soil and air. Phthalates are carcinogenic and can affect the immune sytem, reproduction and development in the human body. The well-known endocrine disruptor is
diethylhexyl phthalate (Lu et al. 2018), and the compounds causing endocrine
disruption, including BPA, have also been linked to causing hormonal imbalance
and increased breast cancer incidence (Shafei et al. 2018). The tubes and catheters used during hemodialysis are often made up of polyvinyl chloride and additives
are used to enhance the utility of the polymer. As a result, dialysis patients may
interact with phthalates because the tubes and containers used during the blood
transfusion also contain considerable amount of phthalates (Tereshchenko and
Posnack 2018). Fig. 2.16 shows the types of diseases caused by various plastic
additives. These additives mainly target reproductive/endocrine, brain/nervous, and
pulmonary cardiovascular organs (Shafei et al. 2018).
Fig. 2.15 Different types of phthalates with their structural formulas (BzBP, benzyl butyl phthalate; DMP, dimethyl phthalate; DEP, diethyl phthalate; DnBP, di-n-butyl phthalate;
DiNP, diisononyl phthalate; DEHP, diethylhexyl phthalate; DiBP, di-isobutyl phthalate). (Modified
from Pecht et al. 2018)
72
Z. Tahir et al.