Extraction of the Plasticizers Diethylhexylphthalate and Polyadipate From Polyvinylchloride Nasogastric Tubes Through Gastric Juice and Feeding Solution

Subotic, Ulrike; Hannmann, Torsten; Kiss, Matthias; Brade, Joachim; Breitkopf, Katja; Loff, Steffan

doi:10.1097/01.mpg.0000237939.50791.4b

Cited by 28 publications

(16 citation statements)

References 27 publications

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“…76 This study suggested that polyadipate nasogastric tubing should be used as an alternative product in order to reduce DEHP exposure in NICU. However, critical data on developmental and reproductive toxicity for polyadipates are unavailable and potential side effects have not been assessed.…”

Section: Dehp-free Plasticizersmentioning

confidence: 90%

“…7,14,76 Although a broad range of molecular weights can be obtained based on use through polycondensation, the highest molecular weight polyesters have the lowest potential for migration into a lipophilic substance of all the plasticizers discussed. 14 Polyadipates are promoted by chemical companies in Europe as a low-cost alternative to DEHP for short-term use of gastric tubes, whereas polyurethane or silicone devices are suggested for long-term tube feeding because of their durability.…”

Section: Dehp-free Plasticizersmentioning

confidence: 99%

“…14 Polyadipates are promoted by chemical companies in Europe as a low-cost alternative to DEHP for short-term use of gastric tubes, whereas polyurethane or silicone devices are suggested for long-term tube feeding because of their durability. 76 …”

Section: Dehp-free Plasticizersmentioning

confidence: 99%

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A review of alternatives to di (2-ethylhexyl) phthalate-containing medical devices in the neonatal intensive care unit

et al. 2011

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Objective To conduct an extensive literature and toxicological database review on substitute compounds and available alternative medical products to replace polyvinyl chloride (PVC) and/or di(2-ethylhexyl) phthalate (DEHP), and conduct a DEHP-medical inventory analysis at a large metropolitan neonatal intensive care unit (NICU). Study Design A systematic search for DEHP-free alternative products was performed using online databases. An informal audit of a large metropolitan NICU was undertaken in 2005 and 2006; 21 products were identified that could potentially contain DEHP. Availability of DEHP-free alternatives was determined through company websites and phone interviews. Result Two alternative approaches are available for replacing DEHP in NICU medical products: (1) replacement by DEHP-free plasticizers; and (2) replacement of PVC entirely through the use of other polymers. Both approaches seem to provide less harmful substitutes to DEHP, but support PVC-free polymers as the preferred alternative. However, significant data gaps exist, particularly for the alternative polymers. In all, 10 out of 21 (48%) products in the NICU audit were DEHP-free; six consisted of alternative polymers and four of alternative plasticizers. Of the remaining 11 products, only three were available without DEHP at the time of the audit. Conclusion Because of significant data gaps, systematic toxicological testing of DEHP-free alternatives is imperative. Continued development of alternative products is also needed.

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Section: Dehp-free Plasticizersmentioning

confidence: 90%

Section: Dehp-free Plasticizersmentioning

confidence: 99%

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A review of alternatives to di (2-ethylhexyl) phthalate-containing medical devices in the neonatal intensive care unit

et al. 2011

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“…Di-(2-ethylhexyl) phthalate (DEHP), a plasticizer commonly used by industry to add flexibility to polyvinyl chloride products, is highly prevalent in the environment and is present in a wide variety of consumer products, including medical devices such as intravenous tubing, catheters, and dialysis bags [1][2][3][4]. DEHP, which has been shown to have antiandrogenic properties, exerts its effects through its metabolite mono-2-ethylhexyl phthalate (MEHP), which is formed after cleavage of one of its side chains by lipases in the gut, and is 10 times more active than the parent compound [1,5].…”

Section: Introductionmentioning

confidence: 99%

In Utero Exposure to the Antiandrogen Di-(2-Ethylhexyl) Phthalate Decreases Adrenal Aldosterone Production in the Adult Rat1

Martinez–Arguelles

Guichard

Culty

et al. 2011

Biology of Reproduction

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We previously reported that in utero exposure of the male fetus to the plasticizer di-(2-ethylhexyl) phthalate (DEHP) resulted in decreased circulating levels of testosterone in the adult without affecting Leydig cell numbers, luteinizing hormone levels, or steroidogenic enzyme expression. Fetal exposure to DEHP resulted in reduced mineralocorticoid receptor (MR; NR3C2) expression in adult Leydig cells. In the present studies, treatment of pregnant Sprague-Dawley dams from Gestational Day 14 until birth with 20, 50, 100, 300, or 750 mg kg(-1) day(-1) of DEHP resulted in significant sex-specific decreases in serum aldosterone but not corticosterone levels at Postnatal Day 60 (PND60) but not at PND21. There was no effect on circulating levels of potassium, angiotensin II or adrenocorticotropin hormone (ACTH). However, there was reduced expression of AT receptor Agtr1a, Agtr1b, and Agtr2 mRNAs. The mRNA levels of proteins and enzymes implicated in aldosterone biosynthesis were not affected by in utero DEHP treatment except for Cyp11b2, which was decreased at high (≥ 500 mg kg(-1) day(-1)) doses. The data presented herein, together with our previous observation that aldosterone stimulates testosterone production via an MR-mediated mechanism, suggest that in utero exposure to DEHP causes reduction in both adrenal aldosterone synthesis and MR expression in Leydig cells, leading to reduced testosterone production in the adult. Moreover, these results suggest the existence of a DEHP-sensitive adrenal-testis axis regulating androgen formation.

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“…In a recently published study, 5 cm of PVC nasogastric tubes containing DEHP or polyadipate were incubated with feeding solution and gastric juice (Subotic et al 2007). Although at least 10 times lower leaching was observed compared to that of DEHP, no conclusion can be made from this study because the contents of the two plasticizers in the tubings are not described.…”

Section: Exposure To Alternative Plasticizersmentioning

confidence: 99%

Response to ‘Dr Raymond David, BASF Corporation’

Vliet

Whyatt

2012

J Perinatol

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Extraction of the Plasticizers Diethylhexylphthalate and Polyadipate From Polyvinylchloride Nasogastric Tubes Through Gastric Juice and Feeding Solution

Cited by 28 publications

References 27 publications

A review of alternatives to di (2-ethylhexyl) phthalate-containing medical devices in the neonatal intensive care unit

A review of alternatives to di (2-ethylhexyl) phthalate-containing medical devices in the neonatal intensive care unit

In Utero Exposure to the Antiandrogen Di-(2-Ethylhexyl) Phthalate Decreases Adrenal Aldosterone Production in the Adult Rat1

Response to ‘Dr Raymond David, BASF Corporation’

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