title: Potential sources of bisphenol A in the neonatal intensive care unit.
abstract: OBJECTIVE
  To determine whether nutritional intake and medical devices are bisphenol A (BPA) exposure sources among premature infants in the NICU.
  
  
  METHODS
  Mothers and their premature infants cared for in the NICU for the past 3 days were recruited for this exposure assessment study. Forty-three mothers contributed 1 nutrition sample (breast milk or formula) to characterize the infant's intake. Two urine samples (before and after feeding) were collected from each of 55 infants. Medical device use was categorized as "low" or "high" based on the number and invasiveness of devices used. BPA urinary concentrations used as a biomarker to estimate BPA exposure were measured by online solid-phase extraction, high performance liquid chromatography, isotope dilution, tandem mass spectrometry. Nonparametric equivalence tests, intraclass correlations, and hierarchical linear mixed-effects models were conducted.
  
  
  RESULTS
  Breast milk and formula samples did not differ in total BPA concentration nor did infants' median urinary concentration of total BPA before or after feedings. However, the median urinary total BPA concentration among infants who required the use of 4 or more medical devices in the past 3 days was significantly higher (36.6 µg/L) than among infants who required the use of 0 to 3 devices (13.9 µg/L). The calculated BPA exposures are lower than the US Environmental Protection Agency reference dose, but considerably higher (16- to 32-fold) than among infants or children from the general population.
  
  
  CONCLUSIONS
  The number of medical devices used in the past 3 days, but not nutritional intake, was positively associated with exposure to BPA.
authors: Department of Nursing, Simmons College, School of Nursing and Health Sciences, Boston, MA 02115, USA. susan.duty@simmons.edu
authors: Susan M
authors: SM
authors: Duty
authors: Kaitlin
authors: K
authors: Mendonca
authors: Russ
authors: R
authors: Hauser
authors: Antonia M
authors: AM
authors: Calafat
authors: Xiaoyun
authors: X
authors: Ye
authors: John D
authors: JD
authors: Meeker
authors: Robin
authors: R
authors: Ackerman
authors: Judi
authors: J
authors: Cullinane
authors: Josephine
authors: J
authors: Faller
authors: Steven
authors: S
authors: Ringer
mesh_terms: D000328:Adult; D001559:Benzhydryl Compounds / Q000652:urine*; D001942:Breast Feeding; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis* / Q000592:standards; D004864:Equipment and Supplies / Q000009:adverse effects / Q000592:standards*; D005260:Female; D006801:Humans; D041943:Infant Formula / Q000737:chemistry*; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000592:standards*; D008297:Male; D010636:Phenols / Q000652:urine*; D000098826:Bisphenol A Compounds
chemical_list: D001559:Benzhydryl Compounds; D010636:Phenols; C006780:bisphenol A; D000098826:Bisphenol A Compounds