DEHP is among the first six compounds that the EU is phasing out under its Registration, Evaluation, Authorization & Restriction of Chemical substances (REACH) program. Sale or use of these six chemicals will cease in three to five years unless industry obtains authorization, the European Commission announced on February17, 2011.
In addition to DEHP, the ban affects two other phthalates—benzyl butyl phthalate and dibutyl phthalate. The three phthalates are targeted because of reproductive toxicity. The EU already prohibits use of these three compounds in children's toys.
DEHP is highly lipophilic (fat soluble). When used in PVC plastic, DEHP is loosely chemically bonded to the plastic and readily leaches into blood or other lipid-containing solutions in contact with the plastic.
This leaching of DEHP into humans via the solution with which it is in contact increases the risk of certain adverse health outcomes. Animal studies show that exposure to DEHP can damage the liver, kidneys, lungs, and reproductive system, particularly the developing testes of prenatal and neonatal males.
Who would suspect that the everyday plastics in your house or the medical products used at your hospital would be made in such a way as to leach a toxic chemical into your body?
But this is exactly the case with DEHP.
This includes the IV tubing connecting your preemie to life-sustaining nutrition...And the teething toy your toddler chews on to relieve the pain in his gums...And the "Cinderella shoes" your little princess runs around in while playing dress-up.These common plastic products contain a toxic chemical that can potentially damage you or your child's liver, kidneys, lungs, and reproductive system—and particularly the developing testes of prenatal and neonatal boys.
Unfortunately, these products carry varying amounts of a chemical called di(2-ethylhexyl)phthalate, or DEHP. DEHP is an industrial chemical used in vinyl-type plastics to make them soft and pliable. Unplasticized PVC is hard and brittle, so the DEHP polymer is added to soften it.
You can be exposed to DEHP through air, water, food, intravenous fluids, or skin contact with DEHP-containing plastics.
But before I go into the risks specific to DEHP, it is important to understand the chemical family to which it belongs, whose risks have been known for decades: the phthalates.
Phthalates: Industrial Strength Gender-Benders
DEHP is a phthalate, which is an ester of phthalic acid.
Phthalates are used as plasticizers in everything from vinyl flooring to detergents, hoses, raincoats, adhesives, air fresheners, and toys—and even in some soaps, shampoos, lotions and nail polish. They are also used as food additives and as "inert" ingredients in pesticides.
Phthalates are one of the groups of "gender-bending" chemicals causing males of all species to become more female. These chemicals have disrupted the endocrine systems of wildlife, causing testicular cancer, genital deformations, low sperm counts and infertility in a number of species, including polar bears, deer, whales and otters, just to name a few.
Scientists believe phthalates are responsible for a similar pattern in humans as well.
And the really disturbing fact is that phthalates may now be present in all human beings. According to The Endocrine Society, there is credible scientific research linking phthalates with the following adverse health effects:
"Decreased dysgenesis syndrome": A syndrome involving cryptorchidism (undescended testicles), hypospadias (birth defect in which opening of urethra is on the underside of the penis instead of at the end), and oligospermia (low sperm count), and testicular cancer Interference with sexual differentiation in utero Enlarged prostate glands Impaired ovulatory cycles and polycystic ovary disease (PCOS) Numerous hormonal disruptions Early or delayed puberty Breast cancer and uterine fibroids
Phthalates Detected in ALL Americans Tested
In 2000, the CDC discovered high levels of phthalates in all 289 adult Americans tested.
And the levels of some phthalates (including DEHP) in women of childbearing age exceeded the government's safe levels set to protect against birth defects, leading scientists to conclude phthalate exposures are "much higher and more common than previously suspected."
According to Environment California:
"In 2003, the CDC confirmed widespread contamination with the largest and most extensive U.S. survey of human chemical contamination to date, finding phthalates in virtually every person tested and the highest levels in children and women of reproductive age, demonstrating the potential for developmental effects on the fetus and children."
