Banned chemical in hospital IVs linked to ADHD in critically ill children

© Ruslan Krivobok
A chemical that has been banned from use in children’s toys but is still used in medical devices, such as plastic IV tubes and catheters, has been linked to the development of attention deficit hyperactivity disorder in critically ill children.

The devices contain a high level of plastic-softening chemicals called phthalates which circulate in the blood and can seep into the bloodstream, according to EU funded researchers.

Phthalates have long been banned in toys and other products, in both the US and EU, due to their potential toxic effects but there is no such prohibition for their use in medical devices.

Research carried out under Soren Verstraete, from Leuven, Belgium found a “clear match between previously hospitalized children’s long-term neurocognitive test results and their individual exposure to the phthalate DEHP during their stay in intensive care.” DEHP, is the most commonly used plastic softener in medical devices

Four hundred forty-nine children, ranging from newborns to age 16, who were treated in pediatric intensive care units and whose care involved between one and 12 medical tubes were tested. One hundred healthy children were also tested for comparison.

The researchers measured blood levels of DEHP metabolites, or byproducts, and found that levels were not detectable in the blood samples of healthy children but were “sky high” in children admitted with catheters.

These remained 18 times higher than levels in healthy children until they were discharged from the ICU.

The previously critically ill children underwent neurocognitive tests four years later and a strong association between high exposure to phthalates and development of attention deficit hyperactivity disorder was noted.

The findings were validated with a different group of 221 pediatric ICU patients.

Verstraete called the use of medical tubing and catheters "potentially harmful" to children's brain development and function and said the development of alternative plastic softeners for use in indwelling medical devices should be considered as a matter of urgency.

The Food and Drug Administration previously recommended reducing exposure to phthalates in medical devices back in 2002.

The study, conducted by the NUTRI-CARE project, was presented to The Endocrine Society’s 98th annual meeting in Boston last week.