Making the NICU Safer | Fit Pregnancy

Making the NICU Safer

If your newborn is in the neonatal intensive-care unit (NICU), certain medical devices used there may expose him to a hazardous chemical called di (2-ethylhexyl) phthalate, or DEHP.

If your newborn is in the neonatal intensive-care unit (NICU), certain medical devices used there may expose him to a hazardous chemical called di (2-ethylhexyl) phthalate, or DEHP. Harvard University researchers measured chemical levels in the urine of 54 infants in Boston-area NICUs and found that babies who received treatment from devices made with polyvinyl chloride (PVC)--including IV bags, feeding tubes and umbilical catheters--were exposed to DEHP at levels up to 25
to 50 times higher than the general population, according to findings published in 2005. DEHP, one of a family of industrial chemicals called phthalates, is added to PVC to make it flexible.


"We only assessed exposure, not potential health effects," says study co-author Russ Hauser, M.D., Sc.D., an associate professor in the Department of Environmental Health at Harvard School of Public Health in Boston. "However, animal studies show that DEHP is toxic to the development of the male reproductive system, so there is concern about high exposure among newborns." Animal research alone was enough
to prompt the U.S. Food and Drug Administration in 2002 to recommend that hospitals consider using alternative equipment when performing procedures on newborns and pregnant women that carry a high risk for DEHP exposure.


Chemical industry representatives believe the benefits of such medical
treatments far outweigh the risk of DEHP exposure. "We're talking about critically ill neonates who would very possibly die without these procedures," says Marian Stanley, manager of the Phthalates Esters Panel and a senior director with the American Chemistry Council, an organization that represents phthalate manufacturers. "We don't believe that [DEHP exposure] is a concern."


Health and environmental advocates say they aren't trying to prevent newborns from receiving necessary treatments. "If your baby is in intensive care, you're worrying about life and death decisions. It's not an appropriate time to say, 'I don't want a treatment because my baby might be exposed to DEHP,' " says Anna Gilmore Hall, R.N., executive director of Health Care Without Harm, an international coalition that works to make health care ecologically sustainable. "But cost-effective PVC-free alternatives exist for every device used in neonatal intensive-care units, so we're working with hospitals across the country to make the switch."


Catholic Healthcare West, a system of 40 hospitals in the Western United States; Kaiser Permanente, the nation's largest nonprofit health plan; and other hospitals have begun removing PVC equipment from NICUs, and Hall expects more to follow suit. There is still a long way to go, however, so ask if you can request DEHP-free care when you take your prenatal hospital tour.


For more information, visit sustain ablehospitals.org.

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