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Citation
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HERO ID
5701707
Reference Type
Journal Article
Title
Perioperative exposure to suspect neurotoxicants from medical devices in newborns with congenital heart defects
Author(s)
Gaynor, JW; Ittenbach, RF; Calafat, AM; Burnham, NB; Bradman, A; Bellinger, DC; Henretig, FM; Wehrung, EE; Ward, JL; Russell, WW; Spray, TL
Year
2019
Is Peer Reviewed?
Yes
Journal
Annals of Thoracic Surgery
ISSN:
0003-4975
EISSN:
1552-6259
Publisher
Elsevier USA
Volume
107
Issue
2
Page Numbers
567-572
Language
English
PMID
30071236
DOI
10.1016/j.athoracsur.2018.06.035
Web of Science Id
WOS:000456733600062
URL
https://search.proquest.com/docview/2083723048?accountid=171501
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Abstract
BACKGROUND: Industrial chemicals are increasingly recognized as potential developmental neurotoxicants. Di(2-ethylhexyl) phthalate (DEHP), used to impart flexibility and temperature tolerance to polyvinylchloride, and bisphenol A (BPA), used to manufacture polycarbonate, are commonly present in medical devices. The magnitude of exposure in neonates during hospitalization for cardiac operations is unknown.
METHODS: We quantified urinary concentrations of DEHP metabolites and BPA preoperatively and postoperatively in neonates undergoing cardiac operations and their mothers. Urinary concentrations of these biomarkers reflect recent exposures (half-lives are approximately 6 to 24 hours). Biomarker concentrations in mothers' and infants' preoperative and postoperative samples were compared.
RESULTS: Operations were performed in 18 infants (mean age, 5 ± 4 [SD] days). The maternal sample was obtained on postpartum day 4 ± 4. The preoperative urine sample was obtained on day-of-life 4 ± 2 and the postoperative sample on day-of-life 6 ± 4. Mean maternal concentrations for DEHP metabolites and BPA were at the 50th percentile for females in the United States general population. Infant preoperative concentrations of 1 DEHP metabolite and BPA were significantly higher than maternal concentrations. Postoperative concentrations for all DEHP metabolites were significantly greater than preoperative concentrations.
CONCLUSIONS: There is considerable perioperative exposure to DEHP and BPA for neonates undergoing cardiac operations. Infant concentrations for both BPA and DEHP metabolites were significantly higher than maternal concentrations, consistent with the infant's exposure to medical devices. Further study is needed to determine the potential role of these suspect neurotoxicants in the etiology of neurodevelopmental disability after cardiac operations.
Keywords
4,4' isopropylidenediphenol; mono (2 ethyl 5 hydroxyhexyl)phthalate; mono [2 ethyl(2 ethyl 5 hydroxyhexyl]phthalate; phthalic acid 2 ethylhexyl monoester; phthalic acid bis(2 ethylhexyl) ester; polycarbonate; unclassified drug; 4,4' isopropylidenediphenol; benzhydryl derivative; biological marker; neurotoxin; phenol derivative; phthalic acid bis(2 ethylhexyl) ester; aortic arch surgery; arterial switch operation; Article; cardiopulmonary bypass; child hospitalization; clinical article; comparative study; congenital heart malformation; controlled study; exposure; female; gestational age; heart surgery; heart ventricle septum defect; human; limit of detection; male; metabolite; neurotoxicity; newborn; newborn surgery; postoperative period; preoperative evaluation; priority journal; prospective study; urine level; urine sampling; adverse event; congenital heart malformation; devices; environmental exposure; follow up; preoperative period; risk factor; urine; Benzhydryl Compounds; Biomarkers; Diethylhexyl Phthalate; Environmental Exposure; Equipment and Supplies; Female; Follow-Up Studies; Heart Defects, Congenital; Humans; Infant, Newborn; Male; Neurotoxins; Phenols; Postoperative Period; Preoperative Period; Prospective Studies; Risk Factors
Tags
IRIS
•
Dibutyl Phthalate (DBP)
Database Searches
LitSearch July 2017 - Sept 2018
New from Previous
Pubmed
•
Phthalates – Targeted Search for Epidemiological Studies
Included
Source-March 2019 Update
WOS
Toxline
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