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Lordelo R, Branco R, Gama F, Morais PV. Assessment of antimicrobial resistance, biofilm formation, and surface modification potential in hospital strains of Pseudomonas aeruginosa and Klebsiella pneumoniae. Heliyon 2024; 10:e30464. [PMID: 38711646 PMCID: PMC11070870 DOI: 10.1016/j.heliyon.2024.e30464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 04/12/2024] [Accepted: 04/26/2024] [Indexed: 05/08/2024] Open
Abstract
The occurrence of healthcare-associated infections is a multifactorial phenomenon related to hospital space contamination by bacteria. The ESKAPE group, specifically Pseudomonas aeruginosa and Klebsiella pneumoniae, play a relevant role in the occurrence of these infections. Therefore, comprehensive research is needed to identify characteristics that justify the prevalence of these species in the healthcare environment. In this line, the study aimed to determine the antimicrobial resistance, biofilm formation, and the potential for polymer degradation in a collection of 33 P. aeruginosa strains and 2 K. pneumoniae strains sampled from various equipment and non-critical surfaces in a Portuguese hospital. Antimicrobial susceptibility tests revealed that none of the strains was categorized as multidrug-resistant (non-MDR). An assessment of their biofilm-forming capabilities indicated that 97 % of the strains exhibited biofilm-producing characteristics. Notably, within this group, the majority of P. aeruginosa and half of K. pneumoniae strains were classified as strong biofilm producers. Furthermore, the strains were evaluated for their potential to cause damage or change medical devices, namely infusion sets, nasal cannula, and urinary catheters. Three P. aeruginosa strains, two strong and one moderate biofilm producers, showed the highest ability to modify surfaces of the nasal cannula and infusion sets. Additionally, the Chi-square test revealed a statistically significant relationship between the presence of P. aeruginosa strains and the water accession spots. In conclusion, this work suggests that bacteria from this group hold a significant ability to grow in the healthcare environment through the degradation of non-critical materials. This suggests a potential concern for the persistence and proliferation of these organisms in hospital environments, emphasizing the importance of robust infection control measures to mitigate the risks associated with bacterial growth on such surfaces.
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Affiliation(s)
- Roberta Lordelo
- University of Coimbra, Centre for Mechanical Engineering Material and Processes, ARISE, Department of Life Sciences, Coimbra, Portugal
| | - Rita Branco
- University of Coimbra, Centre for Mechanical Engineering Material and Processes, ARISE, Department of Life Sciences, Coimbra, Portugal
| | - Fernando Gama
- Health Sciences Research Unit: Nursing (UICISA: E), Portugal and Health School of the Polytechnic Institute of Viseu, Portugal
| | - Paula V. Morais
- University of Coimbra, Centre for Mechanical Engineering Material and Processes, ARISE, Department of Life Sciences, Coimbra, Portugal
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2
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Wiesinger H, Bleuler C, Christen V, Favreau P, Hellweg S, Langer M, Pasquettaz R, Schönborn A, Wang Z. Legacy and Emerging Plasticizers and Stabilizers in PVC Floorings and Implications for Recycling. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58:1894-1907. [PMID: 38241221 PMCID: PMC10832040 DOI: 10.1021/acs.est.3c04851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 11/17/2023] [Accepted: 11/28/2023] [Indexed: 01/21/2024]
Abstract
Hazardous chemicals in building and construction plastics can lead to health risks due to indoor exposure and may contaminate recycled materials. We systematically sampled new polyvinyl chloride floorings on the Swiss market (n = 151). We performed elemental analysis by X-ray fluorescence, targeted and suspect gas chromatography-mass spectrometry analysis of ortho-phthalates and alternative plasticizers, and bioassay tests for cytotoxicity and oxidative stress, and endocrine, mutagenic, and genotoxic activities (for selected samples). Surprisingly, 16% of the samples contained regulated chemicals above 0.1 wt %, mainly lead and bis(2-ethylhexyl) phthalate (DEHP). Their presence is likely related to the use of recycled PVC in new flooring, highlighting that uncontrolled recycling can delay the phase-out of hazardous chemicals. Besides DEHP, 29% of the samples contained other ortho-phthalates (mainly diisononyl and diisodecyl phthalates, DiNP and DiDP) above 0.1 wt %, and 17% of the samples indicated a potential to cause biological effects. Considering some overlap between these groups, they together make up an additional 35% of the samples of potential concern. Moreover, both suspect screening and bioassay results indicate the presence of additional potentially hazardous substances. Overall, our study highlights the urgent need to accelerate the phase-out of hazardous substances, increase the transparency of chemical compositions in plastics to protect human and ecosystem health, and enable the transition to a safe and sustainable circular economy.
