Determination of bisphenol A in water and the medical devices used in hemodialysis treatment

Bacle, Astrid; Thevenot, S.; Grignon, Claire; Belmouaz, Mohamed; Bauwens, Marc; Teychene, Benoît; Venisse, Nicolas; Migeot, Virginie; Dupuis, Antoine

doi:10.1016/j.ijpharm.2016.03.003

Cited by 35 publications

(16 citation statements)

References 33 publications

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“…In a clinical context, BPA exposure likely occurs most commonly during dialysis. Dialyzers leach BPA even after rinsing with normal saline, and since hemodialysis can expose patients to more than 300 L of water weekly, potential exposure to BPA is substantial ( 18 ). In addition to dialysis, BPA-based resins are used to coat aluminum ointment tubes ( 19 ).…”

Section: Endocrine Disruptors In Medical Equipmentmentioning

confidence: 99%

Unwitting Accomplices: Endocrine Disruptors Confounding Clinical Care

Genco

Anderson-Shaw

Sargis

2020

The Journal of Clinical Endocrinology &Amp; Metabolism

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Abstract Burgeoning evidence over the last 25 years has identified myriad synthetic chemicals with the capacity to alter various aspects of hormone synthesis and action. These endocrine-disrupting chemicals (EDCs) have been linked to various diseases, including reproductive disorders, metabolic diseases, and developmental abnormalities among others. Exposure to EDCs arises from industrial activity, use of personal and home care products, and consumption of contaminated food and water; however, the role of healthcare in exposing individuals to EDCs is grossly underappreciated. Indeed, through the use of medications as well as medical equipment and devices, healthcare providers are unknowing mediators of exposure to EDCs, chemicals that might not only promote disease but that may also antagonize the efficacy of treatments. The ethical implications of provider-dependent exposure are profound. A failure to disclose the endocrine-disrupting properties of medical interventions violates core principles of non-maleficence, patient autonomy, and justice as well as the practice of informed consent. Furthermore, physicians’ lack of knowledge regarding EDCs in medical practice artificially skews risk-benefit calculations that are fundamental to informed medical decision-making. To combat this underappreciated ethical challenge, urgent action is required. Healthcare providers must be educated about endocrine disruption. Known EDCs, defined by endocrinologists, should be clearly labeled on all medical products, and all medication components and devices should be screened for endocrine-disrupting properties. Finally, communication strategies must be devised to empower patients with knowledge about these risks. Providing ethically-competent care requires an open acknowledgment of endocrine risks imposed by the medical community that have heretofore been ignored.

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Section: Endocrine Disruptors In Medical Equipmentmentioning

confidence: 99%

Unwitting Accomplices: Endocrine Disruptors Confounding Clinical Care

Genco

Anderson-Shaw

Sargis

2020

The Journal of Clinical Endocrinology &Amp; Metabolism

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“…Up to now, we analyzed the dialyzer contribution to BPA in the blood of hemodialyzed patients, but recently, Bacle et al [40] evaluated the potential exposure to BPA via the entire process of hemodialysis treatment, from production of puriied water to dialysate and dialyzers. In their work, they could conirm that no BPA leaching is observed from bloodlines, conirming the information provided by the European PVC manufacturers who no longer use BPA in polyvinylchloride (PVC) production.…”

Section: Housing)mentioning

confidence: 99%

Bisphenol A in Chronic Kidney Disease

Palladino¹,

Sereni²

2017

Bisphenol a Exposure and Health Risks

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Several types of medical devices are produced using polycarbonate (PC) polymer. Unfortunately, these medical devices produced using PC could contain and release Bisphenol A (BPA) residual in routinely use. Published evidence on BPA in dialysis or Chronic Kidney patients (CKD) is scarce and limited to the observation of increased blood BPA levels. Increased serum BPA with decreasing renal function was observed in a smaller study of 32 CKD patients, suggesting that BPA may accumulate. Recently a crossover study evaluated the impact of the choice of dialyzer (BPA-free versus BPAcontaining) on serum and intracellular BPA levels and on inlammation and oxidative stress markers. Currently, BPA is still considered, from regulatory agencies, safe enough in the general population, despite several red lags, as it is readily excreted in the urine. However, patients in End Stage Renal Disease (ESRD) are unable to excrete BPA in their urine, leading to BPA accumulation. Repeated loading of BPA during hemodialysis with BPA-containing membranes may aggravate the problem due to migration of BPA from dialyzers to the blood of patients. In contrast, some recent studies on the chronic use of BPA-free dialyzers, results in decreased BPA levels.

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“…Only BPA release from dialyzers has been taken into account in risk assessment of exposure in dialysis. However, we have recently demonstrated that BPA was present in other medical devices as well as in water used during HD, leading to significant exposure of patients suffering from ESRD [23]. Moreover, few data are available concerning BPA exposure during OL-HDF treatment sessions, even though patients can be highly exposed to micropollutants via the replacement fluid infused in blood circulation.…”

Section: Introductionmentioning

confidence: 99%

Overexposure to Bisphenol A and Its Chlorinated Derivatives of Patients with End-Stage Renal Disease during Online Hemodiafiltration

et al. 2019

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The health safety conditions governing the practice of online hemodiafiltration (OL-HDF) do not yet incorporate the risks related to the presence of endocrine disruptors such as bisphenol A (BPA). The aim of this study was to assess, for the first time, the exposure to BPA but also to its chlorinated derivatives (ClxBPA) (100 times more estrogenic than BPA) during OL-HDF. We demonstrated that BPA is transmitted by the different medical devices used in OL-HDF: ultrafilters, dialysis concentrate cartridges (and not only dialyzers, as previously described). Moreover, BPA has been found in dialysis water as well as in ultrapure dialysate and replacement fluid due to contamination of water coming from municipal network. Indeed, due to contaminations provided by both ultrafilters and water, high levels of BPA were determined in the infused replacement fluid (1033 ng.L−1) from the beginning of the session. Thus, our results demonstrate that dialysis water must be considered as an important exposure source to endocrine disruptors, especially since other micropollutants such as ClxBPA have also been detected in dialysis fluids. While assessment of the impact of this exposure remains to be done, these new findings should be taken into account to assess exposure risks in end-stage renal disease patients.

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Determination of bisphenol A in water and the medical devices used in hemodialysis treatment

Cited by 35 publications

References 33 publications

Unwitting Accomplices: Endocrine Disruptors Confounding Clinical Care

Unwitting Accomplices: Endocrine Disruptors Confounding Clinical Care

Bisphenol A in Chronic Kidney Disease

Overexposure to Bisphenol A and Its Chlorinated Derivatives of Patients with End-Stage Renal Disease during Online Hemodiafiltration

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