Use of blood product containers manufactured with the plasticizer DEHP

A blood donor center medical director located in the heartland of America reports that their blood center has received a request to help reduce or eliminate DEHP [Di(2-Ethylhexyl) Phthalate] exposure in hospitalized neonates due to concerns about toxicity. This chemical, which makes plastic products soft and flexible, is present in many items in the NICU, including blood product storage bags. They wonder if there is an FDA approved blood product collection and storage system that is free of this plasticizer. Alternatively, are there techniques that could be used in the laboratory to reduce patient exposure to this chemical, such as preferentially using 'fresher' products or transferring a product from a storage bag with DEHP to a syringe or second bag that does not have it prior to transfusion? How are other blood banks responding to this or similar requests?

Editors' note: Colleagues might find the information at the following links to be germane to this discussion:

• FDA Public Health Notification: PVC Devices Containing the Plasticizer DEHP
• Proposition 65 - Administrative Listing: Chemical Listed Effective October 24, 2003 as Known to the State to Cause Reproductive Toxicity: Di(2-ethylhexyl)phthalate (DEHP)

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The following comments have been received.

ADDENDA October 14, 2008

1. 1. A transfusion service manager in Ohio reports that they are considering reducing the amount of DEHP products in their pediatric hospital. They report that Charter Medical makes a syringe set with standard blood filter (30ml and 60ML) that is DEHP-free. Their local American Red Cross also uses some reportedly DEHP-free collections sets from Fenwal. They have not yet found any transfer bags that are made without DEHP, and have not decided whether or not to go ahead and make the switch to the DEHP-free syringes if they can not make the switch completely. They are in the beginning phases of contacting other areas of the hospital to evaluate which products used throughout the hospital contain DEHP, and whether or not there are other alternatives.
   
   
2. The medical director at a university hospital in Southern California reports his investigation of of DEHP