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Affiliation(s)
- Helene Wiesinger
- Chair
of Ecological Systems Design, Institute of Environmental Engineering, ETH Zürich, 8093 Zürich, Switzerland
| | - Christophe Bleuler
- Service
de l’air, du bruit et des rayonnements non ionisants (SABRA), Geneva Cantonal Office for the Environment, 1205 Geneva, Switzerland
| | - Verena Christen
- Institute
for Ecopreneurship, School of Life Sciences, University of Applied Sciences and Arts Northwestern Switzerland,
FHNW, 4132 Muttenz, Switzerland
| | - Philippe Favreau
- Service
de l’air, du bruit et des rayonnements non ionisants (SABRA), Geneva Cantonal Office for the Environment, 1205 Geneva, Switzerland
| | - Stefanie Hellweg
- Chair
of Ecological Systems Design, Institute of Environmental Engineering, ETH Zürich, 8093 Zürich, Switzerland
- National
Centre of Competence in Research (NCCR) Catalysis, Institute of Environmental
Engineering, ETH Zürich, 8093 Zürich, Switzerland
| | - Miriam Langer
- Institute
for Ecopreneurship, School of Life Sciences, University of Applied Sciences and Arts Northwestern Switzerland,
FHNW, 4132 Muttenz, Switzerland
- Eawag—Swiss
Federal Institute of Aquatic Science and Technology, 8600 Dübendorf, Switzerland
| | - Roxane Pasquettaz
- Service
de l’air, du bruit et des rayonnements non ionisants (SABRA), Geneva Cantonal Office for the Environment, 1205 Geneva, Switzerland
| | - Andreas Schönborn
- Institute
of Natural Resource Sciences, ZHAW Zurich
University of Applied Science, 8820 Wädenswil, Switzerland
| | - Zhanyun Wang
- Chair
of Ecological Systems Design, Institute of Environmental Engineering, ETH Zürich, 8093 Zürich, Switzerland
- National
Centre of Competence in Research (NCCR) Catalysis, Institute of Environmental
Engineering, ETH Zürich, 8093 Zürich, Switzerland
- Empa—Swiss
Federal Laboratories for Materials Science and Technology, Technology and Society Laboratory, 9014 St. Gallen, Switzerland
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3
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Masse M, Jimenez M, Genay S, Pettinari A, Bellayer S, Barthélémy C, Décaudin B, Blanchemain N, Odou P. Limitation of the migration of plasticizers from medical devices through treatment with low-pressure cold plasma, polydopamine coating, and annealing. Int J Pharm 2023; 646:123422. [PMID: 37722492 DOI: 10.1016/j.ijpharm.2023.123422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 09/20/2023]
Abstract
Poly(vinyl chloride) (PVC) is widely used in the manufacture of medical devices. The plasticizers added to PVC are potentially toxic for humans, likely to migrate, and thus unintentionally administered to patients. The objective of the present study was to reduce the migration of plasticizer (1,2-cyclohexanedicarboxylic acid, diisononylester (DINCH) or trioctyltrimellitate (TOTM)) from PVC by implementing a three-step surface treatment process: (i) pretreatment with low-pressure argon cold plasma, (ii) polydopamine coating, and (iii) post-treatment with cold plasma exposure or thermal treatment at 140 °C. Samples were then characterized in terms of the water contact angle (WCA) and the aspect in scanning electron microscopy. Plasticizer migration (n = 5) was measured using an HPLC technique with ultraviolet detection and found to depend on the treatment and the plasticizer. Plasticized PVC was hydrophobic, with a measured mean ± standard deviation WCA of 96.7 ± 3.6° for PVC-DINCH and 110.2 ± 5.8° for PVC-TOTM. Plasma post-treatment and thermal post-treatment were respectively associated with a mean decrease in migration of 38.3 ± 1.9% for DINCH and 61.5 ± 4.4% for TOTM. Our results are promising with regard to limiting the migration of plasticizers into the patient's blood and thus enabling the development of safer medical devices.
