DEHP in Medical Tubes Linked to Attention Deficit in Kids
Author: The Endocrine Society
Published: 2016/04/02 - Updated: 2026/03/31
Publication Details: Peer-Reviewed, Research, Study, Analysis
Category Topic: ADHD - ADD - Related Publications
Contents: Synopsis - Introduction - Main - Insights, Updates
Synopsis: This research, presented at The Endocrine Society's 98th Annual Meeting in Boston, examines how exposure to the phthalate DEHP - a chemical used to soften PVC medical tubes and catheters in pediatric intensive care units - may be directly associated with attention deficit disorders diagnosed years after a child's hospitalization. The study, which involved 449 former pediatric ICU patients and 100 healthy children, found that DEHP metabolite blood levels in critically ill children were dramatically elevated compared to healthy children, and that high DEHP exposure accounted for roughly half of the attention deficit identified during neurocognitive testing four years after discharge. Published in the journal Intensive Care Medicine, this work carries important implications for parents, pediatric healthcare providers, and policymakers considering the continued use of DEHP-containing medical devices in the care of seriously ill children - Disabled World (DW).
- Topic Definition: DEHP (Di(2-ethylhexyl)phthalate)
DEHP, or Di(2-ethylhexyl)phthalate, is a synthetic chemical belonging to the phthalate family, widely used as a plasticizer to increase the flexibility and durability of polyvinyl chloride (PVC) medical devices such as intravenous tubing, blood bags, and catheters. As an endocrine-disrupting compound, DEHP can interfere with hormone signaling and has been associated with adverse developmental and neurological effects, particularly in children. Although regulatory bodies in many countries have restricted or banned DEHP in consumer products including children's toys, it remains in widespread use within healthcare settings due to a lack of universally approved alternatives, making its presence in pediatric medical care a subject of active scientific and regulatory scrutiny.
Introduction
Attention Deficit Linked to Plasticizers in Medical Tubes
Children who are often hospitalized in intensive care units are more likely to have attention deficit disorders later, and new research finds a possible culprit: a high level of plastic-softening chemicals called phthalates circulating in the blood. The researchers, who will present their study results Friday at The Endocrine Society's 98th annual meeting in Boston, suggest these chemicals, which are added to indwelling medical devices such as plastic tubes and catheters, seep into the child's bloodstream.
"Phthalates have been banned from children's toys because of their potential toxic and hormone-disrupting effects, but they are still used to soften medical devices," said lead researcher Sören Verstraete, MD, a PhD student at KU (Katholieke Universiteit) Leuven in Leuven, Belgium. "We found a clear match between previously hospitalized children's long-term neurocognitive test results and their individual exposure to the phthalate DEHP during intensive care."
Main Content
Di(2-ethylhexyl)phthalate, or DEHP, is the most commonly used plastic softener in medical devices made of polyvinyl chloride (PVC). Verstraete called the use of medical devices containing this phthalate "potentially harmful" for the brain development and function of critically ill children.
"Development of alternative plastic softeners for use in indwelling medical devices may be urgently indicated," he said.
Their study included 100 healthy children and 449 children who received treatment in a pediatric intensive care unit (PICU) and underwent neurocognitive testing four years later. Most of the PICU patients were recovering from heart surgery, but some had sustained accidental injuries or had severe infections. The researchers measured blood levels of DEHP metabolites, or byproducts. Initially they performed the blood tests in the healthy children and 228 of the patients while they were in the PICU. Patients had one to 12 medical tubes in the PICU and ranged in age from newborn to 16 years.
The investigators found that DEHP metabolite levels were not detectable in the blood samples of healthy children. However, at admission to the PICU, the critically ill children, already connected to catheters, had levels that Verstraete called "sky-high." Although the DEHP levels decreased rapidly, they remained 18 times higher until discharge from the PICU compared with those of healthy children, he said.
Then the researchers conducted statistical analyses that adjusted for the patients' initial risk factors that could influence the neurocognitive outcome as well as length of stay, complications and treatments in the PICU. A high exposure to DEHP during the PICU stay, according to Verstraete, was strongly associated with attention deficit found at neurocognitive testing four years after discharge. They validated this finding in a different group of 221 PICU patients.
"This phthalate exposure explained half of the attention deficit in former PICU patients," he said, adding that other factors may account for the other half.
The research received funding from the Research Foundation-Flanders (FWO) in Brussels; Methusalem program from the Flemish government in Belgium; European Union's Seventh Framework Programme for Research and Technological Development; and Institute for the Promotion of Innovation by Science and Technology in Flanders (IWT), Brussels. This study appeared in the March issue of the journal Intensive Care Medicine.
Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world's oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.
Insights, Analysis, and Developments
Editorial Note: The findings presented here raise a serious and long-overdue question about a chemical that has already been banned from children's toys, yet remains widely present in the medical devices used on the most vulnerable young patients in hospital settings. While the study stops short of proving direct causation, the statistical association between DEHP exposure and long-term attention deficits is too significant to overlook. As the lead researcher noted, the development of safer alternative plasticizers for use in indwelling medical devices may be urgently needed - particularly given that children in intensive care are already fighting for their health, not taking on additional neurological risk - Disabled World (DW).Attribution/Source(s): This peer reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by The Endocrine Society and published on 2016/04/02, this content may have been edited for style, clarity, or brevity.