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Jenkins R, Ondusko D, Montrose L, et al. Phthalate Exposures in the Neonatal Intensive Care Unit. Toxics. 2021;9(5)doi: 10.3390/toxics9050090.
Jenkins, R., Ondusko, D., Montrose, L., Forbush, R., & Rozansky, D. (2021). Phthalate Exposures in the Neonatal Intensive Care Unit. Toxics, 9(5), . https://doi.org/10.3390/toxics9050090
Jenkins, Randall, et al. "Phthalate Exposures in the Neonatal Intensive Care Unit." Toxics vol. 9,5 (2021). doi: https://doi.org/10.3390/toxics9050090
Jenkins R, Ondusko D, Montrose L, Forbush R, Rozansky D. Phthalate Exposures in the Neonatal Intensive Care Unit. Toxics. 2021 Apr 21;9(5). doi: 10.3390/toxics9050090. PMID: 33919093; PMCID: PMC8143182.
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Toxics. 2021 Apr 21;9(5). doi: 10.3390/toxics9050090.

Phthalate Exposures in the Neonatal Intensive Care Unit.

Toxics

Randall Jenkins, Devlynne Ondusko, Luke Montrose, Ryan Forbush, David Rozansky

Affiliations

  1. Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA.
  2. Department of Community and Environmental Health, Boise State University, Boise, ID 83725, USA.
  3. Department of Respiratory Care, Boise State University, Boise, ID 83725, USA.

PMID: 33919093 PMCID: PMC8143182 DOI: 10.3390/toxics9050090

Abstract

BACKGROUND: Di-2-ethylhexyl phthalate (DEHP), a phthalate compound found in medical devices, may cause toxic effects in premature infants. In this study, the objective is to quantify DEHP exposures from various intravenous and respiratory therapy devices, and to use these values to predict typical exposure for an infant in a neonatal unit.

METHODS: Common IV products used on infants are directed through various types of IV tubing (IVT) and analyzed for DEHP content. DEHP exposure for infants receiving respiratory therapy was determined indirectly through analysis of urine DEHP metabolites. By deriving these values for DEHP we calculated the daily exposure to DEHP from common IV fluids (IVF) and respiratory devices during hospitalization in a neonatal unit.

RESULTS: IVF labeled DEHP-positive showed very high concentrations of DEHP, but when passed through IVT, substantial amounts were adsorbed. DEHP was undetectable with all DEHP-negative IVF tests, except when passed through DEHP-positive IVT. The DEHP leached from most respiratory devices was relatively modest, except that detected from bubble CPAP. In 14 very low birthweight infants, the mean DEHP exposure was 182,369 mcg/kg over 81.2 days of the initial hospitalization. Ninety-eight percent of the exposure was from respiratory devices, with bubble CPAP accounting for 95% of the total DEHP exposure in these infants.

CONCLUSIONS: The DEHP exposure in our neonatal unit can be reduced markedly by avoiding or modifying bubble CPAP equipment and avoiding IV tubing containing DEHP.

Keywords: di-2-ethylhexyl phthalate (DEHP); hypertension; phthalates; prematurity; toxicity

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