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Affiliation(s)
- Morgane Masse
- Univ. Lille, CHU Lille, ULR 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France.
| | - Maude Jimenez
- Univ. Lille, CNRS, INRA, ENSCL UMR8207, UMET - Unité Matériaux et Transformations, F-59000 Lille, France; Institut Universitaire de France, 1 rue Descartes, F-75005 Paris, France
| | - Stéphanie Genay
- Univ. Lille, CHU Lille, ULR 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - Alice Pettinari
- Univ. Lille, CHU Lille, ULR 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - Séverine Bellayer
- Univ. Lille, CNRS, INRA, ENSCL UMR8207, UMET - Unité Matériaux et Transformations, F-59000 Lille, France
| | - Christine Barthélémy
- Univ. Lille, CHU Lille, ULR 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - Bertrand Décaudin
- Univ. Lille, CHU Lille, ULR 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
| | - Nicolas Blanchemain
- Univ. Lille, Inserm, CHU Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France
| | - Pascal Odou
- Univ. Lille, CHU Lille, ULR 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000 Lille, France
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Cleys P, Panneel L, Bombeke J, Dumitrascu C, Malarvannan G, Poma G, Mulder A, Jorens PG, Covaci A. Hair as an alternative matrix to assess exposure of premature neonates to phthalate and alternative plasticizers in the neonatal intensive care unit. ENVIRONMENTAL RESEARCH 2023; 236:116712. [PMID: 37482128 DOI: 10.1016/j.envres.2023.116712] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/27/2023] [Accepted: 07/19/2023] [Indexed: 07/25/2023]
Abstract
Due to adverse health effects, di-(2-ethylhexyl) phthalate (DEHP), a plasticizer used to soften plastic medical devices (PMDs), was restricted, and gradually replaced by alternative plasticizers (APs). Up to this date, urine was the sole matrix studied for plasticizer exposure in neonates hospitalized in the neonatal intensive care unit (NICU), a population highly vulnerable to toxic effects of plasticizers. The primary aim of this study was to assess simultaneous measurement of phthalate and AP metabolites in neonatal scalp hair. In addition, we aimed to use this matrix to investigate exposure of premature neonates to plasticizers during their stay in the NICU. Hair samples in this study were collected from premature neonates and their mothers included in a prospective birth cohort study in a tertiary NICU at the Antwerp University Hospital (UZA), Belgium. Samples from premature neonates (n = 45) and their mothers (n = 107) as well as from control neonates (n = 24) and mothers (n = 29) were analyzed using liquid-chromatography coupled to tandem mass spectrometry. This is the first study reporting metabolites of phthalate and alternative plasticizers in neonatal hair samples as biomarkers for exposure to these plasticizers. Results showed that hair sampled from premature neonates after a NICU stay contained significantly higher metabolite concentrations of both phthalates (DEHP, DiBP, and DnBP; 9.0-2500, 9.3-2200, and 24.7-5300 ng/g), and alternative plasticizers (DEHA, DEHT, and TOTM; 38.8-3400, 127.5-5700, and 10.8-8700 ng/g) - when compared to healthy control neonates. Besides, DEHP and DEHT metabolite concentrations were significantly higher than in hair sampled from adult populations. In addition, prolonged NICU exposure to non-invasive respiratory support devices and gastric tubes was correlated with increased concentrations in hair samples, indicating accumulation of plasticizers in this alternative matrix. In conclusion, our data indicate that preterm neonates are still highly exposed to phthalate and alternative plasticizers during NICU stay, despite the EU Medical Devices Regulation.
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Affiliation(s)
- Paulien Cleys
- Toxicological Centre, University of Antwerp, Building S.5, Universiteitsplein 1, 2610, Wilrijk, Belgium.
| | - Lucas Panneel
- Neonatal Intensive Care Unit, Antwerp University Hospital, Drie Eikenstraat 655, 2650, Edegem, Belgium; Laboratory for Experimental Medicine and Paediatrics, University of Antwerp, Building T.3, Universiteitsplein 1, 2610, Wilrijk, Belgium.
| | - Jasper Bombeke
- Toxicological Centre, University of Antwerp, Building S.5, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - Catalina Dumitrascu
- Toxicological Centre, University of Antwerp, Building S.5, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - Govindan Malarvannan
- Toxicological Centre, University of Antwerp, Building S.5, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - Giulia Poma
- Toxicological Centre, University of Antwerp, Building S.5, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - Antonius Mulder
- Neonatal Intensive Care Unit, Antwerp University Hospital, Drie Eikenstraat 655, 2650, Edegem, Belgium; Laboratory for Experimental Medicine and Paediatrics, University of Antwerp, Building T.3, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - Philippe G Jorens
- Laboratory for Experimental Medicine and Paediatrics, University of Antwerp, Building T.3, Universiteitsplein 1, 2610, Wilrijk, Belgium; Department of Intensive Care Medicine, Antwerp University Hospital, Drie Eikenstraat 655, 2650, Edegem, Belgium
| | - Adrian Covaci
- Toxicological Centre, University of Antwerp, Building S.5, Universiteitsplein 1, 2610, Wilrijk, Belgium.
