Plasticizers are chemicals found in cosmetics, food packaging and other sources that improve plastics’ durability and flexibility. In the December 2025 issue of The Lancet Planetary Health, researchers reported an association between greater exposure to a mixture of common plasticizers and an increased risk of cardiovascular mortality, cancer mortality and mortality from any cause during an average 8.5-year follow-up period.¹ However, the risk was only found among a group of individuals who had the lowest red blood cell folate and serum vitamin D levels.

“Although humans are exposed to complex mixtures of plasticizer chemicals that share common exposure sources and can interact with each other, leading to synergistic or antagonistic actions, no previous study has examined the contribution of plasticizer mixture exposure to mortality risk,” authors Yu Zhang, PhD, and colleagues announced.

The study found that exposure to a mixture of eight phthalate metabolites and bisphenol A was associated with a greater risk of cancer, cardiovascular disease and all-cause mortality during follow-up. This association was observed only among individuals whose red blood cell folate and serum vitamin D levels were among the lowest one-third of people included in the study. “These findings highlight the enormous health burden posed by human exposure to plastic-associated chemicals, urging efforts to intervene and reduce exposure levels, optimize folate and vitamin D status, and regulate chemicals on a mixture basis,” Dr. Zhang and associates wrote. They suggested that the vitamins may act by counteracting oxidative stress associated with plasticizer exposure.

The study included 8,378 adults enrolled in the US National Health and Nutrition Examination Survey 2005–16. Researchers divided the individuals in the study into thirds according to their urinary levels of eight phthalate metabolites plus bisphenol-A. During the 8.5-year follow-up period, 633 deaths occurred. At least 10% of total deaths were associated with each one-third increase in urinary levels of the plasticizer mixture.