plastics in humidifier and tubing

I've posted on this topic a few times--here's a cut-and-paste from one of them:

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 . . .

Okay, I’m extremely disappointed in my search abilities. I have no idea how I missed it before, but here’s a letter from Respironics -- in fact, from exactly the person with whose voice mail I was connected yesterday. It was received by cpap.com and posted online by them months ago: https://www.cpap.com/DisplayArticle/5

When it comes to articles on the Net, from what I've seen, for every one saying it’s nothing to worry about there’s another that says the opposite. This one from a month ago, entitled “It's Not the Answers That Are Biased, It's the Questions,” wins my vote: http://www.washingtonpost.com/wp-dyn/co ... rss_health

Marsha

Goofproof wrote:

Snoredog wrote:FDA Draft Report: No Risk From BPA In Food Containers

Sure glad I didn't toss all my water bottles:

http://tinyurl.com/5gljru

Isn't the FDA the same people that allowed the faulty defibulator leads, to be installed in me? I wish they had installed a plastic water bottle in me, instead. Jim

No NO NO they were the people that allowed tainted dog food to be imported and tainted tomatoes from Florida, no Mexico no they were not tomatoes at all they were peppers yep that is what they were peppers. Now that makes them fully qualified to stick peppers in plastic bottles and check for BPA so you have to believe them.

Snoredog wrote:FDA Draft Report: No Risk From BPA In Food Containers

Sure glad I didn't toss all my water bottles:

http://tinyurl.com/5gljru

The FDA allows all sorts of nasties in products that they then later 'pull'. Correct me if I'm wrong, but don't products have to be approved by the FDA to be on the market in the first place?

Our esteemed FDA does not require personal care products pass FDA requirements. They have no problem with the public slathering on all sorts of chemicals and using probable cancer causing products such as baby shampoos that include 1,4-Dioxan. The sweet sounding product Disney Clean as Can Bee Hair & Body Washhas 8.8 ppm.

There are many more.

RE: plastics discussion. Diane Rehm on NPR today is discussing a new book "Poisoned Profits" by the Shabecoffs, investigative journalists. Her show is available online.....They are discussing toxic chemicals, their effects on children and governments response to same.

Talk about a small world... turns out that the husband of the woman I had contacted in western Pennsylvania is a hosehead. She told me she'd mentioned my email to him, and the BPA thing is a no-brainer for him. He just said, "I can't live without my CPAP." I gave her my opinion and decided to share it here, as well:

I feel the same way as your husband. And from the articles I was reading the other day, it seems that BPA's in a lot of things, including what they mix for tooth fillings. Many of the CPAP masks use that hard plastic, too. In our plastic society, I think it would be impossible to avoid it. The way I look at it, getting sick from BPA is a slim possibility -- becoming damaged (from sleep deprivation and lack of oxygen) or dying from sleep apnea is a strong possibility, so there's no contest.

Marsha

There is a reason they call them Federal Dumb Asses

I just received this notification in my Seventh Generation newsletter. I have a houseful of company right now and no time to research the .gov source. However, I will later if someone else doesn't come up with it first. I always like to go to the source versus news sources.

If they are concerned about toys - perhaps medical equipment won't be far behind!

Seventh Generation artilce:
"They just might be. And believe me when I say that's a sentence I never thought I'd write. Yet even after pinching myself for several minutes to make sure I hadn't slipped into some non-toxicological reverie, the news remained: Congress has agreed to ban three phthalates from children's toys and halt the use of three more pending further study."

http://www.seventhgeneration.com/learn/ ... 13%2C+2008

Small URL of the same link above:
http://tinyurl.com/6xlmen

Snoredog wrote:There is a reason they call them Federal Dumb Asses

Oh! That's good!