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Thelliez A, Sumian C, Chazard E, Reichenberg S, Lecoeur M, Decaudin B. Migration of di(2-ethylhexyl) phthalate, diisononylcyclohexane-1,2-dicarboxylate and di(2-ethylhexyl) terephthalate from transfusion medical devices in labile blood products: A comparative study. Vox Sang 2023; 118:533-542. [PMID: 37246454 DOI: 10.1111/vox.13446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/28/2023] [Accepted: 04/29/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND AND OBJECTIVES Polyvinyl chloride (PVC) plasticized with di(2-ethylhexyl) phthalate (DEHP) is a widely used material for medical transfusion devices. Not covalently bound to PVC, DEHP can migrate into blood products during storage. Recognized as an endocrine disruptor and raising concerns about its potential carcinogenicity and reprotoxicity, DEHP is gradually being withdrawn from the medical device market. Therefore, the use of alternative plasticizers, such as diisononylcyclohexane-1,2-dicarboxylate (DINCH) and di(2-ethylhexyl) terephthalate (DEHT), as potential candidates for the replacement of DEHP in medical transfusion devices has been investigated. The purpose of this study was to evaluate the quantity of PVC-plasticizers in the blood components according to their preparation, storage conditions and in function of the plasticizer. MATERIALS AND METHODS Whole blood was collected, and labile blood products (LBPs) were prepared by the buffy-coat method with a PVC blood bag plasticized either with DEHP, DINCH or DEHT. DINCH and DEHT equivalent concentrations were quantified in LBPs by liquid chromatography-tandem mass spectrometry or coupled with UV and compared to DEHP equivalent concentrations. RESULTS The plasticizer equivalent concentration to which a patient is exposed during a transfusion depends on the preparation of LBPs as well as their storage conditions, that is, temperature and storage time. At day 1, for all LBPs, the migration of DEHP is 5.0 and 8.5 times greater than DINCH and DEHT, respectively. At the end of the 49 days storage period, the DEHP equivalent concentration in red blood cells concentrate is statistically higher when compared to DINCH and DEHT, with maximal values of 1.85, 1.13 and 0.86 μg/dm2 /mL, respectively. CONCLUSION In addition to lower toxicity, transfused patients using PVC-DEHT or PVC-DINCH blood bags are less exposed to plasticizers than using PVC-DEHP bags with a ranging exposure reduction from 38.9% to 87.3%, due to lower leachability into blood components.
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Affiliation(s)
- Aurélie Thelliez
- ULR 7365-GRITA-Groupe de Recherche sur les Formes Injectables et Technologies Associées, Université de Lille, CHU Lille, Lille, France
- Macopharma, Tourcoing, France
| | | | - Emmanuel Chazard
- ULR 2694-METRICS, CERIMS, Université de Lille, CHU Lille, Lille, France
| | | | - Marie Lecoeur
- ULR 7365-GRITA-Groupe de Recherche sur les Formes Injectables et Technologies Associées, Université de Lille, CHU Lille, Lille, France
| | - Bertrand Decaudin
- ULR 7365-GRITA-Groupe de Recherche sur les Formes Injectables et Technologies Associées, Université de Lille, CHU Lille, Lille, France
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Al-Saleh I, Elkhatib R, Alnuwaysir H, Aldhalaan H, Alismail E, Binmanee A, Hawari A, Alhazzani F, Jabr MB, Mohamed G. Exposure of preterm neonates receiving total parenteral nutrition to phthalates and its impact on neurodevelopment at the age of 2 months. Sci Rep 2023; 13:6969. [PMID: 37117441 PMCID: PMC10141929 DOI: 10.1038/s41598-023-33715-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 04/18/2023] [Indexed: 04/30/2023] Open
Abstract
