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Newborns at risk
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As doctors are saving younger and younger preemies, questions arise as to the long-term damage that may be caused by some of the equipment they use. (Submitted photo)
Doctors are saving premature babies at younger and younger ages, and helping them live normal healthy lives. But some doctors are concerned that among the life-giving high-tech equipment they use, there may be a hidden danger. A study released today about a potentially toxic chemical in newborn intensive care units raises some uneasy questions for one Minnesota family.

Duluth, Minn. — Kimberly and John Wood are the proud parents of Peter and Benjamin. The identical twins were born in September, ten weeks early. They spent a month and a half in a Twin Cities neonatal intensive care unit.

"They needed help with breathing, and so they were intubated -- a breathing tube was put down," recalls Kim.

The twins also got nutrition through a feeding tube, and blood transfusions from an IV tube.

Those tubes were made of poly-vinyl-chloride, or PVC. To make the tubes flexible, manufacturers add something called DEHP, di-2-ethylhexyl phthalate. Studies show some of the phthalate leaches out of PVC tubes and can enter the body.

In rats and monkeys, phthalates interfere with development of the reproductive system, especially in males.

Phthalates are found in many products, including deodorants, hair spray, and shower curtains.

But a new Harvard study looked at exposure in two newborn intensive care units. Researchers measured a break-down product of phthalates in the infants' urine, and found the babies who were treated more intensively with PVC equipment absorbed more of it into their bodies. This is the first time scientists have conclusively demonstrated such absorption. The study did not examine the risks to the children's health.

Jamie Harvie is a friend of Kim and John Wood. He's also active in Health Care Without Harm, a national group that educates hospitals about reducing environmental and health risks.

Harvie visited the twins and their parents while they were in the intensive care unit. He'd been learning about phthalates for years, and he wanted to tell the new parents about the danger.

"Ideally it would have been nice if the hospital would have taken that initiative, and been looking at an alternative that would not have been as high of a risk."
- Kimberly Wood

"How do you tell them and not worry them?" he wonders. "But how do you tell them so they can perhaps protect these boys, so they're not dosed with these chemicals that are leaching out of this PVC plastic?"

Four years ago the Food and Drug Administration issued a Public Health Notification advising hospitals that newborns, especially preemies, are probably at greater risk than older people to damage from phthalates. The advisory offered sources for information on alternative products.

But Jamie Harvie says few hospitals have replaced their PVC equipment with products made with other plastics.

Bernie Liebler is a spokesman for AdvaMed, a trade association representing medical device manufacturers. He says his group has done its own research, and concluded that babies in intensive care get far more benefit from their treatments than any hazard posed by the phthalate in DEHP.

"They already have a problem," Liebler says. "The question with DEHP is whether the use of the PVC that was manufactured with DEHP creates yet another hazard for these kids. FDA conclusion says it could be the case, but they're not saying it is, and the industry doesn't so far believe it is."

Liebler says PVC products are better than the alternatives. He says they're more flexible, and they last longer.

But some hospitals are switching over anyway. One of them is Sparrow Health System in Lansing Michigan. Sandy Geller manages the neonatology department there. She says since the FDA notice three years ago, she's replaced about three-quarters of the equipment used around babies. They even replaced the vinyl flooring in the ward.

"When a baby is 14, 15, or even 16 weeks early, I would much rather try to eliminate the exposure as much as possible, rather than to ignore what's out there," Geller says.

Geller says a lot of manufacturers are now labeling their products so hospitals can easily choose alternatives.

So far, there's been no conclusive evidence of damage to young boys from PVC exposure. Kim Wood's boys are developing just fine, but they're only eight months old. She may not know whether her boys have been affected until they enter puberty.

"Ideally it would have been nice if the hospital would have taken that initiative, and been looking at an alternative that would not have been as high of a risk," Wood says.

The authors of the Harvard study say they hope more hospitals will become aware of the potential problem, and switch to non-PVC products.

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