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Ongoing exposure to endocrine disrupting phthalates and alternative plasticizers in neonatal intensive care unit patients
https://orcid.org/0000-0003-4073-110X
https://orcid.org/0000-0003-0597-2653
https://orcid.org/0000-0002-5434-957X
https://orcid.org/0000-0003-0527-1136
https://orcid.org/0000-0001-8625-4359
Highlights Preterm neonates are still highly exposed to phthalate and alternative plasticizers. Neonatal intensive care unit exposure to phthalates decreased over time. Neonatal intensive care unit exposure to alternative plasticizers is increasing. Respiratory support and blood transfusion are associated with higher exposure. 29 % of neonates had an estimated phthalate intake above animal-derived safe levels.
Abstract Due to endocrine disrupting effects, di-(2-ethylhexyl) phthalate (DEHP), a plasticizer used to soften plastic medical devices, was restricted in the EU Medical Devices Regulation (EU MDR 2017/745) and gradually replaced by alternative plasticizers. Neonates hospitalized in the neonatal intensive care unit (NICU) are vulnerable to toxic effects of plasticizers. From June 2020 to August 2022, urine samples (n = 1070) were repeatedly collected from premature neonates (n = 132, 4–10 samples per patient) born at <31 weeks gestational age and/or <1500 g birth weight in the Antwerp University Hospital, Belgium. Term control neonates (n = 21, 1 sample per patient) were included from the maternity ward. Phthalate and alternative plasticizers’ metabolites were analyzed using liquid-chromatography coupled to tandem mass spectrometry. Phthalate metabolites were detected in almost all urine samples. Metabolites of alternative plasticizers, di-(2-ethylhexyl)-adipate (DEHA), di-(2-ethylhexyl)-terephthalate (DEHT) and cyclohexane-1,2-dicarboxylic-di-isononyl-ester (DINCH), had detection frequencies ranging 30–95 %. Urinary phthalate metabolite concentrations were significantly higher in premature compared to control neonates (p = 0.023). NICU exposure to respiratory support devices and blood products showed increased phthalate metabolite concentrations (p < 0.001). Phthalate exposure increased from birth until four weeks postnatally. The estimated phthalate intake exceeded animal-derived no-effect-levels (DNEL) in 10 % of samples, with maximum values reaching 24 times the DNEL. 29 % of premature neonates had at least once an estimated phthalate intake above the DNEL. Preterm neonates are still exposed to phthalates during NICU stay, despite the EU Medical Devices Regulation. NICU exposure to alternative plasticizers is increasing, though currently not regulated, with insufficient knowledge on their hazard profile.
Ongoing exposure to endocrine disrupting phthalates and alternative plasticizers in neonatal intensive care unit patients
https://orcid.org/0000-0003-4073-110X
https://orcid.org/0000-0003-0597-2653
https://orcid.org/0000-0002-5434-957X
https://orcid.org/0000-0003-0527-1136
https://orcid.org/0000-0001-8625-4359
Highlights Preterm neonates are still highly exposed to phthalate and alternative plasticizers. Neonatal intensive care unit exposure to phthalates decreased over time. Neonatal intensive care unit exposure to alternative plasticizers is increasing. Respiratory support and blood transfusion are associated with higher exposure. 29 % of neonates had an estimated phthalate intake above animal-derived safe levels.
Abstract Due to endocrine disrupting effects, di-(2-ethylhexyl) phthalate (DEHP), a plasticizer used to soften plastic medical devices, was restricted in the EU Medical Devices Regulation (EU MDR 2017/745) and gradually replaced by alternative plasticizers. Neonates hospitalized in the neonatal intensive care unit (NICU) are vulnerable to toxic effects of plasticizers. From June 2020 to August 2022, urine samples (n = 1070) were repeatedly collected from premature neonates (n = 132, 4–10 samples per patient) born at <31 weeks gestational age and/or <1500 g birth weight in the Antwerp University Hospital, Belgium. Term control neonates (n = 21, 1 sample per patient) were included from the maternity ward. Phthalate and alternative plasticizers’ metabolites were analyzed using liquid-chromatography coupled to tandem mass spectrometry. Phthalate metabolites were detected in almost all urine samples. Metabolites of alternative plasticizers, di-(2-ethylhexyl)-adipate (DEHA), di-(2-ethylhexyl)-terephthalate (DEHT) and cyclohexane-1,2-dicarboxylic-di-isononyl-ester (DINCH), had detection frequencies ranging 30–95 %. Urinary phthalate metabolite concentrations were significantly higher in premature compared to control neonates (p = 0.023). NICU exposure to respiratory support devices and blood products showed increased phthalate metabolite concentrations (p < 0.001). Phthalate exposure increased from birth until four weeks postnatally. The estimated phthalate intake exceeded animal-derived no-effect-levels (DNEL) in 10 % of samples, with maximum values reaching 24 times the DNEL. 29 % of premature neonates had at least once an estimated phthalate intake above the DNEL. Preterm neonates are still exposed to phthalates during NICU stay, despite the EU Medical Devices Regulation. NICU exposure to alternative plasticizers is increasing, though currently not regulated, with insufficient knowledge on their hazard profile.
