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Infants that are born premature need hospital supervision and care. Even though preemies need the medical care, researchers found that the newborns were frequently exposed to unsafe levels of a chemical that can be found in medical products.

According to the researchers, the chemical they identified is known as di(2-ethylhexyl)phthalate (DEHP). DEHP is typically used in plastic devices to help increase flexibility and can be found in intravenous tubing, catheters, endotracheal tubes, and blood bags.

"It's remarkable that the care of sick and developmentally vulnerable preterm infants depends on an environment composed almost entirely of plastic," said the study's lead investigator, neonatologist Eric B. Mallow, MD, MPH, a senior research program coordinator at the Bloomberg School. "The role of these synthetic materials in the clinical course of our patients remains almost completely unexplored. PVC [polyvinyl chloride] is the predominant flexible plastic in most NICUs, and this can result in considerable DEHP exposures during intensive care."

For this study, the researchers measured the levels of DHEP in critically ill premature infants and found exposure levels that were about 4,000 to 160,000 times higher than levels that would be considered safe. Exposure occurred for weeks to months of treatment at the hospital's neonatal intensive care unit (NICU).

"We were floored by how high the exposures are when you look at all of the devices together," co-investigator Mary A. Fox, PhD, MPH, an assistant professor in the Department of Health Policy and Management, said reported in the press release. "It's a population that we know is vulnerable to begin with. They're struggling to survive. And the concern now is whether this phthalate exposure is actually contributing to their problems when these medical products are supposed to be helping them get better."

The researchers added that DEHP could have a wide range of non-endocrine toxic effects, which could affect the short-term and/or long-term health of the preemies. In animal studies, the chemical was tied to increasing inflammation and disrupting the development of certain organs, such as the lung and brain. The team concluded that even though DEHP is the only approved phthalate for medical devices within the United States, manufacturers should consider replacing DEHP in medical products that are used to treat NICU patients.

"We do have to make tradeoffs and we want to save these babies. But can we save them by using alternative products that reduce their exposures to substances that may be harming them? It seems like we could," Fox concluded

The study, "Phthalates and critically ill neonates: device-related exposures and non-endocrine toxic risks," was published in the Journal of Perinatology.