This prospective study assessed the exposure to phthalates of preterm neonates who received total parenteral nutrition (TPN) during their stay in the neonatal intensive care unit (NICU) and the risk of neurodevelopment delays at the age of 2 months. Our study recruited 33 preterm neonates who required TPN upon NICU admission. Urine samples for analyzing phthalate metabolites were obtained at admission and then daily until the last day of receiving TPN. Phthalates in the daily TPN received by the preterm neonates were analyzed. The neurodevelopment of the neonates was assessed using the Ages and Stages Questionnaire Edition 3 (ASQ-3). Diethyl phthalate and butyl benzyl phthalate were found in all TPN samples, while 27% and 83% contained dibutyl phthalate and di-(2-ethylhexyl) phthalate (DEHP), respectively. Yet, the daily dose of each phthalate that our preterm neonates received from TPN was much lower than the recommended tolerable limit. Urinary levels of monobenzyl phthalate and four metabolites of DEHP [i.e., mono-(2-ethylhexyl) phthalate (MEHP), mono-(2-ethyl-5-hydroxyhexyl) phthalate, mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), and mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP)] and the sum of four DEHP metabolites (∑4DEHP) increased significantly in preterm neonates before discharge. However, these levels were not correlated with their phthalate parent compounds in TPN, suggesting other sources of exposure in the NICU. At 2 months, we found that urinary levels of mono-iso-butyl phthalate (MiBP), MECPP, MEHP, and ∑4DEHP were inversely related to fine motor skills. After adjusting for head circumference, the inverse relationships remained significant, suggesting direct effects from phthalates. Given the extreme vulnerability of our population, it is critical to minimize exposure to phthalates during their NICU stay.
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Affiliation(s)
- Iman Al-Saleh
- King Faisal Specialist Hospital and Research Centre, Environmental Health Program (MBC#03), P.O. Box: 3354, Riyadh, 11211, Saudi Arabia.
| | - Rola Elkhatib
- King Faisal Specialist Hospital and Research Centre, Environmental Health Program (MBC#03), P.O. Box: 3354, Riyadh, 11211, Saudi Arabia
| | - Hissah Alnuwaysir
- King Faisal Specialist Hospital and Research Centre, Environmental Health Program (MBC#03), P.O. Box: 3354, Riyadh, 11211, Saudi Arabia
| | - Hesham Aldhalaan
- Center for Autism Research, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh, 11211, Saudi Arabia
| | - Eiman Alismail
- Center for Autism Research, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh, 11211, Saudi Arabia
| | - Abdulaziz Binmanee
- Neonatal Critical Care Section, Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh, 11211, Saudi Arabia
| | - Amal Hawari
- Neonatal Critical Care Section, Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh, 11211, Saudi Arabia
| | - Fahad Alhazzani
- Neonatal Critical Care Section, Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh, 11211, Saudi Arabia
| | - Mohammad Bin Jabr
- Neonatal Critical Care Section, Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh, 11211, Saudi Arabia
| | - Gamal Mohamed
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh, 11211, Saudi Arabia
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Neonatal exposure to phthalate and alternative plasticizers via parenteral nutrition. Int J Pharm 2023; 631:122472. [PMID: 36526146 DOI: 10.1016/j.ijpharm.2022.122472] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/03/2022] [Accepted: 12/05/2022] [Indexed: 12/15/2022]
Abstract
Di-(2-ethylhexyl) phthalate (DEHP), a plasticizer used to soften plastic medical devices (PMDs), was restricted in PMDs due to adverse health effects, being gradually replaced by alternative plasticizers (APs). Parenteral nutrition (PN), essential in the care for premature neonates in the neonatal intensive care unit, is stored in plastic storage bags and administered intravenously through plastic infusion circuits. We investigated to which extent PN contributes to current phthalate and AP exposure in premature neonates. First, we showed that DEHP and several APs are present in relevant amounts in PMDs used for neonatal PN administration. Secondly, ex vivo experiments mimicking clinical PN administration showed that lipid emulsions contained significant concentrations of DEHP and several APs (ATBC, TOTM, DEHT & DEHA), while hardly any plasticizers were detected in non-lipid solutions. ATBC leached from infusion circuits, while lipid emulsions were the major source for DEHP, TOTM, DEHT, and DEHA. PN administration resulted in estimated daily exposures of 13.9 µg/kg/d DEHP and 95.7 µg/kg/d ATBC in premature neonates, below their respective reference doses. Our data indicate that premature neonates requiring PN are still exposed to DEHP, as well as to a range of APs, making it a target for reduction of harmful plasticizer exposure.
