Phthalate esters (
PAEs) are
plasticizers associated with multiple toxicities; however, no strict regulations have been implemented to restrict their use in medical applications in Lebanon. Our study aimed at assessing the potential risks correlated with
phthalate exposure from IV bags manufactured in Lebanon. GC-MS analysis showed that di-(2-ethylhexyl)
phthalate (
DEHP) is the predominant
phthalate found in almost all samples tested with values ranging from 32.8 to 39.7% w/w of
plastic.
DEHP concentrations in the IV solutions reached up to 148 µg/L, as measured by
SPME-GC-MS/MS, thus resulting in hazard quotients greater than 1, specifically in neonates. The toxicity of
DEHP is mainly attributed to its metabolites, most importantly mono-(2-ethylhexyl)
phthalate (
MEHP). The IV bag
solution with the highest content in
DEHP was therefore used to extrapolate the amounts of urinary
MEHP. The highest concentrations were found in neonates having the lowest
body weight, which is concerning, knowing the adverse effects of
MEHP in infants. Our study suggests that the use of IV bags manufactured in Lebanon could pose a significant risk in hospitalized patients, especially infants in neonatal care. Therefore, Lebanon, as well as other countries, should start imposing laws that restrict the use of phthalates in medical IV bags and substitute them with less toxic
plasticizers.