Phthalate and Nonphthalate Plasticizer Exposure among Children of Korea, Thailand, Indonesia, and Bangladesh: Occurrences and Risk Comparison.

Children are considered vulnerable to plasticizer exposure and related adverse health effects. In many Asian countries, however, the extent of plasticizer exposure among children is poorly understood despite the increasing use of plasticizers. This study compared plasticizer exposure levels and risks among children in four Asian countries and investigated the major risk drivers. Children aged 6-14 years old were recruited between 2022 and 2023 from Korea ( = 89), Thailand ( = 111), Indonesia ( = 100), and Bangladesh ( = 100). They were measured for major metabolites of phthalates and nonphthalate plasticizers in the first morning void urine. Indonesian and Bangladeshi children showed higher exposure to phthalates but lower exposure to nonphthalate alternatives. At the same time, children from Thailand and Korea exhibited a greater transition to the alternatives. In all countries, DEHA contributed to over 80% of the total estimated daily intake (EDI) for all plasticizers. Bangladeshi children exhibited 1.5-2 times greater total plasticizer exposure than the children of the other countries across all EDI quartiles. Among the high-risk subgroup (within the top 25th percentile of the hazard index), DEHP accounted for 62 and 52% of the cumulative risk in Indonesia and Bangladesh, while DnBP contributed to 63 and 54% in Thailand and Korea, respectively. Our observations reveal critical disparities in plasticizer exposure among Asian children, highlighting an urgent need for follow-up investigations on the exposure sources of major risk drivers and region-specific interventions.