there’s likely some link to phthalates exposure.

In the past few years, researchers have linked phthalates to asthma, attention-deficit hyperactivity disorder, breast cancer, obesity and type II diabetes, low IQ, neurodevelopmental issues, behavioral issues, autism spectrum disorders, altered reproductive development and male fertility issues.

While phthalates is a huge class of chemicals and nowhere near every chemical in the class has been studied, several have been shown to have negative health impacts: butyl benzyl phthalate (BBzP), dibutyl phthalate (DnBP), di-2-ethylhexyl phthalate (DEHP), diethyl phthalate (DEP), di-butyl phthalate (DBP), benzyl butyl phthalate (BBP), diisobutyl phthalate (DiBP), diisononyl phthalate (DiNP), di-n-octyl phthalate (DnOP), dipentyl phthalate (DPP), di-isobutyl phthalate (DiBP), di-isononyl phthalate (DiNP), di-n-octyl phthalate (DnOP), di-isohexyl phthalate, dicyclohexyl phthalate (DcHP), and di-isoheptyl phthalate.

Enough distinct phthalates have been studied to indicate that companies should proceed with caution when using any chemical in the phthalate class, particularly in products for pregnant women or young children, whom the research has indicated are the most vulnerable to the effects of phthalates.

One of the first phthalates to raise a red flag, DEHP, was replaced in hundreds of consumer products with DiNP, only for researchers to discover a few years later that exposure to DiNP is correlated to male genital birth defects and impaired reproductive function in adult males.

Public health advocates hope to learn from the mistakes made in regulating bisphenol A (BPA) as momentum gathers behind the regulation of phthalates, and ensure that one harmful phthalate isn’t just replaced with another over and over again.

BPA was singled out as the sole chemical of concern in the bisphenol group, and regulated as such. Manufacturers largely replaced BPA with bisphenol S (BPS), which researchers are now discovering is equally as problematic as BPA.

With phthalates, the research has come before any sort of regulation – companies are not even required to list phthalates on consumer product labels – and legislators are already looking at the entire class of chemicals, as well as any particularly bad ones.

No escape

Both because of their ubiquitous usage and because they are not listed on product labels, phthalates are next to impossible to avoid. They are in household items (vinyl flooring), personal care products (hair care, body wash, some cosmetics), fragrance, household cleaners, and food. Even for those who either avoid these products or buy phthalate-free variations, phthalates lurk in unexpected places.

In food, for example, even milk packaged in glass may have passed through plastic tubes on its way from the cow to the bottle, taking DEHP along with it. “Milking machines use a lot of plastic and DEHP is free and very lipophilic (fat soluble), and milk is full of lipids, so it just pulls the DEHP out of the plastic tubing and into the milk,” explains Robin Whyatt, professor of environmental health sciences at the Columbia University Medical Center and the lead author on several landmark phthalate studies. “So my guess would be that milk is a pretty important source of dietary exposure to DEHP.”

Spices are another surprising source of phthalate exposure. A 2013 study, published in the journal Nature, compared the phthalate levels of two groups, one eating their regular diet but armed with a handout of recommendations for ways to reduce BPA and phthalate exposure in their diet, and the other eating a catered diet consisting solely of local, organic fare, none of which had touched plastic packaging. The study authors were shocked to find that DEHP levels in the local, organic group jumped 2,377% over the course of the experiment. Determined to figure out why, the researchers tested all of the foods consumed by the group and found high levels of the phthalate in dairy products and various organic, imported spices.

“The fact is you can’t know if a food has phthalates in it – you can suspect, but it’s almost impossible to know,” Olson says. “That makes them hard to avoid, which is why you need a regulatory framework.”

What now?

Regulation of consumer products moves slowly in the US, and that has proven to be especially true when it comes to chemicals. Despite the recent movement on phthalates, Olson says it is likely to be a long time before we have the sort of wide-reaching framework that would adequately protect the public from harmful exposure.

That doesn’t mean all is lost in the meantime. State and federal regulations have already eliminated the chemicals from some products, and that list is likely to grow. California’s Proposition 65 now includes four phthalates – DINP, DEHP, DBP and BBP – under its labeling requirements, and the state’s Office of Environmental Health Hazard Assessment (OEHHA) recently proposed changes to Prop 65’s warning requirements, which would require manufacturers to list specific chemicals in their warnings and make those warnings more detailed (currently the warnings are vague, stating only “this product [or building] contains substances known by the state of California to cause cancer”).

“Prop 65 will be a driving force for change on phthalates,” Olson says. “Companies don’t like to put warning labels on their products.”

Consumers can also take matters into their own hands by avoiding products packaged in “recycling-code-3” plastic, products that include the vague ingredient “fragrance” on their label, and purchasing organic products packaged in glass as much as possible.

Whyatt also recommends that consumers remove any food packaged in plastic from its packaging and place them in glass. “DEHP continues to leech over time, so you do actually reduce exposure by changing the storage container, even if it’s been in plastic before you bought it,” she says. “All the DEHP has probably not come out yet by the time you get it home. And if there’s still DEHP in there, it’s probably still leeching out, so you can at least reduce your exposure some extent.”

“If we start by addressing the products where we know there’s significant exposure to phthalates, and we start with the most vulnerable communities – pregnant women and children – we can make a real difference,” Olson said. “We could take care of a lot of food exposure through FDA regulation and toys through the Consumer Product Safety Commission, and that’s a lot. It’s not all, but it’s a good chunk.”

Retailers could also play a significant role, as they have with other chemicals of concern. Target and Walmart both launched initiatives to reduce or eliminate toxic chemicals from their shelves last year. Both retailers have said they will make evidence-based purchasing decisions to protect their customers’ health. With a mountain of scientific evidence piling up on phthalates, it can’t be long before consumers begin to put pressure on retailers and retailers in turn push their suppliers to find both alternatives to phthalates and ways to remove the chemicals from their products altogether.

Phthalates can fairly simply be removed altogether from products, with no replacement, according to “green” chemist Bruce Akers. It’s when the chemicals are used to create tubing or packaging that eliminating them becomes tougher: “If you want soft, squeezable plastic, you’re using phthalates,” Akers says.

But according to Whyatt, companies could be using flexible polymers instead. “There are flexible polymers that don’t require a plasticizer – they exist,” she says. “They haven’t been studied really, so we need to know more, but they probably do not leech the way phthalates do. The problem with phthalates as plasticizers is that they’re free floating, they don’t attach to the polymer, so they leech easily. If you have a flexible polymer that shouldn’t happen.”

Despite the size of the issue, Olson remains positive. “We’ve turned a corner on the regulation of phthalates,” he says. “They’re extremely widely used in the economy and it won’t be overnight that we’ll see widespread phase-outs, but clearly we’ve crossed the river and we’re now at the point of debating exactly which uses need to go and where we can use alternatives.”