The plastic containers in your kitchen, the shiny wrappers around snacks, and even your cosmetic bottles might be silently contributing to one of the deadliest public health crises facing India today. A landmark global study, recently published in The Lancet eBiomedicine, has revealed that a widely used plastic chemical called di(2-ethylhexyl) phthalate (DEHP) is responsible for over 1 lakh deaths annually in India, making the country the worst-hit in the world from plastic-linked cardiovascular fatalities.
The study warns that phthalates, a class of chemicals added to plastics to make them more flexible and durable, are strongly linked to increased risk of heart disease. These chemicals are found in common consumer products like food packaging, plastic containers, cosmetics, lotions, soaps, and even medical devices such as IV bags and blood storage units. DEHP, in particular, has emerged as a leading contributor to premature cardiovascular deaths among adults aged 55 to 64 years, primarily by triggering inflammation and disrupting hormone function.
According to the study, which used health and environmental data from more than 200 countries and territories, DEHP exposure caused 103,587 deaths in India in 2018 in the 55–64 age group alone. That figure is significantly higher than the 60,937 deaths in China and 19,761 in Indonesia from the same chemical exposure. In terms of cumulative impact, India also lost 2.9 million years of life due to these early deaths—far more than any other nation. The researchers measured this through years of life lost (YLL), an indicator of the number of years a person would have lived had they not died prematurely.
The findings point to a worrying pattern in India’s rapidly changing lifestyle and environment. Urban residents, who rely more heavily on processed and packaged foods, face higher levels of exposure to plastic-based products. Women, too, are particularly vulnerable, as they tend to use more personal care products that contain phthalates, such as perfumes, moisturisers, and cosmetics. Experts believe that India’s fast-growing plastics industry, paired with weak regulatory oversight and low public awareness, has created the conditions for a widespread and largely invisible health crisis.
Led by researchers from NYU Langone Health, the study highlights the role of phthalates in disrupting the body’s endocrine system and promoting inflammation in blood vessels—two major risk factors for heart attacks, strokes, and high blood pressure. In total, the study attributes 356,238 cardiovascular deaths globally in 2018 to DEHP exposure among those aged 55 to 64, making up over 13 percent of heart-related mortality in that age group worldwide.
“This is not just about plastics anymore. It’s about public health on a massive scale,” said Sara Hyman, the study’s lead author and an Associate Research Scientist at NYU Grossman School of Medicine. “By connecting phthalates to a leading cause of death globally, our findings confirm the tremendous danger these chemicals pose to human health.”
The economic costs are equally staggering. The study estimates that the global financial burden of DEHP-linked heart disease may be as high as $3.74 trillion, factoring in lost productivity, medical expenses, and years of life lost. In India, these costs are compounded by a rapidly aging population, growing plastic waste, and widespread use of unregulated products containing phthalates.
The researchers also drew attention to India’s ballooning plastic consumption. According to the latest data cited in the study, India emitted 9.3 million metric tonnes of plastic waste in 2024—the highest volume in the world. Southern Asia, Sub-Saharan Africa, and Southeast Asia were collectively identified as the regions most affected by plastic emissions, and, not coincidentally, also among those bearing the heaviest health burdens from DEHP exposure.
Although India has recently introduced restrictions on the use of DEHP in food packaging, enforcement remains weak and regulations for non-food products, such as cosmetics and medical plastics, are either limited or absent. “Our analysis shows a clear link between the scale of plastic production and the rise in heart disease burden, particularly in countries like India where industrialisation and plastic use are growing rapidly but regulatory frameworks remain underdeveloped,” said the study.
The disparity between countries is stark. While nations like the United States and members of the European Union have moved to restrict or phase out the use of certain phthalates, countries in Asia, particularly those undergoing rapid industrial expansion, continue to rely heavily on these toxic additives. This has left their populations disproportionately exposed to dangerous chemicals, often without their knowledge.
Senior author Leonardo Trasande pointed out the urgent need for coordinated international regulation. “There is a clear disparity in which parts of the world bear the brunt of heightened heart risks from phthalates,” he said. “Our results underscore the urgent need for global regulations to reduce exposure to these toxins, especially in areas most affected by rapid industrialisation and plastic consumption.”
As India continues to urbanize and its middle class grows, the reliance on plastic products—from food delivery and grocery storage to cosmetics and hospital supplies—is expected to surge even further. Without stricter oversight and public awareness, the hidden costs of convenience could translate into millions of avoidable deaths and untold economic loss in the coming years.
The study serves as a grim reminder that while plastics may seem like a symbol of modern convenience, their long-term health impact could be far more lethal than previously thought. With India already leading the world in DEHP-related deaths, experts warn that the country must act swiftly to curb plastic-related chemical exposure, tighten regulations, and educate the public about the invisible risks lurking in their daily lives.