Phthalate Exter Exposures from xPAP

SleepGuy · Post by **SleepGuy** » Sat Feb 03, 2007 8:51 pm

Sorry to be the bearer of bad news here but I came accross this study from the FDA a few days ago and haven't seen a word about it on the forum. I'm quite steamed about this and think everyone on xPAP has a right to know about this.

Turns out that polyvinyl chloride (PVC) is the most common plastic used to make medical equipment, including xPAP. PVC is brittle at room temperature and so [un]healthy amounts of plasticizers, primarily a substance called DEHP is used to make the PVC soft. Everyone is familiar with the clear plastic tubing used for IVs, blood bags, cpap tubing--that's PVC with up to 80% DEHP.

DEHP is not bonded to the PVC and starts to volatilize immediately and continues to release over time. According to the FDA:

"DEHP has been shown to produce a wide range of adverse effects in experimental animals, notably liver toxicity and testicular atrophy. Although toxic adn carcinogenic effects of DEHP have been well established in experimental animals, the ability of this compound to produce adverse effects in humans is controversial."

Safety Assessment of Di(2-ethylhexyl)phthalate (DEHP) Released from PVC Medical Devices (http://www.fda.gov/cdrh/ost/dehp-pvc.pdf). There are a lot of other goodies in that report if anyone cares to read it.

I was pretty upset when I found out about this--that I am continuously exposed to DEHP from my CPAP, all night, ever night but feel rather helpless to know what to do about it (except to raise cain with xPAP manufacturers and give them all kinds of reasons to stop poisoning us).

Some other sources I found ranked xPAP therapy as posing "moderate" risks from phthalate exposures. The docs seem to be particularly concerned about neonates and children on xPAP (as they should be) but what about the rest of us?

Truth be told, there are a number of alternative materials that do not contain phthalates that would certainly be suitable for xPAP hosing and masks, including teflon, silicone, and urethane. But these cost more and manufacturers don't want this to impact their profit margins.

I think the point here might be to air out, wash, and maybe even operate new equipment as much as possible during the day to get out as much of the plastic smells as possible . . .

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CPAPopedia Keywords Contained In This Post (Click For Definition): tubing, news, CPAP

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CPAPopedia Keywords Contained In This Post (Click For Definition): tubing, news, CPAP

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CPAPopedia Keywords Contained In This Post (Click For Definition): tubing, news, CPAP

JimW · Post by **JimW** » Sat Feb 03, 2007 9:01 pm

I've wondered about this (in a general way) since starting on the machine in November. Thanks, will have to read the article. (Or maybe I don't really want to know the details!) I'd certainly be willing to pay out of pocket for a hose and other items which would not result in my breathing toxic matter!

dsm · Post by **dsm** » Sat Feb 03, 2007 9:05 pm

An interesting report. Thanks.

Hmmm

DSM

tomjax · Post by **tomjax** » Sat Feb 03, 2007 9:05 pm

I took a quick look at this and noticed that most of the studies were in the 1970 and 1980's.

Not sure of the date of this report, but it would seem that if there was a genuine concern for immediate safety issues, it would be raised by now.

Not sure if this is something to be concerned with.
But who knows what evil or harm lurks out there in something we come in contact with every day.

But what do I know.

tomjax

Goofproof · Post by **Goofproof** » Sat Feb 03, 2007 9:24 pm

PVC is also what pipes the water inside your house, makes the trim in your new cars, the thing that makes that wonderful New Car smell. In the 70's we even had Ner Car smell in a can, to spray inside detailed used cars.

A Stainless Steel Remstar "M"agic, would weight 20 pounds, then you wouldn't be able to take it on a plane, because of muscle loss from carrying around the old lightweight "M"agic and your new hose would like the stainless steel line used to hook up gas water heaters. Jim

Wulfman · Post by **Wulfman** » Sat Feb 03, 2007 9:41 pm

In the words of our esteemed former Surgeon General Joyceln Elders, "We're all going to die of something, someday."

I'm not going to lose any sleep over THAT report.

Den

SleepGuy · Post by **SleepGuy** » Sat Feb 03, 2007 9:46 pm

The PVC used in plumbing etc. is hard--no plasticizers.

Do a google search--this is a very current issue in medicine. Most of the references in the FDA report date from the mid 1990s to early 2000s. It looks like the EU is being more pro-active about it at this point. Here's another website that's trying to push the industry towards safer alternatives: http://www.noharm.org/details.cfm?type=document&id=591

I don't think people should stay up all night worrying about this but I do think it's worth thinking about trying to do something to encourage manufacturers to make (at a minimum) non PVC tubing (the source for most xpap exposures).

I hope people don't think I'm one of those over-sensitive types to chemicals etc. Most definitely I am not--quite the opposite (hey I'm the slob who never cleans his cpap equipment). But finding this whole PVC thing did really bother me and I thought I'd pass it along.

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JimW · Post by **JimW** » Sat Feb 03, 2007 10:08 pm

A growth of slime mold on the inside of the tubing would likely greatly reduce any exposure hazards.

I'd note that the tubing we use for xpap is different in character from that used in hospitals on ventilators; whether it's still primarily PVC, I couldn't say. Additionally, on p. 87 (or thereabouts) of the first-cited study, they talk about exposure through ventilator tubing; it would appear to be fairly minimal, although perhaps still significant.