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DEHP: Hospital Plastics May Put Sick Infants At Risk

Title: DEHP: Hospital Plastics May Put Sick Infants At Risk
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Hospital Plastics May Put Sick Infants At Risk

By Cat Lazaroff

ARLINGTON, Virginia, July 17, 2000 (ENS) - A government panel has expressed
"serious concern" that chemicals used in vinyl medical products may harm
the reproductive organs of critically ill male infants exposed during
medical treatments.

The panel of scientists also concluded that they have "concern" that the
development of the reproductive system of healthy male infants and toddlers
could have been harmed by exposure to the chemical softeners, known as
phthalates, during their mother's pregnancy or from non-medical exposures
during the first years of life.
Female infants may also be affected by exposure, but appear not to be as
sensitive to the reproductive effects as males, the panel said.

The independent, expert panel appointed by the federal National Toxicology
Program (NTP) began the phthalate review last August. This is the first
time the NTP has evaluated the reproductive and developmental toxicity of a
chemical rather than its cancer causing properties.

Panelists reviewed existing literature in their areas of expertise and
provided other panel members with their summary evaluations. The scientists
reviewed almost 1,000 reports and studies covering general toxicity of
these chemicals in animals and humans, their developmental and reproductive
toxicity, and information on human exposure.

The expert panel continued its work at a second meeting in December. The
third meeting, held last week, concluded the panelís literature review and
summary on the effects of one particular phthalate, DEHP (di-ethylhexyl
phthalate), which is used to make vinyl plastics soft and flexible.

The threat of exposure is high from some medical procedures because DEHP
leaches from vinyl medical products, the panel said, as it is not
chemically bonded to the plastic it softens.
The National Toxicology Program's expert panel notes that DEHP "can leach
out when the medical device comes in contact with fluids such as blood,
plasma and drug solutions, or it can be released and migrate when the
device is heated," as in some sterilization procedures. The chemical will
"readily dissolve" in blood and blood products, infant formulas, and some
IV medications, the panel says.

In addition to its use in the manufacture of medical products, the chemical
DEHP is used in other vinyl products, including floorings, wall coverings,
furniture, luggage and children's toys.

The panel's findings confirm the report released yesterday by Health Care
Without Harm, a national collaborative campaign for environmentally
responsible health care made up of more than 250 citizens' organizations.

The Health Care Without Harm study found that fetuses, premature infants
and newborns are exposed to large amounts of a chemical suspected to cause
reproductive and developmental problems in humans.

Even medical chairs made of vinyl can be a hazard (Photo courtesy Greenpeace)
Last October, the environmental group Greenpeace - a member of Health Care
Without Harm - released a report on laboratory testing of 46 vinyl medical
products, including intravenous (IV) bags, syringes, tubing and catheters.
The productsí DEHP content ranged from 12 percent to 80 percent by weight.
Medical products manufacturers admit that DEHP can be released into
intravenous solutions, blood, and even the air used in respiratory therapy.
The World Health Organization believes there is a need to "reduce exposure
arising from the use of plastic tubes containing DEHP in such clinical
procedures as transfusion, haemodialysis, and artificial respiration."

Health Care Without Harm's report focuses on critically ill infants as the
most threatened population because multiple medical interventions may
require using devices that have been shown to leach DEHP. Higher exposure
for sick infants comes from neonatal intensive care units filled with vinyl

"These babies are exposed to DEHP from multiple pieces of equipment. It is
entering their bodies through their mouths, through their veins and through
their lungs," said Ted Schettler, MD, science director of the Science and
Environmental Health Network. "No one knows exactly what impact these
multiple exposures will have, but what we know about DEHP's effects on
animals gives us cause for concern and for action."

Exposure to DEHP can cause reproductive problems, including:

structural changes in the testes
reduced fertility
changes in sperm production
ovarian dysfunction
decreased hormone production in females
"Laboratory animal studies of DEHP have shown it to induce both fetal
malformations and adverse effects on the reproductive system," the National
Toxicology Program expert panel has concluded.

PVC products are widely used in medical laboratories (Photo courtesy
Hospitals can avoid much of the exposure premature infants and newborns
receive from DEHP by using products made without the chemical when
available. Alternatives are now available for most products used in
neonatal intensive care units, as well as for other polyvinyl chloride
(PVC) products.
"Here is a government sponsored panel of eminent scientists saying that
phthalate plasticizers in PVC medical products may pose a threat to the
ability to bear healthy children. Now health care professionals and
patients need to insist that if we can make the same products out of
materials that do not threaten fertility, we should do it," said Charlotte
Brody, RN, co-coordinator of Health Care Without Harm.

Health Care Without Harmís report is available at: www.noharm.org.

Summaries of the first two Phthalate Expert Panel meetings are available on
the Centerís website: http://cerhr.niehs.nih.gov.
     Stephanie  C. Davis - BFA, MPA
 Experienced Professional of Healthcare &
Non-Residential Waste Programs

     Waste Reduction Remedies sm
A Multi-Waste Stream, Multi-Material
     Waste Management Company

1497 Hopkins Street #2D Berkeley CA  94702-1201
Telephone & Fax:  510/527-8864 Pacific Time
E-mail:  ScD18@WasteReductionRemedies.com