Risk Assessment of Phthalates and Their Metabolites in Hospitalized Patients: A Focus on Di- and Mono-(2-ethylhexyl) Phthalates Exposure from Intravenous Plastic Bags
Phthalate esters (PAEs) are plasticizers associated with multiple toxicities; however, no strict regulations have been implemented to restrict their use in medical applications in Lebanon. Our study aimed at assessing the potential risks correlated with phthalate exposure from IV bags manufactured i...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-06-01
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| Series: | Toxics |
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| Online Access: | https://www.mdpi.com/2305-6304/10/7/357 |
| _version_ | 1827626433946583040 |
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| author | Yolande Saab Emilia Oueis Stephanie Mehanna Zahi Nakad Rita Stephan Rony S. Khnayzer |
| author_facet | Yolande Saab Emilia Oueis Stephanie Mehanna Zahi Nakad Rita Stephan Rony S. Khnayzer |
| author_sort | Yolande Saab |
| collection | DOAJ |
| description | Phthalate esters (PAEs) are plasticizers associated with multiple toxicities; however, no strict regulations have been implemented to restrict their use in medical applications in Lebanon. Our study aimed at assessing the potential risks correlated with phthalate exposure from IV bags manufactured in Lebanon. GC–MS analysis showed that di-(2-ethylhexyl) phthalate (DEHP) is the predominant phthalate found in almost all samples tested with values ranging from 32.8 to 39.7% <i>w</i>/<i>w</i> of plastic. DEHP concentrations in the IV solutions reached up to 148 µg/L, as measured by SPME-GC–MS/MS, thus resulting in hazard quotients greater than 1, specifically in neonates. The toxicity of DEHP is mainly attributed to its metabolites, most importantly mono-(2-ethylhexyl) phthalate (MEHP). The IV bag solution with the highest content in DEHP was therefore used to extrapolate the amounts of urinary MEHP. The highest concentrations were found in neonates having the lowest body weight, which is concerning, knowing the adverse effects of MEHP in infants. Our study suggests that the use of IV bags manufactured in Lebanon could pose a significant risk in hospitalized patients, especially infants in neonatal care. Therefore, Lebanon, as well as other countries, should start imposing laws that restrict the use of phthalates in medical IV bags and substitute them with less toxic plasticizers. |
| first_indexed | 2024-03-09T12:55:39Z |
| format | Article |
| id | doaj.art-21a04fd144534fe8a254d54e90b7f454 |
| institution | Directory Open Access Journal |
| issn | 2305-6304 |
| language | English |
| last_indexed | 2024-03-09T12:55:39Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Toxics |
| spelling | doaj.art-21a04fd144534fe8a254d54e90b7f4542023-11-30T22:00:43ZengMDPI AGToxics2305-63042022-06-0110735710.3390/toxics10070357Risk Assessment of Phthalates and Their Metabolites in Hospitalized Patients: A Focus on Di- and Mono-(2-ethylhexyl) Phthalates Exposure from Intravenous Plastic BagsYolande Saab0Emilia Oueis1Stephanie Mehanna2Zahi Nakad3Rita Stephan4Rony S. Khnayzer5Pharmaceutical Sciences Department, School of Pharmacy, Lebanese American University, Chouran, Beirut 1102-2801, LebanonPharmaceutical Sciences Department, School of Pharmacy, Lebanese American University, Chouran, Beirut 1102-2801, LebanonDepartment of Natural Sciences, Lebanese American University, Chouran, Beirut 1102-2801, LebanonElectrical and Computer Engineering Department, School of Engineering, Lebanese American University, Chouran, Beirut 1102-2801, LebanonPharmaceutical Sciences Department, School of Pharmacy, Lebanese American University, Chouran, Beirut 1102-2801, LebanonDepartment of Natural Sciences, Lebanese American University, Chouran, Beirut 1102-2801, LebanonPhthalate esters (PAEs) are plasticizers associated with multiple toxicities; however, no strict regulations have been implemented to restrict their use in medical applications in Lebanon. Our study aimed at assessing the potential risks correlated with phthalate exposure from IV bags manufactured in Lebanon. GC–MS analysis showed that di-(2-ethylhexyl) phthalate (DEHP) is the predominant phthalate found in almost all samples tested with values ranging from 32.8 to 39.7% <i>w</i>/<i>w</i> of plastic. DEHP concentrations in the IV solutions reached up to 148 µg/L, as measured by SPME-GC–MS/MS, thus resulting in hazard quotients greater than 1, specifically in neonates. The toxicity of DEHP is mainly attributed to its metabolites, most importantly mono-(2-ethylhexyl) phthalate (MEHP). The IV bag solution with the highest content in DEHP was therefore used to extrapolate the amounts of urinary MEHP. The highest concentrations were found in neonates having the lowest body weight, which is concerning, knowing the adverse effects of MEHP in infants. Our study suggests that the use of IV bags manufactured in Lebanon could pose a significant risk in hospitalized patients, especially infants in neonatal care. Therefore, Lebanon, as well as other countries, should start imposing laws that restrict the use of phthalates in medical IV bags and substitute them with less toxic plasticizers.https://www.mdpi.com/2305-6304/10/7/357phthalatesdi-(2-ethylhexyl) phthalatemono-(2-ethylhexyl) phthalateIV bagsGC–MStoxicities |
| spellingShingle | Yolande Saab Emilia Oueis Stephanie Mehanna Zahi Nakad Rita Stephan Rony S. Khnayzer Risk Assessment of Phthalates and Their Metabolites in Hospitalized Patients: A Focus on Di- and Mono-(2-ethylhexyl) Phthalates Exposure from Intravenous Plastic Bags Toxics phthalates di-(2-ethylhexyl) phthalate mono-(2-ethylhexyl) phthalate IV bags GC–MS toxicities |
| title | Risk Assessment of Phthalates and Their Metabolites in Hospitalized Patients: A Focus on Di- and Mono-(2-ethylhexyl) Phthalates Exposure from Intravenous Plastic Bags |
| title_full | Risk Assessment of Phthalates and Their Metabolites in Hospitalized Patients: A Focus on Di- and Mono-(2-ethylhexyl) Phthalates Exposure from Intravenous Plastic Bags |
| title_fullStr | Risk Assessment of Phthalates and Their Metabolites in Hospitalized Patients: A Focus on Di- and Mono-(2-ethylhexyl) Phthalates Exposure from Intravenous Plastic Bags |
| title_full_unstemmed | Risk Assessment of Phthalates and Their Metabolites in Hospitalized Patients: A Focus on Di- and Mono-(2-ethylhexyl) Phthalates Exposure from Intravenous Plastic Bags |
| title_short | Risk Assessment of Phthalates and Their Metabolites in Hospitalized Patients: A Focus on Di- and Mono-(2-ethylhexyl) Phthalates Exposure from Intravenous Plastic Bags |
| title_sort | risk assessment of phthalates and their metabolites in hospitalized patients a focus on di and mono 2 ethylhexyl phthalates exposure from intravenous plastic bags |
| topic | phthalates di-(2-ethylhexyl) phthalate mono-(2-ethylhexyl) phthalate IV bags GC–MS toxicities |
| url | https://www.mdpi.com/2305-6304/10/7/357 |
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