In 2008, due to pressure from the Environmental Working Group (EWG) and others, the U.S. Congress banned six phthalates from children's toys, adult toys and cosmetics. Legislators in Washington, Vermont, and California have also imposed restrictions on phthalates in children's goods.
Phthalates in our waterways pose another problem.
According to Dr. Gina Solomon, senior scientist with the National Resources Defense Council (NRDC), phthalates have been found in more than 10 percent of streams sampled. Dr. Solomon urged Congress to address the problem of endocrine disruptors in drinking water in her testimony in February of 2010.
According to Dr. Solomon:
"Multiple contaminants are turning up in our nation's waterways, including in water millions of people rely on for drinking. Studies by the U.S. Geological Survey (USGS) have revealed an unsavory mix of pharmaceuticals, steroid hormones, unregulated pesticides, flame retardants, rocket fuel chemicals, plasticizers, detergents, and stain repellants in both the surface water and the groundwater we rely on for drinking, and in our drinking water itself."
The only phthalate that has a maximum contaminant level (MCL) set for it by the Environmental Protection Agency (EPA) is DEHP.
Unfortunately, the MCL for DEHP in drinking water was set way back in 1992, and it was not based on endocrine disrupting effects, but rather on gastrointestinal disturbances and vertigo, which have less serious biological ramifications than damage to your reproductive system.
But, could your highest risk for DEHP poisoning be from your medical care?
DEHP Exposure VERY High in Hospitals
One of DEHP's primary uses is in the medical industry—manufacturers add it to polyvinyl chloride (PVC) to make plastic equipment more flexible. DEHP in PVC extends the shelf life of red blood cells.
As warned in this FDA Alert, DEHP can be found in:
IV tubing and IV bags Nasogastric tubes Umbilical artery catheters Tubing used in cardiopulmonary bypass procedures (CPB) Blood bags and infusion tubing Ventilator tubing Enteral nutrition feeding bags Tubing used during hemodialysis
In fact, these medical devices can contain 20 to 40 percent DEHP by weight—and IV tubing can contain up to 80 percent!
But can this chemical actually leach from the IV tubing into your baby?
Yes, it can and it does. Everyone is exposed to small levels of DEHP in everyday life, but your baby can be exposed to HIGH levels via certain medical procedures. You see, DEHP is not bound to the vinyl. It readily leaches out of these medical devices (the tubing or bag) into the solutions that come into content with the plastic, where it then goes directly into you or your child.
The degree of this leaching depends on the temperature, the lipid content of the solution, agitation of the solution, and the duration of its contact with the plastic (i.e., storage time). Of course, the more medical procedures your child requires, the higher the exposure to this chemical. So, babies who are seriously ill and hospitalized have the greatest risk of exposure, as well as being the most vulnerable to its effects.
Study Confirms Infants' DEHP Levels Rise After Medical Treatments
Evidence of DEHP exposure in infants can be measured by urinary levels of its metabolite (MEHP). One study of 54 neonates found that urinary MEHP levels increased with exposure to DEHP-containing medical products. The typical amount of DEHP neonates absorb, say in a blood transfusion, exceeds the "NOAEL" in animal studies—which stands for "No Adverse Effect Level." (And even the EPA states that DEHP animal studies are relevant to humans.)
According to a presentation by Sarah Janssen of the Natural Resources Defense Council, animal studies have uncovered the following developmental and reproductive toxicities from DEHP exposure:
- Skeletal, cardiovascular, eye, male reproductive tract, and neural tube defects
- Intrauterine death and increased post-natal death
- Male and female infertility
- Altered sexual differentiation of the male reproductive system
Besides endocrine and reproductive dysfunction, other effects of DEHP toxicity include abnormal platelet aggregation, and possibly microemboli during cardiopulmonary bypass surgery (presumably related to the massive amounts of plastic tubing and other plastic equipment being used).
According to Dr. Janssen, infants and children absorb DEHP more easily than adults, and the immature male reproductive tract is the most sensitive to DEHP toxicity.