BPA is now of grave concern to me. I have used a CPAP for three years, and very clearly the plastic in the mask and the plastic in reservoirs contains BPA. CPAP users are not exposing themselves to so-called safe levels of BPA as found in users of plastic water bottles, etc. We are hyper-exposed with an exposure period of 8 or more hours daily seven days a week, 365 days a year. Hasn't someone, anyone considered this? I have been told recently that I have some degree of insulin resistance. BPA? Who knows, but I will soon visit my Internist for BPA urinalysis. Talk about a class action lawsuit waiting to happen. . . wow. . . I can't believe I have been using something touted as benevolent that may actually be harmful.

jdennie wrote:BPA is now of grave concern to me. I have used a CPAP for three years, and very clearly the plastic in the mask and the plastic in reservoirs contains BPA. CPAP users are not exposing themselves to so-called safe levels of BPA as found in users of plastic water bottles, etc. We are hyper-exposed with an exposure period of 8 or more hours daily seven days a week, 365 days a year. Hasn't someone, anyone considered this? I have been told recently that I have some degree of insulin resistance. BPA? Who knows, but I will soon visit my Internist for BPA urinalysis. Talk about a class action lawsuit waiting to happen. . . wow. . . I can't believe I have been using something touted as benevolent that may actually be harmful.

Jdennie, I think the risk from not using cpap is far higher than any risk from possible bpa in cpap. If there is a problem from BPA for cpap use, I think most of that would come from the heated humidifier if that container contains BPA. This is because the bpa release is much higher when heated. However as you pointed out, breathing this 8 hours a day is much longer, intimate exposure than anything the studies had looked into so far, AFAIK. Again we do no know if breathing bpa is less or more risky than ingesting it, so far all studies looked into ingesting it.

I would be interested in hearing about the bpa level after your test.

Now IF we trust the Goverment is a $64,000 dollar question is it? I would like to believe that this stuff won't hurt me but there sure has been lots of things they claimed were safe years back that now we know it bad for us. But you got to keep on living just the same. My thought is that the mortaily rate is still 100 % so I am not going to spend too much time worrying about it. Got plenty of things wrong already so time will tell if this adds too it. Melinda

Dear feeling_better,

I have considered the idea that not using my CPAP may be more dangerous than intimate exposure to BPA. However, a study published just two days ago in the Journal of the Amercian Medical Association had the stated objective of examining associations between urinary BPA concentrations and adult health status. This study used data from the National Health and Nutrition Survey of 2003-2004. Data in that study came from collected urine samples of 1455 adults. This study concluded that "higher BPA exposure reflected in higher urinary concentrations of BPA may be associated with avoidable morbidity in the community-dwelling adult population." Consequently, I am indeed concerned that using my CPAP could potentially be more harmful than not using it. Unfortunately, (and if you're a CPAP user you will know) after using a CPAP for more than three years I have no idea how I can sleep without it. I can't even take an Sunday afternoon nap without it. I'm very concerned. When I first got my CPAP I was a reasonably healthy and athletic 46 year old man. Since using my CPAP I have been diagnosed with arthritis and insulin resistance and have developed what clearly appears to be metabolic syndrome. Don't get me wrong, I have no conclusive proof yet that these conditions have been caused BPA exposure, but it would be dangerously careless of me not to begin some investigation of the possibility.

Finally, you are right about the humidifier tank. I'm no plastics expert but if I'm right about what I've been reading, the tanks definitely containg BPA. And yes, heating that platic may be releasing horrifyingly high levels of BPA straight into a CPAP users lungs.

Anyway . . . all that to say that I am worried. If you would like to take a look at the JAMA article from September 17, the citation for it is at the end of this post. If you read it, let me know what you think.

Association of Urinary Bisphenol A Concentration With Medical Disorders and Laboratory Abnormalities in Adults
Iain A. Lang; Tamara S. Galloway; Alan Scarlett; William E. Henley; Michael Depledge; Robert B. Wallace; David Melzer
JAMA. 2008;300(11):1303-1310. Published online September 16, 2008 (doi:10.1001/jama.300.11.1303).[/u][/u][/u][/u]

jdennie wrote:Dear feeling_better,
...Don't get me wrong, I have no conclusive proof yet that these conditions have been caused BPA exposure, but it would be dangerously careless of me not to begin some investigation of the possibility.

