Exposure to DEHP in Neonates Doesn’t Hurt Physic

Newswise — Newborns exposed to high levels of DEHP during a lifesaving medical procedure did not suffer adverse effects on their physical growth and pubertal maturity as adolescents, according to a study published today in the September issue of the peer-reviewed journal Environmental Health Perspectives (EHP). The study of 13 male and 6 female subjects at age 14-16 also found that thyroid, liver, renal, and male and female gonadal functions tested within normal ranges for age and sex distribution.

DEHP, or di-2-ethylhexyl phthalate, is used to make polyvinyl chloride (PVC) plastic tubing soft and flexible, and is widely used in disposable medical devices. AS DEHP doesn't bind to the plastic, it can leach out of flexible medical devices into the solution it contains, and ultimately enter the patient. Individuals undergoing certain medical treatments such as dialysis, exchange transfusion, extracorporeal membrane oxygenation (ECMO), and cardiovascular surgery have the highest exposures to DEHP.

The present study analyzed adolescents who had been treated as neonates with ECMO. During ECMO, which is used for patients who are too sick to be supported with a ventilator, blood is propelled outside the body, then oxygenated and returned to the body. During ECMO treatment, infants can be exposed to DEHP at three times the level of average adult exposure—levels shown to cause adverse reproductive effects in animals.

Researchers analyzed 19 children who had undergone ECMO in the neonatal period. With the exception of 1 female participant diagnosed with Marfan syndrome, all the children had normal growth percentiles for age and sex. All had normal values for thyroid, liver, and renal function, and hormone levels were normal and appropriate.

"Our study did not show long-term adverse outcome related to physical growth and pubertal development in adolescents previously exposed to DEHP in the neonatal period," the study authors write. "This is in contrast to the animal data in multiple species, which show a variety of reproductive and developmental toxicities when this plasticizer is administered."

The lead author of the study was Khodayar Rais-Bahrami of the Children's National Medical Center and the George Washington University School of Medicine. Other authors were Suzan Nunez, Mary E. Revenis, Naomi L.C. Luban, and Billie L. Short. The article is available free of charge at http://ehp.niehs.nih.gov/docs/2004/6901/abstract.html.

EHP is published by the National Institute of Environmental Health Sciences, part of the U.S. Department of Health and Human Services. EHP became an Open Access journal in January 2004. More information is available online at http://www.ehponline.org/.