A New Ethical Dilemma For Hemodialysis Patients : Exposure To Diethyl Hexyl Phthalate (original) (raw)
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Exposure of hemodialysis patients to di-2-ethylhexyl phthalate
International Journal of Pharmaceutics, 1999
The migration of di-2-ethylhexyl phthalate (DEHP) from dialyzers was studied in 21 patients with chronic renal failure undergoing maintenance hemodialysis. The circulating concentrations of DEHP were measured by high performance liquid chromatography in blood of patients obtained from the inlet and the outlet of the dialyzer during a 4-h dialysis session. During treatment of renal failure using plasticized tubing, the plasma level of DEHP increased. On average, an estimated 75.2 mg of DEHP was extracted from the dialyzer during a single dialysis session, with a range of 44.3-197.1 mg. On the other hand, the total amount of DEHP retained by the patient during the dialysis session was evaluated by the difference between the AUC out and the AUC in and ranged from 3.6 to 59.6 mg. The rate of extraction of DEHP from the dialyzer was correlated (r= 0.705, PB 0.05) with serum lipid content (cholesterol and triglyceride).
Matéria (Rio de Janeiro), 2018
The objective of the work is to demonstrate the applicability of the High-Performance Liquid Chromatography (HPLC) on the quantification of the Di(2-ethylhexyl phthalate) (DEHP) released from the Polyvinyl Chloride (PVC) line into the circulating blood during the hemodialysis procedure. As the proposal is not to validate the method, blood samples from five patients and three healthy volunteers were collected, and the plasmas were isolated, prepared and analyzed. The average concentration of DEHP in the patient's plasma was 0.19±0.12 mg/kg of body mass, while in the plasma of the healthy volunteers was 0.003±0.002 µg/kg of body mass. The results showed that the method presented is an alternative to quantify the DEHP in the blood and could assist in the search for alternative materials to apply to extracorporeal circulation equipment. The study was performed according to the national and international standards of ethics in research involving human beings (CEP PUCPR Prot. n.5802).
Leaching and Exposure of Phthalates from Medical Devices; Health Impacts and Regulations
Environmental Contaminants Reviews, 2019
Phthalates (PAEs) are widely used as plasticizers in medical devices to make polyvinyl chloride flexible and soft. However, PAEs can be leached out from plasticizers undesirably and can migrate within the material and end up with direct exposure to humans. Therefore, a number of studies have been conducted globally focusing on their leaching from medical devices like blood bags, infusion tubing, peritoneal dialysis bags and tubing, catheters etc. In current review an attempt is made to gather information related to leaching, exposure, health implication of PAEs along with the regulation used in different countries. Toxic health effects with the exposure of PAEs includes neurological effects, DNA damage, oxidative stress, asthma with negative impact on lungs, effects on reproductive system, liver impairment and gastrointestinal effects. In addition, leaching studies has shown the presence of DEHP about 31-34 % in peritoneal dialysis set like bags and tubing. DEHP leached out from medical apparatus depends upon temperature, storage time, amount of DEHP present in devices and shaking of device while in touched with medical solution. The exposure of plasticizers for pregnant hospitalised women and infants has also highlighted. In addition, PAEs alternates introduced in market are also discussed like Trioctyltrimellitate/tri-(2-ethylhexyl) trimellitate) along with various regulations regarding the use of PAEs in medical devices and other products. was poor.
International Journal of Pharmaceutics, 2001
The leachability of both Di(2-ethylhexyl) phthalate (DEHP) and Tri(2-ethylhexyl) trimellitate (TEHTM) or Trioctyl trimellitate (TOTM) from haemodialysis tubing was investigated in 20 patients with chronic renal failure undergoing maintenance haemodialysis. The blood tubing made of common polyvinyl chloride (PVC) plasticized with DEHP (group 1 patients) were replaced with tubing plasticized with TOTM-DEHP (group 2 patients). The patient blood obtained from the inlet and the outlet of the dialyzer was analyzed during a 4 h-dialysis session. Thus, the circulating concentrations of both DEHP and TOTM resulting from the release from dialyzer tubes were estimated using High-performance Liquid chromatograph (HPLC). With the common PVC-DEHP blood tubing, a DEHP quantity of 122.95 9 33.94 mg was extracted from tubing during a single dialysis session (ranging from 55 to 166.21 mg). During the same period, the total amounts of DEHP retained by the patients were 27.30 9 9.22 mg (ranging from 12.50 to 42.72 mg). As for blood tubing plasticized with TOTM-DEHP, 41.80 9 4.47 mg of DEHP and 75.11 9 25.72 mg of TOTM were extracted. During the same period, the amounts of DEHP and TOTM retained by the patients were 3.42 91.37 mg and 4.87 9 2.60 mg, respectively. The extraction rate both plasticizers was correlated with serum lipid content (cholesterol +triglyceride) (r 2 =0.75 for DEHP and r 2 = 0.64 for TOTM). In the present investigation, less TOTM and DEHP were apparently released from haemodialysis tubing plasticized with TOTM-DEHP than DEHP released from haemodialysis tubing plasticized with DEHP only. TOTM seems to be a superior alternative to DEHP for use in medical devices because of its potential lower leachability. To recommend it as an alternative plasticizer, its possible toxicity towards human body should be investigated before it can be used routinely. However, patients undergoing haemodialysis using tubing plasticized with DEHP only are regularly exposed to non negligible amounts of DEHP. In view of several biological effects previously reported, it is time to reconsider the use of DEHP only as a plasticizer.