Ongoing exposure to endocrine disrupting phthalates and alternative plasticizers in neonatal intensive care unit patients
https://orcid.org/0000-0003-4073-110X
https://orcid.org/0000-0003-0597-2653
https://orcid.org/0000-0002-5434-957X
https://orcid.org/0000-0003-0527-1136
https://orcid.org/0000-0001-8625-4359
Highlights Preterm neonates are still highly exposed to phthalate and alternative plasticizers. Neonatal intensive care unit exposure to phthalates decreased over time. Neonatal intensive care unit exposure to alternative plasticizers is increasing. Respiratory support and blood transfusion are associated with higher exposure. 29 % of neonates had an estimated phthalate intake above animal-derived safe levels.
Abstract Due to endocrine disrupting effects, di-(2-ethylhexyl) phthalate (DEHP), a plasticizer used to soften plastic medical devices, was restricted in the EU Medical Devices Regulation (EU MDR 2017/745) and gradually replaced by alternative plasticizers. Neonates hospitalized in the neonatal intensive care unit (NICU) are vulnerable to toxic effects of plasticizers. From June 2020 to August 2022, urine samples (n = 1070) were repeatedly collected from premature neonates (n = 132, 4–10 samples per patient) born at <31 weeks gestational age and/or <1500 g birth weight in the Antwerp University Hospital, Belgium. Term control neonates (n = 21, 1 sample per patient) were included from the maternity ward. Phthalate and alternative plasticizers’ metabolites were analyzed using liquid-chromatography coupled to tandem mass spectrometry. Phthalate metabolites were detected in almost all urine samples. Metabolites of alternative plasticizers, di-(2-ethylhexyl)-adipate (DEHA), di-(2-ethylhexyl)-terephthalate (DEHT) and cyclohexane-1,2-dicarboxylic-di-isononyl-ester (DINCH), had detection frequencies ranging 30–95 %. Urinary phthalate metabolite concentrations were significantly higher in premature compared to control neonates (p = 0.023). NICU exposure to respiratory support devices and blood products showed increased phthalate metabolite concentrations (p < 0.001). Phthalate exposure increased from birth until four weeks postnatally. The estimated phthalate intake exceeded animal-derived no-effect-levels (DNEL) in 10 % of samples, with maximum values reaching 24 times the DNEL. 29 % of premature neonates had at least once an estimated phthalate intake above the DNEL. Preterm neonates are still exposed to phthalates during NICU stay, despite the EU Medical Devices Regulation. NICU exposure to alternative plasticizers is increasing, though currently not regulated, with insufficient knowledge on their hazard profile.
Ongoing exposure to endocrine disrupting phthalates and alternative plasticizers in neonatal intensive care unit patients
Panneel, Lucas (author) / Cleys, Paulien (author) / Poma, Giulia (author) / Ait Bamai, Yu (author) / Jorens, Philippe G. (author) / Covaci, Adrian (author) / Mulder, Antonius (author)
2024-03-24
Article (Journal)
Electronic Resource
English
Endocrine disrupting chemicals , Neonatal exposome , Neonatal intensive care unit , Plastic medical devices , Premature neonates , AP , Alternative plasticizer , BBzP , Benzylbutyl phthalate , BPD , Bronchopulmonary dysplasia , DEHA , Di-(2-ethylhexyl) adipate , DEHP , Di-(2-ethylhexyl) phthalate , DEHT , Di-(2-ethylhexyl) terephthalate , DEP , diethyl phthalate , DINCH , Cyclohexane-1,2-dicarboxylic di-isononyl ester , DF , Detection frequency , DiBP , Diisobutyl phthalate , DIDP , Di-isodecyl phthalate , DINP , Di-isononyl phthalate , DnBP , Di-n-butyl phthalate , DNEL , derived no effect level , EDC , Endocrine discrupting chemical , EDI , Estimated daily intake , GA , Gestational age , HI , Hazard index , HQ , Hazard quotient , LOQ , Limit of quantification , MDR , Medical Devices Regulation , MW , Molecular weight , NICU , PHT , phthalate , PMD , Plastic Medical Device , PVC , Polyvinyl chloride , SG , Specific gravity, Tris-(2-ethylhexyl) trimellitate (TOTM)
| British Library Online Contents | 2005