Finally, you are right about the humidifier tank. I'm no plastics expert but if I'm right about what I've been reading, the tanks definitely containg BPA. And yes, heating that platic may be releasing horrifyingly high levels of BPA straight into a CPAP users lungs.
...
Association of Urinary Bisphenol A Concentration With Medical Disorders and Laboratory Abnormalities in Adults
Iain A. Lang; Tamara S. Galloway; Alan Scarlett; William E. Henley; Michael Depledge; Robert B. Wallace; David Melzer
JAMA. 2008;300(11):1303-1310. Published online September 16, 2008 (doi:10.1001/jama.300.11.1303).[/u][/u][/u][/u]

jdennie, I empathize with your concerns.Thanks for posting the urls to the articles. I was in no sense brushing aside your concerns. In fact I had already been reading many of those articles, and I had also posted a couple of urls to medical studies here in this thread and others:
viewtopic.php?f=1&t=34026&start=0#p289643
viewtopic/t34790/Common-plastics-chemic ... eases.html

It is useful to avoid the lesser evil. From what I have learned, my feeling is (I am not sure about all the types of plastics in cpap, I think the hose would be worth checking into, since many different types are there made by many independents) that in cpap machines bpa may be present only in the hh tank, the other plastics are not that type. So to minimize the potential risk, if you can go without a humidifier, that would be the first step. Again, since heating increases bpa release, if that is present in hh material, use passover humidification (heater turned off), if that would do the job for you; or use the lowest possible heating setting.

I wonder how valid/useful even the urine test you are going to take would be, since bpa is so prevalent in the urine of the wide population by now. Perhaps one day somebody will do a bpa study of cpap users; even if that bpa users had higher level it wont be conclusive it was from cpa use, perhaps they ended up using cpap because of bpa Perhaps there would be a study of pre and post cpap users I had written to the leading researcher in the bpa toxicity area to see if there was any indication that breathing bpa had similar bad effects as from ingesting it; but I do not expect to get a reply soon since he would be inundated with enquirers these days.

jdennie wrote:Dear feeling_better,

I have considered the idea that not using my CPAP may be more dangerous than intimate exposure to BPA. However, a study published just two days ago in the Journal of the Amercian Medical Association had the stated objective of examining associations between urinary BPA concentrations and adult health status. This study used data from the National Health and Nutrition Survey of 2003-2004. Data in that study came from collected urine samples of 1455 adults. This study concluded that "higher BPA exposure reflected in higher urinary concentrations of BPA may be associated with avoidable morbidity in the community-dwelling adult population." Consequently, I am indeed concerned that using my CPAP could potentially be more harmful than not using it. Unfortunately, (and if you're a CPAP user you will know) after using a CPAP for more than three years I have no idea how I can sleep without it. I can't even take an Sunday afternoon nap without it. I'm very concerned. When I first got my CPAP I was a reasonably healthy and athletic 46 year old man. Since using my CPAP I have been diagnosed with arthritis and insulin resistance and have developed what clearly appears to be metabolic syndrome. Don't get me wrong, I have no conclusive proof yet that these conditions have been caused BPA exposure, but it would be dangerously careless of me not to begin some investigation of the possibility.

Finally, you are right about the humidifier tank. I'm no plastics expert but if I'm right about what I've been reading, the tanks definitely containg BPA. And yes, heating that platic may be releasing horrifyingly high levels of BPA straight into a CPAP users lungs.

Anyway . . . all that to say that I am worried. If you would like to take a look at the JAMA article from September 17, the citation for it is at the end of this post. If you read it, let me know what you think.

Association of Urinary Bisphenol A Concentration With Medical Disorders and Laboratory Abnormalities in Adults
Iain A. Lang; Tamara S. Galloway; Alan Scarlett; William E. Henley; Michael Depledge; Robert B. Wallace; David Melzer
JAMA. 2008;300(11):1303-1310. Published online September 16, 2008 (doi:10.1001/jama.300.11.1303).[/u][/u][/u][/u]

Sleep apnea can lead to the insulin resistance due to the lack of oxygen when you sleep......screws up your metabolism. Chances are, you had these symptoms building before you started on CPAP therapy......I did too. I'm working on undoing the effects through good therapy. I don't use "heated" humidity and I'm not a bit concerned about this stuff containing BPA.

I think this is much ado about nothing......with regard the the equipment used in this therapy. Those studies cited are over 5 years old and there's no telling where the BPA came from in those folks that they sampled or how it came to be in their systems.

Den