(Press-News.org) 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.
The chemical, di(2-ethylhexyl)phthalate (DEHP), is used to increase flexibility of many plastic devices. These products, made from polyvinyl chloride (PVC), include most intravenous tubing, catheters, endotracheal tubes, and fluid and blood product bags. DEHP doesn't bind chemically to PVC, and is able to leach into fluids and body tissues in contact with it. New Johns Hopkins Bloomberg School of Public Health research suggests that critically ill preterm infants may be exposed to DEHP at levels approximately 4,000 to 160,000 times higher than those believed to be safe. Infants can receive high exposures to DEHP during weeks to months of treatment in a hospital's neonatal intensive care unit (NICU).
The results are reported online Nov. 13 date by the Journal of Perinatology.
"It's remarkable that the care of sick and developmentally vulnerable preterm infants depends on an environment composed almost entirely of plastic," says neonatologist Eric B. Mallow, MD, MPH, a senior research program coordinator at the Bloomberg School and the study's leader. "The role of these synthetic materials in the clinical course of our patients remains almost completely unexplored. PVC is the predominant flexible plastic in most NICUs, and this can result in considerable DEHP exposures during intensive care."
Mallow and co-investigator Mary A. Fox, PhD, MPH, an assistant professor in the Department of Health Policy and Management, reviewed and analyzed previously published studies of DEHP and its potential risks. Nearly all public attention to the health effects of phthalates, for both the general population and hospitalized patients, has focused on their role as endocrine disruptors - substances that can interfere with normal hormone function.
However, the researchers found abundant published evidence that DEHP has a wide range of non-endocrine toxic effects, and they propose that these could affect the short- and long-term health of NICU patients. DEHP has been shown repeatedly in animal studies to increase inflammation, cause liver injury, and interfere with development of lung, brain, and eye. Clinical studies confirm that some of these effects occur in NICU patients as well.
"We were floored by how high the exposures are when you look at all of the devices together," Fox says. "It's a population that we know is vulnerable to begin with. They're struggling to survive. And the concern now is whether this phthalate exposure is actually contributing to their problems when these medical products are supposed to be helping them get better."
Phthalates, including DEHP, are found in a wide range of consumer products, such as food packaging, clothing, upholstery, vinyl flooring, cosmetics, and fragrances. DEHP is the only phthalate approved for medical devices in the U.S., and its use is unregulated. In contrast, DEHP and several other phthalates are limited to trace amounts in children's toys and childcare products.
The new research finds that the total daily exposure for a two-kilogram (four-pound) critically ill infant can reach 16 mg/kg per day. The largest sources are blood products, and endotracheal tubes placed in the airway to deliver breathing support with a ventilator. In analyzing toxic thresholds, the researchers determined that daily DEHP intakes are approximately 4,000 times higher than desired to prevent a type of male reproductive toxicity, and 160,000 times higher than desired to prevent liver injury. They say that a lower DEHP exposure could be one reason why preemies who can be managed without a ventilator seem to have better lung outcomes.
The researchers say that replacing DEHP-containing products in the NICU with existing alternative products that don't contain DEHP would be the most effective initial step in reducing phthalate exposures during critical care. Further reductions could be attained by addressing other sources of phthalates in the NICU, including construction materials (such as vinyl flooring and paints); equipment such as ventilators and incubators; soaps, lotions and other cosmetics used by staff and visitors; and even the soaps, lotions and powders used for baby care.
"We do have to make tradeoffs and we want to save these babies," Fox says. "But can we save them by using alternative products that reduce their exposures to substances that may be harming them? It seems like we could."
INFORMATION:
"Phthalates and critically ill neonates: device-related exposures and non-endocrine toxic risks" was written by Eric B. Mallow and Mary A. Fox. END
In a new study, Use of Social Network Sites at Work: Does it Impair Performance?, Postdoctoral Fellow Cecilie Schou Andreassen and colleagues at the University of Bergen's (UiB) Department of Psychosocial Science looked at the consequences of the use of social media during working hours.