An expert panel expressed "serious concern" for the possibility of adverse effects on the developing reproductive tract of male infants exposed to very high levels of DEHP, as with the intensive medical procedures used in the treatment of critically ill infants. The panel also expressed concern that DEHP exposure can negatively affect reproductive development in infants less than one year old.
And remember, you are exposed to many different phthalates from many different sources, which together have cumulative impacts.
Your child can ingest DEHP from something as simple as chewing on a plastic toy. In fact, one study was reported to have shown that this phthalate can go from plastics into laboratory-simulated saliva.
DEHP Is Also in Bottled Water, Pharmaceutical Drugs, and Your Cling Wrap
You can find DEHP in a variety of everyday household goods, such as:
Bottled water Wall coverings and floor tiles Oral medications (some are coated with phthalates to control when the pills dissolve) Tablecloths Packaging materials and plastic wrap Garden hoses Toys and dolls Automobile upholstery Plastic clothing, like raincoats and shoes Sheathing for wire and cable
DEHP contaminates the environment when it's released from the factories that use it, which is why levels are higher in industrial areas, and near landfills and waste disposal sites. Like the notorious pesticide DDT, DEHP attaches strongly to the soil and stays there for a very long time, and it's now being found in municipal drinking water supplies—and in the tissues of more and more people.
You can also inhale DEHP, because plastic materials in your home and car "outgas" into the air you breathe—think about it, that "new shower curtain smell."
Let's now consider another significant source of DEHP contamination: your drinking water.
Are Your Pipes Leaching DEHP into Your Water Supply?
In the United States and Canada, PVC pipes account for the largest majority of pipe materials used in buried municipal applications for drinking water and wastewater. In the U.S., PVC accounts for about 66 percent of the water distribution market.
If you have PVC pipes, you may have DEHP leaching into your water supply.
PVC is an organochlorine. Organochlorines are favored by industry because of their durability, but they persist in the environment for long periods of time, contributing to contamination. And PVC is one of the world's largest sources of dioxin—one of the most environmentally toxic chemicals in existence.
Dioxins are created in the manufacturing process of PVC, and are also released when it is burned, as with trash incineration—or in the unfortunate case of a house fire.
Just about the only way to tell if a PVC pipe contains DEHP is to ask the manufacturer, since there are so many different varieties and brands on the market today. Some contain plasticizers, and some don't. Some are designed for potable water, and some are designed for wastewater, or for agriculture. PVC pipes are produced to a variety of standards for pressure, temperature, strength and resistance to corrosion, depending on their intended use.
If it's flexible PVC, odds are that it's plasticized with DEHP.
The best option is to avoid PVC pipes altogether. There are greener, safer alternatives for all PVC uses, and many individuals, communities, and companies are phasing it out.
If you have PVC pipe from before 1977, you will definitely want to upgrade to a newer material. This "early-era" PVC pipe can leach a carcinogenic compound called vinyl chloride monomer into your water.
Alternatives to PVC Pipe for Your Plumbing
According to The Clean Water Pipe Council, the primary alternatives to PVC for water piping are:
- Ductile iron—a flexible cast iron material with a graphite-like structure and suitable for potable water, as well as sewage.
- HDPE (high-density polyethylene)—quite strong and flexible, durable, zero leakage, weather resistant, corrosion proof, recyclable
- Concrete Pipe—the strongest pipe available, durable and sustainable.
- Copper—an old standard, copper is durable, resists corrosion, bacteriostatic, reasonably flexible, easy to install, recyclable, and unaffected by ultraviolet rays.
- PEX—cross-linked polyethylene pipe. Durable for extreme temperatures and chemical stresses, adaptable and easy to use, very flexible and can even be stretched around corners. However, it cannot be used outside and it's not recyclable.
Can DEHP Be Filtered Out of Your Drinking Water?
Under the 1974 Safe Drinking Water Act, the EPA set a maximum contaminant level (MCL) for DEHP of 0.006 mg/dL, or 6 ppb. (However, individual states are allowed to set more stringent drinking water MCLs.)
