Use of di(2-ethylhexyl) phthalate-containing medical products and urinary levels of mono(2-ethylhexyl) phthalate in neonatal intensive care unit infants.
Use of di(2-ethylhexyl) phthalate-containing medical products and urinary levels of mono(2-ethylhexyl) phthalate in neonatal intensive care unit infants.
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DOI：
10.1289/ehp.7932
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发表时间：
2005-09
影响因子：
10.4
通讯作者：
Hu H
中科院分区：
文献类型：
--
作者：
Green R;Hauser R;Calafat AM;Weuve J;Schettler T;Ringer S;Huttner K;Hu H
目的：邻苯二甲酸二（2-乙基己基）酯（DEHP）是一种用于聚氯乙烯（PVC）塑料制成的医疗产品的增塑剂，可能对人体有毒。DEHP是亲脂性的，与PVC非共价结合，允许它从这些产品中浸出。含有DEHP的医疗设备广泛用于新生儿重症监护病房（NICUs）。在新生儿重症监护病房中，我们研究了暴露于含有DEHP的医疗器械与尿中邻苯二甲酸单（2-乙基己基）酯（MEHP）水平的关系，MEHP是DEHP的代谢物。设计：本研究采用横断面设计。研究对象：我们研究了2003年3月1日至4月30日期间在两家三级医院nicu住院至少3天的54名新生儿。测量：先验地，我们根据使用的医疗产品对婴儿接触DEHP进行了分类：低DEHP暴露组包括主要接受奶瓶和/或灌食的婴儿；中等暴露组包括接受肠内喂养、静脉高营养和/或鼻腔持续气道正压治疗的婴儿；高暴露组包括接受脐管置管、气管插管、静脉高营养和留置灌胃管的婴儿。我们采用自动固相萃取/同位素稀释/高效液相色谱/串联质谱法测定婴儿尿液中的MEHP。结果：尿MEHP水平随DEHP暴露单调升高。对于低、中、高dehp暴露组，MEHP水平的中位数（四分位数范围）分别为4（18）、28（58）和86 ng/mL (150) （p = 0.004）。在调整制度和性别后，高暴露组婴儿尿MEHP水平是低暴露组婴儿的5.1倍（p = 0.03）。结论：NICU婴儿大量使用含有DEHP的医疗器械会导致DEHP暴露增加，这可以通过尿中MEHP水平升高来反映。
Objective: Di(2-ethylhexyl) phthalate (DEHP) is a plasticizer used in medical products made with polyvinyl chloride (PVC) plastic and may be toxic to humans. DEHP is lipophilic and binds non-covalently to PVC, allowing it to leach from these products. Medical devices containing DEHP are used extensively in neonatal intensive care units (NICUs). Among neonates in NICUs, we studied exposure to DEHP-containing medical devices in relation to urinary levels of mono(2-ethylhexyl) phthalate (MEHP), a metabolite of DEHP. Design: We used a cross-sectional design for this study. Participants: We studied 54 neonates admitted to either of two level III hospital NICUs for at least 3 days between 1 March and 30 April 2003. Measurements: A priori, we classified the infants’ exposures to DEHP based on medical products used: The low-DEHP exposure group included infants receiving primarily bottle and/or gavage feedings; the medium exposure group included infants receiving enteral feedings, intravenous hyperalimentation, and/or nasal continuous positive airway pressure; and the high exposure group included infants receiving umbilical vessel catheterization, endotracheal intubation, intravenous hyperalimentation, and indwelling gavage tube. We measured MEHP in the infants’ urine using automated solid-phase extraction/isotope dilution/high-performance liquid chromatography/ tandem mass spectrometry. Results: Urinary MEHP levels increased monotonically with DEHP exposure. For the low-, medium-, and high-DEHP exposure groups, median (interquartile range) MEHP levels were 4 (18), 28 (58), and 86 ng/mL (150), respectively (p = 0.004). After adjustment for institution and sex, urinary MEHP levels among infants in the high exposure group were 5.1 times those among infants in the low exposure group (p = 0.03). Conclusion: Intensive use of DEHP-containing medical devices in NICU infants results in higher exposure to DEHP as reflected by elevated urinary levels of MEHP.
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DOI：
10.1007/s00128-001-0255-z
发表时间：
2002-03-01
影响因子：
2.7
作者：
Brock, JW;Caudill, SP;Hilborn, ED
通讯作者：
Hilborn, ED
影响因子：
8
作者：
Shea, KM
通讯作者：
Shea, KM
影响因子：
10.4
作者：
PECK, CC;ALBRO, PW
通讯作者：
ALBRO, PW
影响因子：
2.9
作者：
ROCK, G;TOCCHI, M;TACKABERRY, ES
通讯作者：
TACKABERRY, ES
影响因子：
8.8
作者：
Karle, VA;Short, BL;Rubin, RJ
通讯作者：
Rubin, RJ