Tropical Journal of Natural Product Research, 2019
The ubiquitous nature of plastics has caused increased concerns about the effects of exposure of humans to plastic polymers particularly the endocrine-disrupting chemicals (EDCs) like Di-(2ethylhexyl) phthalate (DEHP) and Bisphenol A (BPA) used in plastic production. The aim of this study was to investigate the effects of BPA and DEHP on haematological and renal function parameters. A total of 60 adult Wistar rats were divided into four groups (I-IV) of 15 animals each. Group I was fed with rodent feed only (control), while groups II-IV were administered 5 mg/kg/day of BPA, 0.5 mg/kg/day of DEHP and a mixture of 0.5 mg/kg/day of BPA and 0.5 mg/kg/day of DEHP, respectively. The animals were monitored for 42 days. The result shows that there were significant (p < 0.05) increase in pack cell volume, haemoglobin, red blood cell, reticulocyte, total white blood cell, lymphocyte, platelet, sodium ion and creatinine concentrations in group II, while the concentrations of urea, potassium and bicarbonate were reduced. In group III, there were increase in the concentrations of pack cell volume, mean cell haemoglobin, and mean cell volume, lymphocyte, platelets, sodium ion, and urea while creatinine concentration was reduced. In group IV, there were increase in the concentration of mean cell haemoglobin concentration, reticulocyte, total white cell count, neutrophil, lymphocyte, platelet, sodium ion and a decrease in creatinine and potassium ion concentration. The present study has shown a possible haematinic effect of BPA and DEHP. They also cause significant alterations in kidney function test parameters.
Phthalate exposure and health outcomes
Indian Journal of Occupational and Environmental Medicine, 2006
Phthalates are used in commercial products as softners of plastics, solvents in perfumes and additives to hair sprays, lubricants and insect repellents. The wide spread use of phthalate results in multiple human exposure routes i.e., ingestion, inhalation and dermal exposure. In the present review, a detailed account of respiratory toxicity, phthaltes is high given their use in a vast range of consumable products and because they are not covalently bound to the other chemicals in the formulations. After exposure, phthalates are rapidly hydrolyzed to their respective monoesters which can be further biotransformed to
Phthalates are esters of Pthalic acid, compounds mainly used as plasticisers. Phthalates are widely used chemicals which are of significant research interest as their exposure causes various consequences for human health. There are several categories of phthalates extensively used in many commercial productions with diverse uses, physicochemical properties and toxicological effects. This chapter discusses the toxicity of Phthalates and its potential risks to human health.
International Journal of Environmental Research and Public Health, 2018
Phthalates are widely used in the industrial manufacture of many products. Some phthalates have shown reproductive toxicity in humans, acting as endocrine disruptors, so they were included in the authorization process defined in Reg. CE 1907/2006 (REACH). Two groups of population were recruited, before and after the inclusion of some phthalates in the authorization list in REACH: the first group of 157 volunteers was studied in 2011 and the second, 171 volunteers, in 2016. Each subject completed a questionnaire about personal lifestyle, working activities and use of chemical products. The main urinary metabolites of five phthalates were analyzed by HPLC/MS/MS: mono(2-ethylhexyl)phthalate (MEHP) and mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) for di(2-ethylhexyl)phthalate (DEHP) exposure; monoethylphthalate (MEP) for diethylphtahate (DEP); monobenzylphthalate (MBzP) for butylbenzylphtahalate (BBP) and dibenzylphthalate (DBzP), mono-n-butylphthalate (MnBP) for butylbenzylphtahalate...