Publication
Title
Ongoing exposure to endocrine disrupting phthalates and alternative plasticizers in neonatal intensive care unit patients
Author
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.
Language
English
Source (journal)
Environment international. - Oxford
Publication
Oxford : 2024
ISSN
0160-4120
DOI
10.1016/J.ENVINT.2024.108605
Volume/pages
186 (2024) , p. 1-10
Article Reference
108605
ISI
001215674500001
Pubmed ID
38569425
Full text (Publisher's DOI)
Full text (open access)
UAntwerpen
Faculty/Department
Research group
Project info
Exposure of premature neonates to bisphenol A and phthalates at the intensive care unit: accumulation in hair and long-term neurodevelopmentel and pulmonary toxicity.
Exposure to plasticizers leaching from plastic medical devices in Neonatal Intensive Care and impact on the long-term neurocognitive and pulmonary development.
From exposome to effect assessment of contaminants in human and animal models (EXPOSOME).
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Record
Identifier
Creation 02.04.2024
Last edited 28.05.2024
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