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Specification and Evaluation of Plasticizer Migration Simulants for Human Blood Products: A Delphi Study. Biomolecules 2021; 11:biom11081081. [PMID: 34439748 PMCID: PMC8392596 DOI: 10.3390/biom11081081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/16/2021] [Accepted: 07/20/2021] [Indexed: 11/26/2022] Open
Abstract
Potentially toxic plasticizers are commonly added to polyvinyl chloride medical devices for transfusion in order to improve their flexibility and workability. As the plasticizers are not chemically bonded to the PVC, they can be released into labile blood products (LBPs) during storage. Ideally, LBPs would be used in laboratory studies of plasticizer migration from the medical device. However, short supply (i.e., limited stocks of human blood in collection centres) has prompted the development of specific simulants for each type of LBP in the evaluation of new transfusion devices. We performed a Delphi study with a multidisciplinary panel of 24 experts. In the first (qualitative) phase, the panel developed consensus definitions of the specification criteria to be met by each migration simulant. Next, we reviewed the literature on techniques for simulating the migration of plasticizers into LBPs. A questionnaire was elaborated and sent out to the experts, and the replies were synthesized in order to obtain a consensus. The qualitative study established specifications for each biological matrix (whole blood, red blood cell concentrate, plasma, and platelet concentrate) and defined the criteria required for a suitable LBP simulant. Ten criteria were suggested: physical and chemical characteristics, opacity, form, stability, composition, ability to mimic a particular clinical situation, ease and safety of use, a simulant–plastic interaction correlated with blood, and compatibility with analytical methods. The questionnaire data revealed a consensus on the use of natural products (such as pig’s blood) to mimic the four LBPs. Opinions diverged with regard to synthetic products. However, an isotonic solution and a rheological property modifier were considered to be of value in the design of synthetic simulants. Consensus reached by the Delphi group could be used as a database for the development of simulants used to assess the migration of plasticizers from PVC bags into LBPs.
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Buoso E, Masi M, Racchi M, Corsini E. Endocrine-Disrupting Chemicals' (EDCs) Effects on Tumour Microenvironment and Cancer Progression: Emerging Contribution of RACK1. Int J Mol Sci 2020; 21:ijms21239229. [PMID: 33287384 PMCID: PMC7729595 DOI: 10.3390/ijms21239229] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/26/2020] [Accepted: 12/01/2020] [Indexed: 02/06/2023] Open
Abstract
Endocrine disruptors (EDCs) can display estrogenic and androgenic effects, and their exposure has been linked to increased cancer risk. EDCs have been shown to directly affect cancer cell regulation and progression, but their influence on tumour microenvironment is still not completely elucidated. In this context, the signalling hub protein RACK1 (Receptor for Activated C Kinase 1) could represent a nexus between cancer and the immune system due to its roles in cancer progression and innate immune activation. Since RACK1 is a relevant EDCs target that responds to steroid-active compounds, it could be considered a molecular bridge between the endocrine-regulated tumour microenvironment and the innate immune system. We provide an analysis of immunomodulatory and cancer-promoting effects of different EDCs in shaping tumour microenvironment, with a final focus on the scaffold protein RACK1 as a pivotal molecular player due to its dual role in immune and cancer contexts.
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Affiliation(s)
- Erica Buoso
- Dipartimento di Scienze del Farmaco, Università Degli Studi di Pavia, Viale Taramelli 12/14, 27100 Pavia, Italy; (M.M.); (M.R.)
- Correspondence:
| | - Mirco Masi
- Dipartimento di Scienze del Farmaco, Università Degli Studi di Pavia, Viale Taramelli 12/14, 27100 Pavia, Italy; (M.M.); (M.R.)
