Medical device-related exposures to phthalates by premature infants much too high

JHU Public Health recommend to use alternative products that don’t contain DEHP as initial step in reducing phthalate exposures during critical care

Hospitalized premature infants are exposed to unsafe levels of a chemical found in numerous medical products used to treat them, raising questions about whether critically ill newborns may be adversely affected by equipment designed to help save their lives.

Abstract

JHU Public Health
JHU Public Health recommend to use alternative products that don’t contain DEHP as initial step in reducing phthalate exposures during critical care.

Objective:
To assess the types and magnitudes of non-endocrine toxic risks to neonates associated with medical device-related exposures to di(2-ethylhexyl)phthalate (DEHP).

Study design:
Dose-response thresholds for DEHP toxicities were determined from published data, as were the magnitudes of DEHP exposures resulting from neonatal contact with polyvinyl chloride (PVC) devices. Standard methods of risk assessment were used to determine safe levels of DEHP exposure in neonates, and hazard quotients were calculated for devices individually and in aggregate.

Result:
Daily intake of DEHP for critically ill preterm infants can reach 16 mg/kg per day, which is on the order of 4000 and 160,000 times higher than desired to avoid reproductive and hepatic toxicities, respectively. The non-endocrine toxicities of DEHP are similar to complications experienced by preterm neonates.

Conclusion:
DEHP exposures in neonatal intensive care are much higher than estimated safe limits, and might contribute to common early and chronic complications of prematurity. Concerns about phthalates should be expanded beyond endocrine disruption.

Sources and more information
  • Phthalates and critically ill neonates: device-related exposures and non-endocrine toxic risks, Journal of Perinatology , doi:10.1038/jp.2014.157, 13 November 2014.
  • Premature Infants Are Exposed to Unsafe Levels of Chemical in Medical Products Used to Save Their Lives, Johns Hopkins Bloomberg School of Public Health, newswise, 10-Nov-2014.

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