Saab Yolande, Oueis Emilia, Mehanna Stephanie, Nakad Zahi, Stephan Rita, Khnayzer Rony S
Pharmaceutical Sciences Department, School of Pharmacy, Lebanese American University, Chouran, Beirut 1102-2801, Lebanon.
Department of Natural Sciences, Lebanese American University, Chouran, Beirut 1102-2801, Lebanon.
Toxics. 2022 Jun 30;10(7):357. doi: 10.3390/toxics10070357.
Phthalate esters (PAEs) are plasticizers associated with multiple toxicities; however, no strict regulations have been implemented to restrict their use in medical applications in Lebanon. Our study aimed at assessing the potential risks correlated with phthalate exposure from IV bags manufactured in Lebanon. GC-MS analysis showed that di-(2-ethylhexyl) phthalate (DEHP) is the predominant phthalate found in almost all samples tested with values ranging from 32.8 to 39.7% / of plastic. DEHP concentrations in the IV solutions reached up to 148 µg/L, as measured by SPME-GC-MS/MS, thus resulting in hazard quotients greater than 1, specifically in neonates. The toxicity of DEHP is mainly attributed to its metabolites, most importantly mono-(2-ethylhexyl) phthalate (MEHP). The IV bag solution with the highest content in DEHP was therefore used to extrapolate the amounts of urinary MEHP. The highest concentrations were found in neonates having the lowest body weight, which is concerning, knowing the adverse effects of MEHP in infants. Our study suggests that the use of IV bags manufactured in Lebanon could pose a significant risk in hospitalized patients, especially infants in neonatal care. Therefore, Lebanon, as well as other countries, should start imposing laws that restrict the use of phthalates in medical IV bags and substitute them with less toxic plasticizers.
邻苯二甲酸酯（PAEs）是与多种毒性相关的增塑剂；然而，黎巴嫩尚未实施严格的法规来限制其在医疗应用中的使用。我们的研究旨在评估黎巴嫩生产的静脉输液袋中邻苯二甲酸酯暴露相关的潜在风险。气相色谱 - 质谱分析表明，邻苯二甲酸二（2 - 乙基己基）酯（DEHP）是几乎所有测试样品中主要的邻苯二甲酸酯，其在塑料中的含量范围为32.8%至39.7%。通过固相微萃取 - 气相色谱 - 串联质谱法测得静脉输液溶液中的DEHP浓度高达148μg/L，因此导致危险商数大于1，特别是在新生儿中。DEHP的毒性主要归因于其代谢产物，最重要的是单（2 - 乙基己基）邻苯二甲酸酯（MEHP）。因此，使用DEHP含量最高的静脉输液袋溶液来推断尿中MEHP的量。在体重最低的新生儿中发现了最高浓度，考虑到MEHP对婴儿的不良影响，这令人担忧。我们的研究表明，使用黎巴嫩生产的静脉输液袋可能对住院患者，特别是新生儿护理中的婴儿构成重大风险。因此，黎巴嫩以及其他国家应开始实施法律，限制在医用静脉输液袋中使用邻苯二甲酸酯，并用毒性较小的增塑剂替代它们。
