Effect of phospholipid coating on the migration of plasticizers from PVC tubes

Münch, Frank; Höllerer, Christine; Klapproth, André; Eckert, Elisabeth; Rüffer, André; Cesnjevar, Robert; Göen, Thomas

doi:10.1016/j.chemosphere.2018.03.136

Cited by 34 publications

(18 citation statements)

References 29 publications

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“…Moreover, recent studies demonstrated the considerably slower migration of TOTM into blood compared to DEHP. 2,19,30 Other good alternatives like silicone and polyurethane, which are widely used for platelet and plasma storage bags, have critical financial implications for producers of whole blood bags. 31 RBCUs stored in bags plasticized with 1,2-cyclohexane dicarboxylic acid diisononyl ester (DINCH) could be an alternative to bags releasing DEHP as well.…”

Section: Discussionmentioning

confidence: 99%

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Reduction of exposure to plasticizers in stored red blood cell units

et al. 2019

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Introduction: Plastic can be toxic and hazardous to an organism’s health, but it is being widely used in our daily lives. Di-2-ethylhexyl-phthalate is the most common plasticizer in medical devices made of polyvinylchloride and is commonly found in soft bags storing red blood cell units. Di-2-ethylhexyl-phthalate and its degradation product mono-2-ethylhexyl-phthalate can migrate into human body fluids, for example, blood and tissues. The aim of the study was to assess the concentration of plasticizers in red blood cell units according to storage time and after mechanical rinsing using a cell salvage device. Methods: Levels of di-2-ethylhexyl-phthalate and mono-2-ethylhexyl-phthalate were analysed in 50 unwashed red blood cell units using liquid chromatography coupled with tandem mass spectrometry. In addition, phthalate concentrations were measured before and after mechanical rinsing in six more washed red blood cell units with storage times ranging between 36 and 56 days. A linear regression model was determined by the daily increase of di-2-ethylhexyl-phthalate and mono-2-ethylhexyl-phthalate in the stored red blood cell units subject to their storage time (range = 4-38 days), and the effect of mechanical rinsing on their phthalate concentration was calculated. Results: A linear correlation was found between storage time of unwashed red blood cell units and the concentration of di-2-ethylhexyl-phthalate (p < 0.001) or mono-2-ethylhexyl-phthalate (p < 0.001). Stored red blood cell units older than 14 days had significantly higher concentrations of both contaminants than red blood cell units of shorter storage time (p < 0.001). Mechanical rinsing in washed red blood cell units attained a reduction in the di-2-ethylhexyl-phthalate and mono-2-ethylhexyl-phthalate concentration by a median of 53% (range = 18-68%; p = 0.031) and 87% (range = 68-96%; p = 0.031), respectively. Conclusion: Leaching of di-2-ethylhexyl-phthalate and mono-2-ethylhexyl-phthalate into red blood cell units depends on the duration of storage time. Plasticizers can be significantly reduced by mechanical rinsing using cell salvage devices, and thus, red blood cell units can be regenerated with respect to chemical contamination.

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Section: Discussionmentioning

confidence: 99%

“…In case of DEHP, the TDI is 50 mg/kg body weight. 9,19,20 Patient stress by phthalate contamination and the effect of mechanical rinsing were calculated for a 5-kg child. Calculations included the following:…”

Section: Theoretical Model To Illustrate Patient Stressmentioning

confidence: 99%

Reduction of exposure to plasticizers in stored red blood cell units

et al. 2019

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“…There are already some studies dealing with the question of DEHP migration from PVC medical devices. These studies dealt with the influence of storage time of medical devices [7], of priming procedures [26] and of the applied coating [24,27]. In the present study high values of DEHP and its metabolites are found to be correlated with longer and more intense ECMO (several cannulas, membranes), but not in all patients.…”

Section: Discussionmentioning

confidence: 50%

“…However, its application generally requires the extensive use of plasticized PVC components, bags and tubes with long lasting blood contact. Because of its characteristics, DEHP is often favored as an additive in blood bags and ECMO devices despite the fact that DEHP migrates very easily from PVC material into blood [4,23,24], which may result in a significant inner DEHP exposure of the patients. For healthy individuals, urinanalysis of DEHP metabolites is the established exposure monitoring strategy [21,25].…”

Section: Discussionmentioning

confidence: 99%

Exposure of patients to di(2-ethylhexy)phthalate (DEHP) and its metabolite MEHP during extracorporeal membrane oxygenation (ECMO) therapy

et al. 2020

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The plasticizer di(2-ethylhexyl)phthalate (DEHP) is often used for PVC medical devices, that are also largely used for intensive care medical treatments, like extracorporeal membrane oxygenation (ECMO) therapy. Due to the toxicological potential of DEHP, the inner exposure of patients with this plasticizer is a strong matter of concern as many studies have shown a high leaching potential of DEHP into blood. In this study, the inner DEHP exposure of patients undergoing ECMO treatment was investigated. The determined DEHP blood levels of ECMO patients and the patients of the control group ranged from 31.5 to 1009 μg/L (median 156.0 μg/L) and from 19.4 to 75.3 μg/L (median 36.4 μg/L), respectively. MEHP blood levels were determined to range from < LOD to 475 μg/L (median 15.9 μg/L) in ECMO patients and from < LOD to 9.9 μg/L (median 3.7 μg/L) in the control group patients, respectively. Increased DEHP exposure was associated with the number of cannulas and membranes of the ECMO setting, whereas residual diuresis decreased the exposure. Due to the suspected toxicological potential of DEHP, its use in medical devices should be further investigated, in particular for ICU patients with long-term exposure to PVC, like in ECMO therapy.

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“…Several groups have also reported increased leaching of DEHP in the presence of lipids, either as as emulsions in the tube [4,44] or as a lipidcoating on the inside of the PVC tube [45]. Münch et al reported that this effect was larger for tri-2-ethylhexyl trimellitate (TOTM), however the rate of leaching is still several hundred times slower than for DEHP [45]. Faessler et al reported that in the presence of a lipid emulsion, DEHP leached 10-100 times faster than other investigated plasticisers (DEHT and DINCH).…”

Section: Plasticiser Interaction With Amphiphilesmentioning

confidence: 99%

Interactions of amphiphiles with plasticisers used in polymers: Understanding the basis of health and environmental challenges

Gustafsson

Bowden

Rennie

2020

Advances in Colloid and Interface Science

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Plasticisers are widely used to provide desirable mechanical properties of many polymeric materials. These small molecule additives are also known to leach from the finished products, and this not only may modify the physical properties but the distribution of these materials in the environment and in the human body can cause long-term health concerns and environmental challenges. Many of these plasticisers are esters of polyvalent acids and phthalic acid has previously been predominant but various alternatives are now being more widely explored. The eventual distribution of these compounds depends not just on solubility in aqueous media and on vapour pressure but also on their interaction with other materials, particularly lipids and amphiphiles. This review provides an overview of both the basic physical data (solubility, partition coefficients, surface tension, vapour pressure) that is available in the literature and summarises what has been learnt about the molecular interactions of various plasticisers with surfactants and lipids.

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Effect of phospholipid coating on the migration of plasticizers from PVC tubes

Cited by 34 publications

References 29 publications

Reduction of exposure to plasticizers in stored red blood cell units

Reduction of exposure to plasticizers in stored red blood cell units

Exposure of patients to di(2-ethylhexy)phthalate (DEHP) and its metabolite MEHP during extracorporeal membrane oxygenation (ECMO) therapy

Interactions of amphiphiles with plasticisers used in polymers: Understanding the basis of health and environmental challenges

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