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Your Environment. Your Health.

Respiratory Support Source of Phthalates in NICUs

Annemarie Stroustrup, M.D.
Icahn School of Medicine at Mount Sinai

A new study funded by NIEHS identified noninvasive respiratory support equipment — specifically, nasal prongs that deliver oxygen and air pressure — as a source of phthalate exposure in the neonatal intensive care unit (NICU). Although multiple studies have demonstrated elevated phthalate markers in NICU patients, specific sources of phthalate exposure were not previously identified.

Premature infants were studied during NICU hospitalization. Researchers recorded daily exposure to specific NICU medical equipment in 71 infants. They analyzed 149 urine specimens for phthalate metabolites. The team reported that phthalate markers in urine were 95-132 percent higher for infants exposed to certain medical equipment compared with those without equipment exposure. Phthalate mixtures relevant to neurobehavioral development were significantly associated with noninvasive respiratory support. Feeding supplies and intravenous lines were not significantly associated with these phthalate mixtures.

According to the authors, their discovery of the source of potentially neuroactive phthalate exposure provides an avenue to reduce phthalate exposure among NICU patients. The study also suggested that exposure to common and clinically relevant phthalates still exists, despite previous efforts by hospital NICUs and medical equipment manufacturers to limit exposure by changing the materials used in feeding supplies.

Citation: Stroustrup A, Bragg JB, Busgang SA, Andra SS, Curtin P, Spear EA, Just AC, Arora M, Gennings C. 2018. Sources of clinically significant neonatal intensive care unit phthalate exposure. J Expo Sci Environ Epidemiol; doi: 10.1038/s41370-018-0069-2. [Online 21 Sept 2018].

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