title: Phthalates in the NICU: is it safe?
abstract: OBJECTIVE
  As growing concerns exist regarding phthalate exposure, which could be teratogenic, carcinogenic or induce reproductive toxicity, we aimed to review the evidence of the risks due to the use of medical devices containing di(2-ethylhexyl)phthalate in hospitalized neonates.
  
  
  METHODS
  We reviewed the literature, searching through medical literature databases (Pubmed, MEDLINE, EBM reviews, Cochrane database, Embase and Google Scholar) using the following keywords: phthalate, di(2-ethylhexyl)phthalate, newborn and neonate.
  
  
  RESULTS
  We identified several associations with short and long term health dangers, mainly subfertility, broncho-pulmonary dysplasia, necrotising enterocolitis, parenteral nutrition associated cholestasis and neuro-developmental disorders. These data are based mainly on animal or observational human studies.
  
  
  CONCLUSIONS
  Clinicians must be aware of the potential risks due to phthalate exposure in the NICU. Di(2-ethylhexyl)phthalate containing materials should be identified and alternative devices should be considered. There is a need to improve knowledge in this area.
authors.affiliation: Clinic of Neonatology, Department of Paediatrics, University Hospital of Lausanne.
authors.forename: Céline J
authors.initials: CJ
authors.lastname: Fischer
authors.forename: Myriam
authors.initials: M
authors.lastname: Bickle Graz
authors.forename: Vincent
authors.initials: V
authors.lastname: Muehlethaler
authors.forename: David
authors.initials: D
authors.lastname: Palmero
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Tolsa
mesh_terms: D000818:Animals; D004051:Diethylhexyl Phthalate / Q000633:toxicity*; D004781:Environmental Exposure / Q000009:adverse effects*; D004784:Environmental Monitoring; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D010968:Plasticizers / Q000633:toxicity*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced
chemical_list: D010968:Plasticizers; D004051:Diethylhexyl Phthalate
keywords: di(2-ethylhexyl)phthalate (DEHP); environmental exposure; neonatal intensive care unit (NICU); newborn; phthalates; plasticiser; subfertility