Chronic exposure to phthalates in drinking water: The implications on public health

Phthalates are the most prevalent plasticizers and are known for their endocrine-disrupting properties, hence posing significant concerns. As a vital component of daily intake, phthalate contamination in drinking water poses risks to human health, yet the concept of phthalate as lifelong exposome through drinking water remains underexplored. This review summarizes phthalates levels throughout the drinking water system, including raw water sources, drinking water treatment plants, tap water, and bottled water, highlighting instances where concentrations reaching 1438 μg/L in municipal tap water, far exceeding the World Health Organization guideline of 8 μg/L in some areas. Secondary contamination from plastic water pipes and various water filter elements contributes to the diversity of phthalates, with up to 22 phthalate types present in drinking water. We emphasized that the chronic exposure to phthalates in drinking water leads to bioaccumulation, resulting in health implications across different age groups, for instance, reproductive dysregulation, neurological disorders, and other chronic diseases such as obesity and hypertension. Utilizing the Ecological Structure Activity Relationships (ECOSAR) framework, we evaluate the acute and chronic toxicity of phthalates, revealing that phthalates toxicity aggravates with structural complexity, and chronic toxicity significantly more complicated than acute toxicity. The potential health risks caused by phthalates, particularly their cumulative chronic toxicity and lifelong exposome through contaminated drinking water, necessitate proactive and pre-emptive measures.