The clinical effects of plasticizers, antioxidants, and other contaminants in medical polyvinylchloride tubing during respiratory and non-respiratory exposure

In 1999, a Blue Ribbon Panel convened to examine the health effects of two commonly used plasticizers present in medical devices and toys. Of particular interest were the plasticizers used in medical tubing. Hospitalized patients can be exposed to a high dose of these chemicals while receiving respiratory therapy or during hemodialysis, and are more likely to be vulnerable to potentially ill effects than healthy individuals. After extensive review of existing research, the Panel concluded that there was not enough evidence of harmful health effects to remove di-(2-ethylhexyl) phthalate (DEHP) and other plasticizers From use in medical tubing. The panel recognized the important of plasticizers in enabling tubing such as PVC for respiratory support or in dialysis to be flexible enough for use in a variety of clinical applications that might not be possible with rigid (plasticizer-free) tubing. Nevertheless, we reviewed the literature regarding the health effects for five of the most common compounds, plasticizers and antioxidants found in medical tubing, and suggest that further clinical studies be conducted. We concur with the Panel's recommendation that alternative materials be developed and studied. (C) 2001 Elsevier Science B.V. All rights reserved.