- Classe di Scienze Umane e della Vita (SUV), Scuola Universitaria Superiore IUSS, Piazza della Vittoria 15, 27100 Pavia, Italy
| | - Marco Racchi
- Dipartimento di Scienze del Farmaco, Università Degli Studi di Pavia, Viale Taramelli 12/14, 27100 Pavia, Italy; (M.M.); (M.R.)
| | - Emanuela Corsini
- Laboratory of Toxicology, Dipartimento di Scienze Politiche ed Ambientali, Università Degli Studi di Milano, Via Balzaretti 9, 20133 Milano, Italy;
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10
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Den Braver-Sewradj SP, Piersma A, Hessel EVS. An update on the hazard of and exposure to diethyl hexyl phthalate (DEHP) alternatives used in medical devices. Crit Rev Toxicol 2020; 50:650-672. [PMID: 33006299 DOI: 10.1080/10408444.2020.1816896] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The use of the plasticizer diethyl hexyl phthalate (DEHP) in PVC medical devices is being questioned due to its potential reprotoxic effects in patients exposed as a result from migration from the device. This article reviews new information on migration and toxicity data of eleven alternative plasticizers that have previously been evaluated by the Danish EPA and the EU SCENIHR (Scientific Committee on Emerging and Newly Identified Health Risks). The new toxicity data did not justify the reconsideration of the critical NOAELs as established by SCENIHR and Danish EPA. The dataset on oral toxicity studies is rather complete for most substances; however, in particular for reproductive toxicity and endocrine disruption, data gaps still exist for many alternatives. Toxicity data on intravenous exposure are lacking and these are essential to conclude on hazard characteristics of alternatives that are poorly absorbed via the oral exposure route. Migration data are emerging for a few alternatives but still sparse for the majority of the alternatives. Taking all data on migration and toxicity in consideration, 1,2-cyclohexanedicarboxylic acid, diisononylester (DINCH), and tris(2-ethylhexyl)benzene-1,2,4-tricarboxylate display a more favorable profile compared to DEHP. For these promising alternatives, a risk assessment for use in medical devices should be conducted. As a next step, we recommend the (further) generation of relevant migration data and, where needed, relevant toxicity data for the alternative substances, in order to be able to conduct a benefit-risk analysis of DEHP and the alternatives as obligatory in the new European Union Medical Device Regulation.
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Affiliation(s)
| | - Aldert Piersma
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.,Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Ellen V S Hessel
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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11
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S Wadi V, Jena KK, Halique K, Alhassan SM. Enhanced Mechanical Toughness of Isotactic Polypropylene Using Bulk Molybdenum Disulfide. ACS OMEGA 2020; 5:11394-11401. [PMID: 32478228 PMCID: PMC7254506 DOI: 10.1021/acsomega.0c00419] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/10/2020] [Indexed: 06/11/2023]
Abstract
Herein, we report the use of bulk molybdenum disulfide (MoS2) as the reinforcing agent to enhance the toughness of isotactic polypropylene (iPP). The iPP-MoS2 nanocomposites with varying amounts of MoS2 (0.1 to 5 wt %) were prepared by a one-step melt extrusion method, and the effects of MoS2 on the morphology, thermal, and mechanical properties were evaluated by different instrumental techniques such as Raman, ATR-FTIR, UTM, TEM, TGA, and DSC. TEM images showed the uniform dispersion of multilayer MoS2 in the polymer matrix, and XRD results suggested the formation of the β phase when a low amount of MoS2 is loaded in the composites. Mechanical tests revealed a significant increase in the toughness and elongation at break (300-400%) in the composites containing low amounts of MoS2 (0.25 to 0.5 wt %). Enhanced toughness and elongation in iPP could be related to the combined effect of the β phase and the exfoliation of bulk MoS2 under applied stress. The thermal stability of the composites was also improved with the increase in MoS2 loading. Direct utilization of bulk MoS2 and one-step melt extrusion process could be a cost-effective method to induce high elasticity and toughness in iPP.
