Quantification of bis(2-ethylhexyl) phthalate released by medical devices during respiratory assistance and estimation of patient exposure

Bouattour, Yassine; Wasiak, Mathieu; Bernard, Lise; Pinguet, Jérémy; Richard, Damien; Rouzo-Grèves, Mégane Le; Dhifallah, Imen; Lambert, Céline; Pereira, Bruno; Chennell, Philip; Sautou, V.

doi:10.1016/j.chemosphere.2020.126978

Cited by 24 publications

(18 citation statements)

References 27 publications

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“…One or more regulated phthalates from analyzed products exceeding regulatory limit level ( Oteef and Elhassan, 2020 ). The migration of DEHP from respiratory PVC medical devices dedicated to newborns was investigated by Bouattour et al (2020) . The level of DEHP in the air reaches a cumulative quantity of 123 mg. A humidifying of the air decreased the DEHP content, which is important especially in term of environmental conditions ( Bouattour et al, 2020 ).…”

Section: Dpgs Influence On the Environmentmentioning

confidence: 99%

“…The migration of DEHP from respiratory PVC medical devices dedicated to newborns was investigated by Bouattour et al (2020) . The level of DEHP in the air reaches a cumulative quantity of 123 mg. A humidifying of the air decreased the DEHP content, which is important especially in term of environmental conditions ( Bouattour et al, 2020 ). Similarly as PE products, PVC also may contain BPA.…”

Section: Dpgs Influence On the Environmentmentioning

confidence: 99%

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COVID-19 discarded disposable gloves as a source and a vector of pollutants in the environment

Jędruchniewicz

Oleszczuk

2021

Journal of Hazardous Materials

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Section: Dpgs Influence On the Environmentmentioning

confidence: 99%

Section: Dpgs Influence On the Environmentmentioning

confidence: 99%

COVID-19 discarded disposable gloves as a source and a vector of pollutants in the environment

Jędruchniewicz

Oleszczuk

2021

Journal of Hazardous Materials

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“…For MD used for respiratory assistance, from which the plasticizers are released into a gaseous media, the Fick model might not be appropriate and could therefore lead to exposure overestimation. In recent work (development of a respiratory assistance ex vivo model [50]), our team showed that the migration of plasticizers into gas is about 3000 times lower than into liquid media, such as drug solutions. This observation is supported by several other studies, all showing that DEHP migration into air is between 500 and 20,000 times lower than into a liquid media [51][52][53][54][55].…”

Section: Assessment Of Plasticizers Exposurementioning

confidence: 99%

Association between Urinary Metabolites and the Exposure of Intensive Care Newborns to Plasticizers of Medical Devices Used for Their Care Management

Bernard

Bouattour²,

Masse³

et al. 2021

Metabolites

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Care management of newborns in the neonatal intensive care unit (NICU) requires numerous PVC (PolyVinyl Chloride) medical devices (MD) containing plasticizers that can migrate and contaminate the patient. We measured the magnitude of neonates’ exposure to plasticizers (di-ethylhexylphthalate (DEHP) and alternatives) in relation to urinary concentrations of their metabolites. Plasticizers’ exposure was evaluated (1) by calculating the amounts of plasticizers prone to be released from each MD used for care management, and (2) by measuring the patients’ urinary levels of each plasticizers’ metabolites. 104 neonates were enrolled. They were exposed to di-isononylphthalate (DINP), especially via transfusion and infusion MD, and to DEHP via ECMO (Extra Corporeal Membrane Oxygenation) and respiratory assistance MD. Mean exposure doses exceeded the derived no-effect level of DINP and DEHP by a 10-fold and a 1000-fold factor. No PVC MD were plasticized with di-isononylcyclohexane-1,2-dicarboxylate (DINCH). High urinary concentrations of DEHP metabolites were directly correlated with DEHP exposure through ECMO MD. Urinary concentrations of DINP metabolites in transfused patients were also high. DINCH metabolites were found in urine, suggesting another route of exposure. Neonates in NICU are considerably exposed to plasticizers, with magnitudes varying with the type of MD used. The high exposure to DEHP and DINP leads to a risk of their metabolites’ toxicity.

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“…However, these plasticizers are not those contained in our respiratory assistance MDs, which are plasticized with DEHP. There are several publications presenting the diffusion of DEHP from PVC to gases [ 1 , 2 , 3 , 4 , 5 , 6 ]. We relied on these scientific publications to apply a corrective factor to our Fick model for the MDs concerned (see page 13 of the article).…”

Section: Questioning the Exposure Doses Calculated With The Fick Model In Particular The Estimated Doses For Respiratory Assistance Mdsmentioning

confidence: 99%

Reply to Otter et al. Comment on “Bernard et al. Association between Urinary Metabolites and the Exposure of Intensive Care Newborns to Plasticizers of Medical Devices Used for Their Care Management. Metabolites 2021, 11, 252”

et al. 2021

Self Cite

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show abstract

Quantification of bis(2-ethylhexyl) phthalate released by medical devices during respiratory assistance and estimation of patient exposure

Cited by 24 publications

References 27 publications

COVID-19 discarded disposable gloves as a source and a vector of pollutants in the environment

COVID-19 discarded disposable gloves as a source and a vector of pollutants in the environment

Association between Urinary Metabolites and the Exposure of Intensive Care Newborns to Plasticizers of Medical Devices Used for Their Care Management

Reply to Otter et al. Comment on “Bernard et al. Association between Urinary Metabolites and the Exposure of Intensive Care Newborns to Plasticizers of Medical Devices Used for Their Care Management. Metabolites 2021, 11, 252”

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