The Adverse Cardiac Effects of Di(2-ethylhexyl)phthalate and Bisphenol A

Abstract

The ubiquitous nature of plastics has raised concerns pertaining to continuous exposure to plastic polymers and human health risks. Of particular concern is the use of endocrine-disrupting chemicals (EDCs) in plastic production, including Di(2-ethylhexyl) phthalate (DEHP) and Bisphenol A (BPA). Widespread and continuous exposure to DEHP and BPA occurs through dietary intake, inhalation, dermal and intravenous exposure via consumer products and medical devices. This article reviews the literature examining the relationship between DEHP and BPA exposure and cardiac toxicity. In vitro and in vivo experimental reports are outlined, as well as epidemiological studies which examine the association between these chemicals and cardiovascular outcomes. Gaps in our current knowledge are also discussed, along with future investigative endeavors that may help resolve whether DEHP and/or BPA exposure has a negative impact on cardiovascular physiology.

Sudden cardiac arrest in end‐stage renal disease patients on dialysis: A nationwide study

“…The most frequently used plasticizer chemical to soften PVC is Di (2‐ethylhexyl) phthalate (DEHP). DEHP loosely bonds to PVC polymers and thus is susceptible to detachment when it comes in contact with lipophilic substances such as blood . Increased DEHP concentration has been shown to alter cardiomyocyte electrical conduction.…”

“…DEHP loosely bonds to PVC polymers and thus is susceptible to detachment when it comes in contact with lipophilic substances such as blood. 23 Increased DEHP concentration has been shown to alter cardiomyocyte electrical conduction. Animal models have shown reduced conduction velocities across several cardiomyocyte layers attributable to loss of gap junction protein connexin 43.…”

Sex- and Strain-dependent Effects of Bisphenol: A Consumption in Juvenile Mice

“…Epidemiological studies based on NHANES as well as other populations globally link BPA exposure to risk of obesity and its consequences. Urinary level of BPA, the primary means for assessing exposure in humans, is positively associated with incidence of obesity [9][10][11] and with risk for insulin resistance [12][13][14] and cardiovascular disease [15][16][17] in both the U.S. and other countries.…”

Closing in on DEHP‐free red blood cell concentrate containers

“…DEHP does not chemically bond to the PVC plastic and therefore will leach into the blood components, where it can be infused into the blood donor during apheresis collections or into the patient during a transfusion. Concerns over the toxicity of DEHP and its metabolite mono ethylhexyl phthalate (MEHP), and their association with long‐term adverse reproductive, cardiac, metabolic, and neurologic health effects, has been well documented . The potential for these phthalates to induce reproductive toxicity, infertility, and carcinogenicity is supported by in vitro and in vivo animal studies .…”

“…Concerns over the toxicity of DEHP and its metabolite mono ethylhexyl phthalate (MEHP), and their association with long-term adverse reproductive, cardiac, metabolic, and neurologic health effects, has been well documented. [7][8][9] The potential for these phthalates to induce reproductive toxicity, infertility, and carcinogenicity is supported by in vitro and in vivo animal studies. 6,7,10 As specific patient groups, such as neonates, pregnant women, children, and adult patients, who require massive or frequent transfusions, are considered at a greater risk of DEHP exposure, a case for taking active precautionary measures to reduce or eliminate exposure has been made.…”