Every day, more than one billion people worldwide use social media. This habit has also invaded the workplace, as some research reports that four out of five employees use social media for private purpose during working hours.
Surprisingly, although this type of distraction may potentially ...
Scientists used mathematical models to show that analysing genetic data, alongside a range of other risk factors, could substantially improve the ability to flag up women at highest risk of developing breast cancer.
Their study showed that prevention strategies could be improved by testing not only as currently for major cancer predisposition genes such as BRCA1 and BRCA2 - which identify a small percentage of women at very high risk - but also by factoring in data on multiple gene variants that individually have only a small effect on risk, but are more common in the ...
Researchers at the Bellvitge Biomedical Research Institute of Bellvitge, the Catalan Institute of Oncology and the University Hospital of Bellvitge have participated in an international study published in the journal Cancer Cell that describes how exosomes secreted by tumor cells contain protein and microRNA molecules capable of transform neighboring cells into tumoral cells promoting tumor growth.
What are exosomes?
Exosomes are small vesicles which are secreted by all cells and contain proteins and messenger RNAs and microRNAs. At first it was thought that only functioned ...
Researchers at the ARC Centre of Excellence for Coral Reef Studies (Coral CoE) at James Cook University in Australia have found a way to predict illegal fishing activities to help authorities better protect marine reserves.
Marine reserves are the most common strategy used to protect and maintain marine ecosystems around the world.
The International Convention of Biological Diversity aims to have 10 per cent of the world's marine areas protected by 2020.
Many countries are contributing to this target by protecting remote, offshore areas. For example, the United ...
(SACRAMENTO, Calif.) -- This week's issue of the New England Journal of Medicine features an article that highlights an unprecedented analysis of the nation's childhood head injuries. The study, authored by physicians at UC Davis School of Medicine and Washington University School of Medicine, analyzed more than 43,000 children who were evaluated for head trauma at 25 emergency departments around the United States. In the accompanying supplements, detailed information about these children, their presentations and results will be useful to doctors and helpful to policy makers ...
BOSTON, MA - Sleep disorders are independent risk factors for heart attacks and motor vehicle crashes, which are the two leading causes of death for firefighters in the United States. In a national sample of almost 7,000 firefighters, researchers at Brigham and Women's Hospital (BWH) examined the prevalence of common sleep disorders and their association with adverse health and safety outcomes and found that sleep disorders are highly prevalent, and associated with substantially increased risk of motor vehicle crashes and cardio-metabolic diseases among firefighters.
Findings ...
VIDEO:
NC State researchers have developed a new way to transfer thin semiconductor films, which are only one atom thick, onto arbitrary substrates, paving the way for flexible computing or photonic...
Click here for more information.
Researchers from North Carolina State University have developed a new way to transfer thin semiconductor films, which are only one atom thick, onto arbitrary substrates, paving the way for flexible computing or photonic devices. The technique ...
COLUMBUS, Ohio - In six out of 10 cases, ovarian cancer is diagnosed when the disease is advanced and five-year survival is only 27 percent. A new study suggests that a cancer-killing virus combined with a chemotherapy drug might safely and effectively treat advanced or recurrent forms of the disease.
Researchers at The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James), led the cell and animal study. Reporting in the journal Clinical Cancer Research, the researchers showed that ...
Some people experience cold not only as feeling cold, but actually as a painful sensation. This applies even to fairly mild temperatures - anything below 20°C. A group of researchers from Lund University in Sweden have now identified the mechanism in the body that creates this connection between cold and pain. It turns out that it is the same receptor that reacts to the pungent substances in mustard and garlic.
Professor of Pharmacology Peter Zygmunt and Professor of Clinical Pharmacology Edward Högestätt have long conducted research on pain and the connection ...
For several years the Danish health service has been moving towards increased centralisation and specialisation in large hospital departments based on the thesis that this provides better results for patients. A new study involving more than 12,000 Danish patients with hip fractures presents a different picture, however:
"Our study shows that the mortality rate for this group of patients is lower in the smaller hospital departments compared to the larger departments. We can also see that the length of stay in hospital is shorter and the quality of care is generally better, ...