Note that the Safe Drinking Water Act regulates DEHP levels only for public water supplies, not for well water.
EPA states that granular activated carbon is sufficient to remove DEHP at the level of 6 ppb. However, one of the downfalls of granular carbon filters is that the loose material inside can create a channel—and this channel in the carbon material allows water to pass through, escaping filtering.
Your absolute best source of drinking water is from a mountain spring. However, it requires time and energy to collect it, depending on your location. (Check out FindASpring.com for help finding a spring near you.)
If a mountain spring is not feasible, then filtering your water is the next best option.
If you rely on a municipal water supply or even well water, I recommend a line of filter systems called Pure & Clear, certified by the California Department of Health, which has the highest standards of quality. They are reasonably priced and easy to use, and they excel at removing contaminants such as industrial solvents and synthetic chemicals, in addition to lead, chlorine, THMs, cysts, and the like.
Pure & Clear has a few models to choose from, depending on you your needs and budget.
Choose Your Water Bottles Carefully
Glass water bottles are best.
But if you feel you must use plastic, be sure to select a water bottle designed for reuse. These bottles will be labeled with one of the following numbers:
- High-density polyethylene, labeled as "#2 HDPE"
- Low-density polyethylene, labeled as "#4 LDPE"
- Polypropylene, labeled as "#5 PP"
Above all, be sure to avoid all plastic bottles labeled "Nalgene", PVC #3, and Polycarbonate #7. These can leach potential endocrine disruptors like DEHP, bisphenol A, and even highly dangerous dioxins into their contents.
It's worth mentioning that not all plastics labeled as #7 contain BPA. For example, corn PLA plastic and other biodegradable and renewable resource resins are classified under #7 as well. Be sure you know what your #7 plastic is made from before using it.
Read, Read, READ Those Labels
And read the ingredient list on your product labels, if they are provided. You will rarely find the word "phthalate" on a label, but instead an abbreviation for the chemical name.
Besides DEHP, look for the following:
- DBP (di-n-butyl phthalate)
- DEP (diethyl phthalate)
- BzBP (benzylbutyl phthlate)
- DMP (dimethyl phthalate)
Also, be wary of anything listing a "fragrance," which often contains hundreds to thousands of compounds, and phthalates are often in the mix.
Make Sure Your Child Isn't "Playing with Fire"
Be careful that the toys you buy for your child are phthalate free. Fortunately, these toys are becoming easier to find all the time. Retailers such as Wal-Mart, Target, Sears, Kmart, and Toys "R" Us have begun to require their suppliers to eliminate PVC from many products and their packaging.
Be Proactive with Your Medical Care
If you or your child must undergo medical procedures, do your best to ensure the tubing and bags do not contain DEHP.
The FDA states that many medical procedures can be done without DEHP-infused PVC materials (replacing them with PVC made of silicone, ethylene vinyl acetate (EVA), polyethylene, or polyurethane). They caution you to especially avoid DEHP-containing materials for medical procedures performed on "male neonates, pregnant women carrying male fetuses, and peripubertal males," which are the groups at highest risk of adverse effects.
Dr. Janssen of NRDC recommends that DEHP-containing products be labeled, and that the time blood products are stored in PVC bags be minimized. She also suggests workers take care not to overly warm or agitate IV solutions. She calls for the industry to immediately start changing their purchasing policies in favor of safer products.
For more information about phthalates in health care, go to Health Care Without Harm.
The following are signs that things are slowly moving in the right direction:
- Microsoft has now completely eliminated most PVC products from its packaging
- Kaiser Permanente has pledged to reduce PVC whenever possible in new construction
- A few hospitals (such as Evergreen Hospital in Kirkland, WA) have eliminated nearly all PVC products from their neonatal intensive care units
- Seattle and Olympia, WA, have passed resolutions to seek alternatives to PVC for city operations
If you suspect that you or your child has experienced an adverse effect from DEHP, or any other chemical, please report it to the USDA MedWatch center. The more adverse effects are reported, the faster positive changes will come about.