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Affiliation(s)
- Vijay S Wadi
- Department of Chemical Engineering, Khalifa University of Science and Technology, P. O. Box 127788, Abu Dhabi 00000, United Arab Emirates
| | - Kishore K. Jena
- Department of Chemical Engineering, Khalifa University of Science and Technology, P. O. Box 127788, Abu Dhabi 00000, United Arab Emirates
| | - Kevin Halique
- Department of Chemical Engineering, Khalifa University of Science and Technology, P. O. Box 127788, Abu Dhabi 00000, United Arab Emirates
| | - Saeed M. Alhassan
- Department of Chemical Engineering, Khalifa University of Science and Technology, P. O. Box 127788, Abu Dhabi 00000, United Arab Emirates
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12
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Maiguy‐Foinard A, Masse M, Degoutin S, Genay S, Chai F, Barthélémy C, Odou P, Blanchemain N, Décaudin B. To what extent do the storage conditions of polyether‐based polyurethane have an impact on diazepam delivery? J Appl Polym Sci 2020. [DOI: 10.1002/app.49333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Aurélie Maiguy‐Foinard
- Université Lille, CHU Lille, ULR 7365, Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) Lille France
| | - Morgane Masse
- Université Lille, CHU Lille, ULR 7365, Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) Lille France
| | - Stéphanie Degoutin
- Université Lille, CNRS, INRA, ENSCL UMR8207, Unité Matériaux et Transformations (UMET) Lille France
| | - Stéphanie Genay
- Université Lille, CHU Lille, ULR 7365, Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) Lille France
| | - Feng Chai
- Université Lille, Inserm, CHU Lille, U1008—Controlled Drug Delivery Systems and Biomaterials Lille France
| | - Christine Barthélémy
- Université Lille, CHU Lille, ULR 7365, Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) Lille France
| | - Pascal Odou
- Université Lille, CHU Lille, ULR 7365, Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) Lille France
| | - Nicolas Blanchemain
- Université Lille, Inserm, CHU Lille, U1008—Controlled Drug Delivery Systems and Biomaterials Lille France
| | - Bertrand Décaudin
- Université Lille, CHU Lille, ULR 7365, Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) Lille France
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13
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Interactions of amphiphiles with plasticisers used in polymers: Understanding the basis of health and environmental challenges. Adv Colloid Interface Sci 2020; 277:102109. [PMID: 32028074 DOI: 10.1016/j.cis.2020.102109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/18/2020] [Accepted: 01/20/2020] [Indexed: 11/21/2022]
Abstract
Plasticisers are widely used to provide desirable mechanical properties of many polymeric materials. These small molecule additives are also known to leach from the finished products, and this not only may modify the physical properties but the distribution of these materials in the environment and in the human body can cause long-term health concerns and environmental challenges. Many of these plasticisers are esters of polyvalent acids and phthalic acid has previously been predominant but various alternatives are now being more widely explored. The eventual distribution of these compounds depends not just on solubility in aqueous media and on vapour pressure but also on their interaction with other materials, particularly lipids and amphiphiles. This review provides an overview of both the basic physical data (solubility, partition coefficients, surface tension, vapour pressure) that is available in the literature and summarises what has been learnt about the molecular interactions of various plasticisers with surfactants and lipids.
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Haned Z, Moulay S, Lacorte S. Migration of plasticizers from poly(vinyl chloride) and multilayer infusion bags using selective extraction and GC–MS. J Pharm Biomed Anal 2018; 156:80-87. [DOI: 10.1016/j.jpba.2018.04.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 04/02/2018] [Accepted: 04/09/2018] [Indexed: 11/25/2022]
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15
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Tortolano L, Matmati H, Bourhis M, Manerlax K, Lemare F, Saunier J, Yagoubi N. DinCH and ESBO actual migration from PVC infusion tubings used in an oncopediatric unit. J Appl Polym Sci 2018. [DOI: 10.1002/app.46649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Lionel Tortolano
- EA 401: Matériaux et santé; Université Paris-Saclay, UFR Pharmacie; Châtenay-Malabry F-92290 France
- Groupe hospitalier Henri Mondor, Department of Pharmacy; Assistance Publique-Hôpitaux de Paris; Créteil F-94010 France
| | - Houssem Matmati
- EA 401: Matériaux et santé; Université Paris-Saclay, UFR Pharmacie; Châtenay-Malabry F-92290 France
| | - Matthieu Bourhis
- Département de Pharmacie Clinique; Gustave Roussy, Université Paris-Saclay; Villejuif F-94805 France
| | - Katia Manerlax
- EA 401: Matériaux et santé; Université Paris-Saclay, UFR Pharmacie; Châtenay-Malabry F-92290 France
| | - François Lemare
- Département de Pharmacie Clinique; Gustave Roussy, Université Paris-Saclay; Villejuif F-94805 France
- Chair of Clinical Pharmacy, Faculty of Pharmacy of Paris; Sorbonne-Paris University; Paris F-75006 France
- EA 7348 (MOS) de l'Ecole des Hautes Etudes de Santé Publique; Rennes F-35000 France
| | - Johanna Saunier
- EA 401: Matériaux et santé; Université Paris-Saclay, UFR Pharmacie; Châtenay-Malabry F-92290 France
| | - Najet Yagoubi
- EA 401: Matériaux et santé; Université Paris-Saclay, UFR Pharmacie; Châtenay-Malabry F-92290 France
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