Evaluation of childhood exposure to di(2-ethylhexyl) phthalate from perfusion kits during long-term parenteral nutrition

Kambia, K; Dine, T.; Gressier, Bernard; Bah, S.; Germe, Anne-Françoise; Luyckx, M.; Brunet, C.; Michaud, Laurent; Gottrand, Frédéric

doi:10.1016/s0378-5173(03)00335-1

Cited by 54 publications

(48 citation statements)

References 34 publications

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“…5) During medical treatments that involve infusion, such as hemodialysis and peritoneal dialysis therapies or parenteral nutritional therapy, patients may be exposed to several milligrams of DEHP from bags and tubes. 6,7) Most importantly, several stud-ies have indicated that infants and toddlers, who are highly susceptible to PEs, are extensively exposed to these compounds. [8][9][10] Considerable evidence suggests that many people are routinely exposed to PEs on a daily basis.…”

Section: Introductionmentioning

confidence: 99%

Potential Risks of Phthalate Esters: Acquisition of Endocrine-disrupting Activity during Environmental and Metabolic Processing

Okamoto

Ueda

Kojima

2011

JOURNAL OF HEALTH SCIENCE

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Phthalate esters (PEs) are plasticizers used in many plastic products, food packaging materials, and medical bags. The widespread use of PEs has led to ubiquitous environmental contamination and human-exposure. Several epidemiological studies have indicated that exposure to PEs, especially during the prenatal period, induces adverse effects, including developmental and behavioral abnormalities, suggesting that PEs are endocrine-disrupters. Although the endocrine-disrupting effect of PEs is thought to be estrogen receptor (ER)-mediated, the ER-binding affinity of PEs is quite low, indicating that other mechanisms should be considered. In this review, we demonstrate that alkyl chain length and hydroxylation of PEs have a significant impact on binding to ERs and peroxisome proliferator-activated receptors. In addition, we discuss recent results from our laboratory that suggest additional risks may arise from environmental and metabolic processing of PEs through microbial transformation, microsomal metabolism, and sunlight exposure.

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Section: Introductionmentioning

confidence: 99%

Potential Risks of Phthalate Esters: Acquisition of Endocrine-disrupting Activity during Environmental and Metabolic Processing

Okamoto

Ueda

Kojima

2011

JOURNAL OF HEALTH SCIENCE

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“…• Exchange transfusion in neonates • ECMO in neonates • Transfusion in adult undergoing ECMO Depending on the medical procedure exposure to DEHP varies widely and is a function of the lipophilicity of the fluid that comes into contact with the medical devices, the PVC surface size, the temperature, the flow rate and the contact time (Haishima et al 2005, Hanawa et al 2003, Hanawa et al 2000, Kambia et al 2003, Loff et al 2002, Loff 2000, Loff et al 2004. Polyethylene linings of PVC articles (e.g.…”

Section: Metabolism Of Dehp In Humansmentioning

confidence: 99%

Plasticizer concentration in cord blood cryopreserved with DMSO

Yamaguchi

Takanashi

Ito

et al. 2013

Bone Marrow Transplant

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The Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) has evaluated the exposure to DEHP for the general population and patients during medical procedures. In many cases the exposure is significant and exceeds the toxic doses observed in animal studies. There is limited evidence indicating a relation between DEHP exposures and certain effects in humans. However, it is recognised that especially the potentially high exposure during medical treatments raise a concern, even in the absence of clinical or epidemiological evidence, for harmful effects in humans. For certain uses of DEHP alternative plasticizers for PVC are available. The Committee got access to toxicity data for eight possible alternative plasticizers and compared their toxicity with that of DEHP. In respect to reproductive toxicity in animal studies DEHP induces more severe effects compared with some of the alternatives. A risk assessment of these available alternative plasticizers could not be performed due to a lack of exposure data from medical devices. Each alternative to DEHP, however, must also be evaluated with regard to their functionality in respect to medical devices. The risk and benefits of using alternative plasticizers should be evaluated case by case.

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“…DEHP is extracted from the bags and tubing due to the high solubility of DEHP in lipids and DEHP extraction by total parenteral nutrition depends on the lipid content of each total parenteral nutrition preparation and the flow rate (Kambia et al, 2003).…”

Section: The Effect Of Plasticizers On Human Healthmentioning

confidence: 99%