title: Urinary di-(2-ethylhexyl)phthalate metabolites in athletes as screening measure for illicit blood doping: a comparison study with patients receiving blood transfusion.
abstract: BACKGROUND
  Subjects submitted to intravenous (IV) blood transfusions for medical reasons or blood doping to increase athletic performance are potentially exposed to the plasticizer di-(2-ethylhexyl)phthalate (DEHP) found in IV bags. Exposure to DEHP has been evaluated by measuring DEHP metabolites in selected groups of subjects.
  
  
  METHODS
  Urinary DEHP metabolites, mono-(2-ethylhexyl)phthalate, mono-(2-ethyl-5-hydroxyhexyl)phthalate (MEHHP), and mono-(2-ethyl-5-oxohexyl)phthalate (MEOHP) were measured in a control group with no explicit known exposure to DEHP (n = 30), hospitalized patients receiving blood transfusions (n = 25), nontransfused hospitalized patients receiving other medical care involving plastic materials (n = 39), and athletes (n = 127). Patients were tested in the periods 0 to 24 and 24 to 48 hours after exposition.
  
  
  RESULTS
  Urinary concentrations of all three DEHP metabolites were significantly higher in patients receiving blood transfusion than in nontransfused patients and the control group, except for MEHHP and MEOHP in the period 24 to 48 hours. Samples from four athletes showed increased concentrations of DEHP metabolites comparable to urinary concentrations of patients receiving blood transfusion.
  
  
  CONCLUSIONS
  Elevated concentrations of urinary DEHP metabolites represent increased exposure to DEHP. High concentrations of DEHP metabolites present in urine collected from athletes may suggest illegal blood transfusion and can be used as a qualitative screening measure for blood doping.
authors.affiliation: Bioanalysis Research Group, IMIM-Hospital del Mar, Barcelona, Spain.
authors.forename: Núria
authors.initials: N
authors.lastname: Monfort
authors.forename: Rosa
authors.initials: R
authors.lastname: Ventura
authors.forename: Ana
authors.initials: A
authors.lastname: Latorre
authors.forename: Viviana
authors.initials: V
authors.lastname: Belalcazar
authors.forename: Mercè
authors.initials: M
authors.lastname: López
authors.forename: Jordi
authors.initials: J
authors.lastname: Segura
mesh_terms: D000328:Adult; D000368:Aged; D056352:Athletes; D015415:Biomarkers / Q000652:urine*; D001803:Blood Transfusion; D004051:Diethylhexyl Phthalate / Q000031:analogs & derivatives* / Q000652:urine; D004300:Doping in Sports; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010795:Phthalic Acids / Q000652:urine*
chemical_list: D015415:Biomarkers; D010795:Phthalic Acids; C479069:mono(2-ethyl-5-hydroxyhexyl) phthalate; C080276:mono(2-ethyl-5-oxohexyl)phthalate; D004051:Diethylhexyl Phthalate; C016599:mono-(2-ethylhexyl)phthalate