Conclusions
This study is the largest to date to evaluate associations between phthalates and allergic sensitization and symptoms in both adults and children. Although not entirely consistent with previous studies, our study does provide additional evidence that phthalates, particularly HMW phthalates, may be associated with allergic symptoms in adults and possibly children. The findings were stronger in adults because HMW phthalates were generally positively associated with both allergic sensitization and symptoms in adults, but positively associated only with rhinitis in children. The inverse association estimated for MEP and allergic sensitization is consistent with avoidance of compounds containing DEP by people who are allergen sensitized. We conducted this cross-sectional analysis of urinary phthalate levels and allergic sensitization and symptoms in a large nationally representative racially diverse sample, although generalizability to younger children is limited by the lack of phthalate data for children < 6 years of age. Future studies should not only better characterize the temporal association between exposure and outcome, but they should also include measures such as allergen exposure in order to better understand the potential mechanisms by which phthalates may contribute to allergic outcomes.